卒中后基底节失语症患者针刺联合语言康复训练前后静息态脑功能网络连通性变化分析  

Analysis of changes in connectivity of resting brain functional network before and after acupuncture combined with language rehabilitation training in patients with basal ganglia aphasia after stroke

作　　者：吕天丽 马佳骏 刘璐[1] 付明阳 谭中建[4] 常静玲[4] 孙敬青[1] Lyu Tianli;Ma Jiajun;Liu Lu;Fu Mingyang;Tan Zhongjian;Chang Jingling;Sun Jingqing(Department of Acupuncture and Moxibustion,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing Key Laboratory of Acupuncture Neuromodulation,Beijing 100010,China;Department of Clinical Medical School,Beijing University of Chinese Medicine,Beijing 100105,China;School of Electronic and Information Engineering,Bejing Jiaotong University,Beijing 100091,China;Department of Neurology,Dong Zhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]首都医科大学附属北京中医医院针灸中心,针灸神经调控北京市重点实验室,北京100010 [2]北京中医药大学临床医学院,北京100105 [3]北京交通大学电子信息工程学院,北京100091 [4]北京中医药大学东直门医院脑病科,北京100700

出　　处：《中国医师杂志》2023年第9期1313-1318,共6页Journal of Chinese Physician

基　　金：国家自然科学基金(82004435)。

摘　　要：目的采用基于独立成分分析(ICA)的静息态脑功能网络连通性(FNC)方法,分析卒中后基底节失语症(BGA)患者的FNC变化特征,探讨其发生及针刺联合语言康复训练干预下的恢复机制。方法采用前瞻性观察性研究方法,纳入2021年7月至2022年12月于首都医科大学附属北京中医医院就诊的右利手BGA患者16例,以及年龄、性别、教育程度、利手相匹配的健康被试者14例,采集健康被试者及干预前后BGA患者的静息态功能磁共振、人口学信息以及《西部失语症检查》资料,应用基于MATLAB平台的GIFT工具箱进行ICA及静息态脑网络FNC分析,横向对比BGA患者与健康被试者FNC差异,纵向比较干预前后BGA患者FNC变化。结果与健康被试者相比,卒中后BGA患者干预前表现为基底节网络与默认网络、视觉网络的连通性减弱,而听觉网络和右侧额顶网络、楔前叶网络的连通性增强;针刺联合语言康复训练干预后表现为基底节网络与视觉网络、楔前叶网络的连通性减弱,前凸显网络与双侧额顶网络的连通性减弱,而默认网络和听觉网络、右侧额顶网络、视觉网络的连通性增强。BGA患者组内干预前后表现为基底节网络与左侧额顶网络连通性增强。结论基底节网络与其他脑网络间的FNC变化是反映BGA发生与语言功能恢复机制的关键,针刺联合语言康复训练可能通过增强基底节网络与左侧额顶网络的连通性来改善语言功能,而注意力资源的重新分配可能也是促进BGA患者语言功能恢复的原因之一。Objective To use the resting state functional network connectivity(FNC)method based on independent component analysis(ICA)to analyze the characteristics of FNC changes in patients with basal ganglia aphasia(BGA)after stroke,and to explore its occurrence and recovery mechanism under the intervention of acupuncture combined with language rehabilitation training.Methods Using a prospective observational research method,16 right-handed BGA patients who were treated at Beijing Hospital of Traditional Chinese Medicine,Capital Medical University from July 2021 to December 2022,as well as 14 healthy subjects matched in age,gender,education level,and handedness,were included.The resting state functional magnetic resonance imaging,demographic information,and Western Aphasia Examination data of healthy subjects and BGA patients before and after intervention were collected.The GIFT toolbox based on MATLAB platform was applied for ICA and resting state brain network FNC analysis.The FNC differences between BGA patients and healthy subjects were compared horizontally,and the FNC changes in BGA patients before and after intervention were compared vertically.Results Compared with healthy subjects,post-stroke BGA patients showed decreased connectivity between the basal ganglia network,default network,and visual network before intervention,while increased connectivity between the auditory network,right frontoparietal network,and anterior cuneiform network;After the intervention of acupuncture combined with language rehabilitation training,the connectivity between the basal ganglia network,visual network,and anterior cuneiform network decreased,while the connectivity between the anterior convex network and bilateral frontoparietal network decreased,while the connectivity between the default network,auditory network,right frontoparietal network,and visual network increased.The BGA patient group showed enhanced connectivity between the basal ganglia network and the left frontoparietal network before and after intervention.Conclusions

关 键 词：针刺疗法 言语和语言障碍康复 基底节失语 功能网络连通性 磁共振成像 

分 类 号：R743.3[医药卫生—神经病学与精神病学]