针刺风池对后循环缺血性单发性眩晕患者即时效应的静息态功能MRI研究  

The immediate brain effect of acupuncture at Fengchi in patients with posterior circulation ischemia vertigo:a resting-state functional MRI study

作　　者：袁小佳 徐彧 王伟涛 钟利群[2] 李小圳 许聃 佘文龙 陈正光[1] YUAN Xiaojia;XU Yu;WANG Weitao;ZHONG Liqun;LI Xiaozhen;XU Dan;SHE Wenlong;CHEN Zhengguang(Department of Radiology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 107000,China;Department of Encephalopathy,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 107000,China)

机构地区：[1]北京中医药大学东直门医院放射科,北京107000 [2]北京中医药大学东直门医院脑病科,北京107000

出　　处：《实用放射学杂志》2024年第2期186-189,共4页Journal of Practical Radiology

摘　　要：目的利用静息态功能磁共振成像(rs-fMRI)技术低频振幅(ALFF)和功能连接的方法观察针刺风池后循环缺血性单发性眩晕(PCIV)患者即时脑活动变化。方法纳入PCIV患者20例,采用眩晕残碍程度评定量表(DHI)对患者进行眩晕程度的评估,将患者随机分为针刺组和假针组,针刺前、后行rs-fMRI扫描,基于MATLAB采用DPABI 6.1分析2组患者针刺前、后ALFF变化,提取差异脑区ALFF值与DHI进行相关性分析,并以ALFF差异脑区为种子点进行功能连接分析。结果相较于假针组,针刺组针刺后ALFF值升高的脑区主要在左侧楔前叶、左侧额上回和左侧尾状核,ALFF值减低的脑区主要在左侧小脑和右侧枕下回;左侧额上回ALFF值与DHI评分呈负相关(P=0.04);左侧楔前叶与右侧额中回、右侧额上回功能连接增强,与两侧中央旁小叶和右侧小脑功能连接减弱。结论针刺风池后ALFF和功能连接均发生改变,提示针刺风池可多节点地调节前庭网络、视觉和躯体运动相关脑区功能活动,可能是针刺治疗PCIV的重要脑功能基础。Objective To investigate the immediate brain effect of acupuncture at Fengchi using amplitude of low-frequency fluctuation(ALFF)and functional connectivity by the resting-state functional magnetic resonance imaging(rs-fMRI)in patients with posterior circulation ischemia vertigo(PCIV).Methods Twenty patients with PCIV were enrolled.The dizziness handicap inventory(DHI)was used to evaluate the severity of vertigo.The patients were randomly divided into acupuncture group and sham acupoint acupuncture group.Rs-fMRI scan was performed before and after acupuncture.MATLAB-based DPABI 6.1 software was used to analyze rs-fMRI data.Correlation analysis was used between the altered ALFF values and DHI scores.The regions of altered ALFF were taken as seeds to analyze functional connectivity.Results Compared with the sham acupoint acupuncture group,the increased ALFF values were mainly located on the left precuneus,left superior frontal gyrus and left caudate nucleus after acupuncture in the acupuncture group;the decreased ALFF values were mainly located on the left cerebellum and right inferior occipital gyrus.The ALFF value of the left superior frontal gyrus was negatively correlated with the DHI score(P=0.04).The increased functional connectivity was mainly found between left precuneus and the right middle frontal gyrus,the right superior frontal gyrus,the decreased functional connectivity was mainly found between left precuneus and the bilateral paracentral lobule and right cerebellum.Conclusion The ALFF value and functional connectivity are different before and after acupuncture,indicating that the vestibular network,visual and motor brain regions functional activities are changed after needling at Fengchi,which may be the brain functional basis of Fengchi for vertigo in PCIV.

关 键 词：针刺 后循环缺血性单发性眩晕 低频振幅 功能连接 静息态功能磁共振成像 

分 类 号：R245.31[医药卫生—针灸推拿学] R441.2[医药卫生—中医临床基础] R445.2[医药卫生—中医学]