即刻耳甲电针刺激对轻度认知障碍脑功能影像的影响初探  

Preliminary exploration of the impact of immediate transcutaneous auricular vagus nerve stimulation on brain function imaging in patients with mild cognitive impairment

作　　者：郭春蕾 马跃 高山山 罗屹 陈庆燕 方继良[1] Chunlei GUO;Yue MA;Shanshan GAO;Yi LUO;Qingyan CHEN;Jiliang FANG(Department of Radiology,Guang'anmen Hospital of China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院放射科,北京100053

出　　处：《阿尔茨海默病及相关病杂志》2024年第2期94-102,81,共10页Chinese Journal of Alzheimer's Disease and Related Disorders

基　　金：北京市自然科学基金面上项目(No.7212191);医疗机构制剂研发与新药转化专项(NO.HLCMHPP2023072)和临床科研一体化人才专项(N0.HLCMHPP2023094)(本项目受中央高水平中医医院临床科研业务费资助)。

摘　　要：目的:基于静息态功能磁共振成像(rs-fMRI)探讨即刻(30分钟)耳甲电针(taVNS)刺激对轻度认知障碍(MCI)患者脑功能的影响。方法:纳入22例MCI患者,随机分为taVNS组和sham taVNS组,每组各11例,同时纳入11例健康对照(HCs)。3组受试者均进行30分钟耳部电针刺激,其中taVNS组和HCs组接受耳甲刺激位于迷走神经主要分布区,sham taVNS组接受的刺激位于非迷走神经分布的耳舟部,在刺激前后各进行一次rs-fMRI扫描。采用DPABI 8.0软件对rs-fMRI扫描结果进行预处理,随后计算功能连接(FC),对3组受试者刺激前后的FC图像进行比较,并将结果提值,用Graphpad Prism9.0.0进行事后分析,观察taVNS对脑功能的影响。结果:与刺激前相比,刺激后taVNS组右侧海马与右侧小脑_6的FC值显著降低(P<0.005)、左侧尾状核与右侧额上回以及右侧苍白球与左侧尾状核的FC值显著升高(P<0.05);刺激后HCs组左侧尾状核与小脑_8的FC值显著降低(P<0.05)。结论:即刻taVNS可以调节记忆及认知脑区,以及基底节区及小脑等脑功能网络,可能是taVNS治疗MCI的效应靶点。Objective:This study investigated the impact of immediate(30 minutes)transcutaneous auricular vagus nerve stimulation(taVNS)on brain function in patients with mild cognitive impairment(MCI)using resting-state functional magnetic resonance imaging(rs-fMRI).Methods:The study included 22 MCI patients randomly divided into a taVNS group and a sham taVNS group,with 11 patients in each,as well as 11 healthy controls(HCs).All three groups of subjects underwent 30 minutes of auricular electrical stimulation,with the taVNS group and HCs group receiving stimulation on the concha,located in the main distribution area of the vagus nerve,while the sham taVNS group received stimulation on the non-vagus nerve distributed helicis.Each subject underwent an rs-fMRI scan before and after the stimulation.For preprocessing of the rs-fMRI scan results,DPABI 8.0 was used,followed by calculation of functional connectivity(FC).Comparison of FC images before and after stimulation in three groups of subjects,with the results being extracted and post-hoc analysis performed using Graphpad Prism 9.0.0 to observe the effects of taVNS on brain function.Results:Compared to pre-stimulation,post-stimulation FC values in the taVNS group showed a significant decrease between the right hippocampus and the right cerebellum_6,and a significant increase between the left caudate nucleus and the right superior frontal gyrus(P<0.005),as well as between the right pallidum and the left caudate(P<0.05).In the HCs group,there was a significant decrease in the FC values between the left caudate and the cerebellum_8 after stimulation(P<0.05).Conclusion:Immediate taVNS can modulate brain functional networks related to memory and cognition,as well as the basal ganglia and cerebellum,which may be the effector targets of taVNS treatment for MCI.

关 键 词：轻度认知障碍 耳甲电针 静息态功能磁共振成像 功能连接 

分 类 号：R445[医药卫生—影像医学与核医学]