基于被试间相关性探究针刺治疗丘脑卒中后麻木患者的群体脑效应  

Exploration on the Collective Brain Responses of Acupuncture Treatment for Thalamic Stroke Patients with Numbness Based on Inter-subject Correlation

作　　者：钱勋琦 陈星[1] 贾卫华[1] 马燕红[1] 宋蕾 吕秋艺 彭景 单之彧 张华[1] QIAN Xunqi;CHEN Xing;JIA Weihua;MA Yanhong;SONG Lei;LYU Qiuyi;PENG Jing;SHAN Zhiyu;ZHANG Hua(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院,北京100700

出　　处：《中国中医药信息杂志》2024年第7期148-155,共8页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家自然科学基金(81904285)。

摘　　要：目的探究针刺对脑卒中后肢体麻木患者的疗效及群体脑效应。方法招募24例脑卒中后肢体麻木患者(患者组)及年龄、性别匹配的健康受试者(对照组)23名,对2组受试者进行每周3次、持续4周的形神共调针刺治疗,观察针刺前后麻木VAS量表评分变化。对2组受试者进行功能核磁共振扫描,并在扫描时进行针刺干预,分别采集静息态、针刺任务态和留针态3种状态下的血氧依赖水平数据,运用fMRIPrep、BrainIAK等软件进行数据处理,计算被试间相关性(ISC),分别比较不同条件下2组受试者各脑区的ISC值。结果针刺治疗显著降低麻木VAS量表评分。静息状态下,2组受试者ISC值均未出现显著变化。针刺条件下,患者组左侧中央前回、左侧中央旁小叶、左侧中央后回、左侧岛叶、左侧前扣带回、右侧额中回、右侧前扣带回脑区ISC值显著升高。留针条件下,对照组两侧中央前回部分脑区出现轻微负激活。患者组针刺态较静息态左侧额上回、左侧中央前回、左侧中央旁小叶、左侧楔前叶、左侧中央后回、左侧岛叶、左侧前扣带回、左侧丘脑、右侧额上回、右侧额中回、右侧中央前回、右侧前扣带回ISC值显著升高。结论针刺能改善卒中后肢体麻木症状,并能在患者中引起一种特异性的群体激活模式,该模式涉及中央前回、中央后回、丘脑、岛叶、前额叶、扣带回等区域。针刺可能通过激活感觉运动网络和皮质-丘脑-皮质环路增强对感觉信息的处理能力,同时调节中央执行网络和下行疼痛控制通路促进疼痛症状的缓解。Objective To investigate the efficacy and the collective brain responses of acupuncture for post-stroke limb numbness.Methods A total of 24 patients with post-stroke limb numbness and 23 matched healthy participants were recruited.Both groups received coordinated acupuncture treatment to regulate their physical and mental state,three times a week for 4 weeks.Changes in limb numbness assessed by the visual analog scale(VAS)were observed before and after acupuncture.Functional magnetic resonance imaging(fMRI)scans were conducted on the participants during the scanning process with acupuncture intervention.Blood oxygen level-dependent(BOLD)data were collected in three states:resting state,acupuncture task state,and needle retention state.Data processing was performed using software such as fMRIPrep and brainIAK.Intersubject correlation(ISC)analysis was conducted to compare the ISC values of different brain regions between the two groups under different conditions.Results Acupuncture treatment significantly reduced the VAS scores of limb numbness.No significant changes in ISC values in both groups during resting state.Under acupuncture conditions,the patient group exhibited significantly increased ISC values in the left precentral gyrus,left paracentral lobule,left postcentral gyrus,left insula,left anterior cingulate gyrus,right middle frontal gyruss and right anterior cingulate gyrus.Under the needle retention condition,a slight negative activation was observed in the bilateral precentral gyrus of the control group.In the patient group,the ISC values of the left superior frontal gyrus,left precentral gyrus,left paracentral lobule,left precuneus,left postcentral gyrus,left insula,left anterior cingulate gyrus,left thalamus,right superior frontal gyrus,right middle frontal gyrus,right precentral gyrus,and right anterior cingulate gyrus showed a significant increase compared to the resting state.Conclusion Acupuncture can improve post-stroke limb numbness symptoms and induce a specific pattern of collective brain acti

关 键 词：针刺 丘脑卒中 肢体麻木 功能核磁共振 被试间相关性 群体脑效应 

分 类 号：R277.733[医药卫生—中医学]