太极拳训练对2型糖尿病合并轻度认知功能障碍患者脑网络拓扑结构的影响  

Effects of Tai Chi on the topologies of brain network in patients with type 2 diabetes and mild cognitive impairment

作　　者：阮懿泽 黄力 张宇思 陈焰南[2] 秦佳维 黄佳[1] 柳维林[2] 刘志臻[2] 梁胜祥 陶静[1,2] RUAN Yize;HUANG Li;ZHANG Yusi(Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian,350122)

机构地区：[1]福建中医药大学康复医学院,福建省福州市350122 [2]福建中医药大学康复产业研究院

出　　处：《中国康复医学杂志》2024年第12期1775-1782,共8页Chinese Journal of Rehabilitation Medicine

基　　金：国家科技部“十三五”重点研发计划项目(2019YFC1710301)。

摘　　要：目的:研究旨在探讨太极拳训练对2型糖尿病(type 2 diabetes mellitus,T2DM)合并轻度认知功能障碍(mild cognitive impairment,MCI)患者脑网络拓扑结构的影响。方法:招募T2DM合并MCI的患者,随机分为太极拳训练组(n=33)、健步走组(n=31)和健康教育组(n=35),在基线和干预24周,使用MoCA评估整体认知功能,采用磁共振成像技术和图论方法分析特征路径长度、介数中心性和节点效率,评估脑网络拓扑结构。结果:24周后,太极拳训练组的MoCA评分与健康教育组相比有显著提高(P=0.016),但与健步走组相比差异不显著;特征路径长度在三组之间无显著变化;太极拳训练组的介数中心性在右侧中央前回、右侧颞中回(颞枕部)、左侧角回区域较健康教育组显著增加,且太极拳训练组的介数中心性在双侧颞中回(颞枕部)的高于健步走组;太极拳训练组的节点效率在右侧缘上回(后部)节点效率较健康对照组显著增加;相关分析显示干预前后,太极拳训练组左侧颞中回的介数中心性与MoCA得分变化呈显著正相关(r=0.642,P<0.001),右侧缘上回的节点效率与MoCA得分变化也呈正相关(r=0.372,P=0.033)。结论:本研究初步揭示了太极拳训练可能通过调节左侧颞中回、右侧缘上回等脑区的脑网络局部拓扑属性,改善了T2DM合并MCI患者的认知功能。Objective:To investigate the impact of Tai Chi on brain network topology in patients with type 2 diabetes mellitus(T2DM)and mild cognitive impairment(MCI).Method:Patients with T2DM and MCI were recruited and randomly assigned to three groups:Tai Chi group(n=33),fitness walking group(n=31),and health education control group(n=35).Cognitive function was assessed using the Montreal Cognitive Assessment(MoCA)at baseline and after 24 weeks of intervention.Magnetic resonance imaging(MRI)and graph theory methods were used to analyze characteristic path length,betweenness centrality,and nodal efficiency to evaluate brain network topology.Result:After 24 weeks,the MoCA score of the Tai Chi group significantly improved compared to the control group(P=0.016),but there was no significant difference compared to the fitness walking group.No significant changes in characteristic path length were observed among the three groups.Compared to the control group,the betweenness centrality in the Tai Chi group significantly increased in the right precentral gyrus,right middle temporal gyrus(temporoccipital part),and left angular gyrus.Additionally,the betweenness centrality in the bilateral middle temporal gyri(temporoccipital part)was higher in the Tai Chi group than in the fitness walking group.Nodal efficiency in the right supramarginal gyrus(posterior part)significantly increased in the Tai Chi group compared to the control group.Correlation analysis showed that the change in betweenness centrality of the left middle temporal gyrus in the Tai Chi group was positively correlated with the change in MoCA score(r=0.642,P<0.001),and the nodal efficiency of the right supramarginal gyrus was also positively correlated with the change in MoCA score(r=0.372,P=0.033).Conclusion:This study preliminarily reveals that Tai Chi may improve cognitive function in patients with T2DM and MCI by modulating the local topological properties of brain networks,particularly in the left middle temporal gyrus and right supramarginal gyrus.

关 键 词：太极拳 2型糖尿病 轻度认知功能障碍 脑网络 拓扑 静息态功能磁共振 

分 类 号：R493[医药卫生—康复医学] R587.1[医药卫生—临床医学]