基于功能性近红外技术观察电针对脑卒中后上肢运动功能障碍患者脑功能连接网络的影响  

The effects of electroacupuncture on brain functional connectivity networks in patients with upper limb motor dysfunction after stroke based on functional near-infrared spectroscopy

作　　者：宁雅丹 舒象忠 罗敷 贾飞阳 黄夏荣 王亚琳 屈萌艰 刘红雅 周君 彭婷 NING Yadan;SHU Xiangzhong;LUO Fu;JIA Feiyang;HUANG Xiarong;WANG Yalin;QU Mengjian;LIU Hongya;ZHOU Jun;PENG Ting

机构地区：[1]南华大学衡阳医学院,湖南衡阳421001 [2]南华大学附属第一医院,湖南衡阳421000

出　　处：《中医临床研究》2024年第33期6-10,共5页Clinical Journal Of Chinese Medicine

基　　金：湖南省自然科学基金青年项目(2023JJ40590);湖南省自然科学基金青年项目(2023JJ40589);南华大学临床医学4310项目(20214310NHYCG07);南华大学校级重点项目(USCKF201902K02)。

摘　　要：目的:以静息态功能性近红外技术(Functional Near-infrared Spectroscopy,fNIRS)观察电针曲池穴、合谷穴对脑卒中后上肢运动功能障碍患者大脑功能活动模式的改变,为探索曲池穴、合谷穴改善脑卒中后功能障碍发挥效应的中枢机制提供影像学依据。方法:选取脑卒中后上肢功能障碍患者12例,其中病灶在左侧脑卒中患者5例,女性3例、男性2例;病灶在右侧脑卒中患者7例,女性2例、男性5例。采集患者休息状态、电针刺激患侧曲池穴和合谷穴过程中的fNIRS静息态数据,以功能连接为观察指标,选择双侧运动区、双侧颞叶、前额作为感兴趣区(Regions of Interest,ROI),观察运动网络功能连接模式的变化。使用NirSpark软件中Modify SD模块对脑卒中组进行左右脑转换,统一转换为左脑模式,采用Levene检验进行方差齐性检验,在NirSpark软件中对不同组间的功能连接比较采用单因素方差分析,进一步使用最小显著性差异法进行多重比较。结果:ROI功能连接强度统计提示,与静息态相比,电针干预时,左侧运动区到颞叶ROI连接增强有上升趋势,差异无统计学意义(P>0.05);其他区域的连接均增强,差异有统计学意义(P<0.05)。结论:电针通过参与大脑皮质功能连接网络的调节使脑卒中后上肢功能障碍患者脑功能连接增强。Objective:Functional near-infrared spectroscopy(fNIRS)was used to observe the changes of brain functional activity pat-terns in patients with upper limb motor dysfunction after stroke by electroacupuncture at Quchi(LI11)and Hegu(LI4)acupoints,so as to provide imaging basis for exploring the central mechanism of Quchi and Hegu acupoints in ameliorating post-stroke dysfunction.Methods:A total of 12 patients with upper limb dysfunction after stroke were selected,including 5 patients with left stroke of 3 females and 2 males,and 7 patients with right stroke of 2 females and 5 males.The resting state data of patients and fNIRS resting state during electroacupunc-ture stimulation of the affected side cranium and synvalley were collected.With functional connectivity as the observation index,bilateral motor area,bilateral temporal lobe and forehead were selected as the ROI to observe the change of the functional connection mode of the motor network.The Modify SD module in NirSpark software was used to convert the left and right brain into the left brain model in the stroke group,the homogeneity of variance was tested by Levene test,and the one-way ANOVA was used for the comparison of functional connections between different groups in Nir-Spark software.The least significant difference method was further used for multiple comparisons.Results:The functional connection strength statistics of ROI showed that compared with the resting state,the ROI connection enhancement from the left motor region to the temporal lobe showed an increasing trend after electroacupuncture intervention,with no statistical significance(P>0.05).The connections in other regions were enhanced,and the difference was statistically significant(P<0.05).Conclusion:Electroacupuncture enhances the cerebral functional connections in patients with upper limb dysfunction after stroke by participating in the regulation of cerebral cortex functional connection network.

关 键 词：电针 脑卒中 上肢功能障碍 功能性近红外光谱技术 静息态 

分 类 号：R255.2[医药卫生—中医内科学]