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稳定感觉性卒中患者的针刺得气:与运动恢复的有效大脑网络的关系。

Acupuncture de qi in stable somatosensory stroke patients: relations with effective brain network for motor recovery.

机构信息

The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China.

出版信息

Evid Based Complement Alternat Med. 2013;2013:197238. doi: 10.1155/2013/197238. Epub 2013 Jun 2.

Abstract

Acupuncture has been widely used for treating stroke and De Qi may play an important role. In spite of its acceptance, the neural mechanism underlying acupuncture for motor recovery is still elusive. Particularly, by what extent De Qi sensations can reliably predict the therapeutical acupuncture effect on the mediating recovery from stroke is urgent to investigate. Nine stroke patients were assessed by De Qi, neurological examination, and scanned with acupuncture stimuli across two time points at an interval of two weeks. And we adopted multivariate Granger causality analysis to explore the interregional influences within motor executive brain network during post-acupuncture resting state. Our findings indicated that acupuncture at GB34 can enhance the recovery of stroke mainly by strengthening causal influences between the ipsilesional and contralesional motor cortex. Moreover, centrality of some motor-related regions correlated with clinical variables and thus served as a predictor of stroke recovery. Along the same line, the centrality of these motor-related regions has also high relations with the De Qi sensation. Our findings suggest that De Qi having relatively stable reliability may be essential and used as a predictor to the therapeutic effectiveness of acupuncture for stroke recovery.

摘要

针灸在治疗中风方面得到了广泛的应用,而“得气”可能发挥着重要作用。尽管已被广泛接受,但针灸治疗运动功能恢复的神经机制仍然难以捉摸。特别是,“得气”感觉在多大程度上可以可靠地预测治疗性针灸对中风介导的恢复的影响,这一点亟待研究。本研究纳入了 9 名中风患者,通过“得气”、神经学检查和在 2 周间隔的两个时间点上的针灸刺激进行扫描。并采用多元格兰杰因果分析来探索针刺后静息状态下运动执行脑网络内的区域间影响。研究结果表明,针刺 GB34 可以增强中风的恢复,主要是通过加强同侧和对侧运动皮层之间的因果影响。此外,一些与运动相关的区域的中心度与临床变量相关,因此可以作为中风恢复的预测因子。同样,这些与运动相关的区域的中心度与“得气”感觉也有较高的相关性。研究结果表明,“得气”具有相对稳定的可靠性,可能是针灸治疗中风恢复效果的重要预测因子。

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