Chen Xing, Zhang Hua, Zou Yihuai
Department of Neurology and Stroke Center, Dongzhimen Hospital Affiliated to Beijing University of Chines;e Medicine, Beijing 100700, China.
Brain Res. 2015 Mar 19;1601:64-72. doi: 10.1016/j.brainres.2015.01.011. Epub 2015 Jan 16.
Functional disability of stroke patients, especially limb motor function, seriously impacts the quality of life. Although acupuncture at GB34 (Yang-ling-quan) has been shown to be effective on the recovery of motor function, the underlying mechanism has not been well explored.
To explore the central mechanisms of immediate effect of acupuncture at GB34 on motor-related network of stroke patients with hemiplegia.
A repeated measures ANOVA method was employed to investigate the effect of acupuncture at GB34 on functional connectivity of motor-related network. Six stroke patients with left hemiplegia were recruited. A left hand motor task fMRI experiment was performed before and right after acupuncture. Sham point acupuncture was taken as control. The most significant fMRI signal changes during motor task in the right precentral gyrus were identified, which was selected as a seed point for connectivity analysis. Then the functional connectivity of this seed point was compared between verum and sham point acupuncture.
Compared to sham, acupuncture at GB34 showed positive interaction effect at right temporal pole, left lingual gyrus, and left cerebellum. While negative interaction effect mainly occurred at contralateral motor cortex and ipsilateral motor cortex of lower limb.
Acupuncture at GB34 may increase motor-cognition connectivity meanwhile decrease compensation of unaffected motor cortex and homolateral synkinesis, which can definitely promote the rehabilitation of hemiplegia and spasm.
中风患者的功能残疾，尤其是肢体运动功能，严重影响生活质量。尽管针刺阳陵泉（GB34）已被证明对运动功能恢复有效，但其潜在机制尚未得到充分探索。
探讨针刺阳陵泉（GB34）对偏瘫中风患者运动相关网络即时效应的中枢机制。
采用重复测量方差分析方法研究针刺阳陵泉（GB34）对运动相关网络功能连接的影响。招募6例左侧偏瘫的中风患者。在针刺前后分别进行左手运动任务功能磁共振成像（fMRI）实验。以假穴针刺作为对照。识别出右侧中央前回运动任务期间最显著的fMRI信号变化，将其作为连接性分析的种子点。然后比较真穴针刺和假穴针刺之间该种子点的功能连接性。
与假穴针刺相比，针刺阳陵泉（GB34）在右侧颞极、左侧舌回和左侧小脑显示出正性交互作用效应。而负性交互作用效应主要发生在对侧运动皮层和下肢同侧运动皮层。
针刺阳陵泉（GB34）可能增加运动-认知连接性，同时减少未受影响运动皮层的代偿和同侧联带运动，这肯定能促进偏瘫和痉挛的康复。
