Wu Ping, Zhou Yu-Mei, Liao Chen-Xi, Tang Yu-Zhi, Li Yong-Xin, Qiu Li-Hua, Qin Wei, Zeng Fang, Liang Fan-Rong
Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China.
Institute of Clinical Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong Province, China.
Evid Based Complement Alternat Med. 2018 May 23;2018:5179689. doi: 10.1155/2018/5179689. eCollection 2018.
The aim of this study was to observe the grey matter (GM) tissue changes of ischemic stroke patients, to explore the therapy responses and possible mechanism of acupuncture. 21 stroke patients were randomly assigned to receive either acupuncture plus conventional (Group A) or only conventional (Group B) treatments for 4 weeks. All patients in both groups accepted resting-state functional magnetic resonance (fMRI) scan before and after treatment, and the voxel-based morphometry (VBM) analysis was performed to detect the cerebral grey structure changes. The modified Barthel index (MBI) was used to evaluate the therapeutic effect. Compared with the patients in Group B, the patients in Group A exhibited a more significant enhancement of the changes degree of MBI from pre- to post-treatment intervention. VBM analyses found that after treatment the patients in Group A showed extensive changes in GMV. In Group A, the left frontal lobe, precentral gyrus, superior parietal gyrus, anterior cingulate cortex, and middle temporal gyrus significantly increased, and the right frontal gyrus, inferior parietal gyrus, and middle cingulate cortex decreased ( < 0.05, corrected). In addition, left anterior cingulate cortex and left middle temporal gyrus are positively related to the increase in MBI score ( < 0.05, corrected). In Group B, right precentral gyrus and right inferior frontal gyrus increased ( < 0.05, corrected). In conclusion, acupuncture can evoke pronounced structural reorganization in the frontal areas and the network of DMN areas, which may be the potential therapy target and the potential mechanism where acupuncture improved the motor and cognition recovery.
本研究旨在观察缺血性中风患者的灰质（GM）组织变化，探讨针刺治疗的反应及可能机制。将21例中风患者随机分为针刺加常规治疗组（A组）和单纯常规治疗组（B组），治疗4周。两组患者均在治疗前后接受静息态功能磁共振成像（fMRI）扫描，并采用基于体素的形态学测量（VBM）分析检测脑灰质结构变化。采用改良Barthel指数（MBI）评估治疗效果。与B组患者相比，A组患者治疗前后MBI变化程度的增强更为显著。VBM分析发现，治疗后A组患者的灰质体积（GMV）出现广泛变化。在A组中，左侧额叶、中央前回、顶上叶、前扣带回皮质和颞中回显著增加，右侧额回、顶下叶和扣带中央回减少（校正后P<0.05）。此外，左侧前扣带回皮质和左侧颞中回与MBI评分增加呈正相关（校正后P<0.05）。在B组中，右侧中央前回和右侧额下回增加（校正后P<0.05）。综上所述，针刺可引起额叶区域和默认模式网络（DMN）区域网络的明显结构重组，这可能是针刺改善运动和认知恢复的潜在治疗靶点和潜在机制。
