Nierhaus Till, Chang Yinghui, Liu Bin, Shi Xuemin, Yi Ming, Witt Claudia M, Pach Daniel
Neurocomputation and Neuroimaging Unit, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany.
Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
Front Neurosci. 2019 Mar 11;13:147. doi: 10.3389/fnins.2019.00147. eCollection 2019.
Xingnao Kaiqiao (XNKQ) acupuncture is an acupuncture technique used for stroke patients. In 24 healthy volunteers, we applied this complex acupuncture intervention, which consists of a manual needle-stimulation on five acupuncture points (DU26 unilaterally, PC6, and SP6 bilaterally). XNKQ was compared to three control conditions: (1) insertion of needles on the XNKQ acupuncture points without stimulation, (2) manual needle-stimulation on five nearby non-acupuncture points, and (3) insertion of needles on the non-acupuncture points without stimulation. In a within-subject design, we investigated functional connectivity changes in resting-state functional magnetic resonance imaging (fMRI) by means of the data-driven eigenvector centrality (EC) approach. With a 2 × 2 factorial within-subjects design with two-factor stimulation (stimulation vs. non-stimulation) and location (acupuncture points vs. non-acupuncture points), we found decreased EC in the precuneus after needle-stimulation (stimulation<non-stimulation), whereas the factor location showed no statistically significant EC differences. XNKQ acupuncture compared with needle-stimulation on non-acupuncture points showed decreased EC primarily in subcortical structures such as the caudate nucleus, subthalamic nucleus, and red nucleus. seed-based analysis revealed that the decrease in EC was mainly driven by reduced temporal correlation to primary sensorimotor cortices. The comparison of XNKQ acupuncture with the other two (non-stimulation) interventions showed no significant differences in EC. Our findings support the importance of the stimulation component of the acupuncture intervention and hint toward the modulation of functional connectivity by XNKQ acupuncture, especially in areas involved in motor function. As a next step, similar mechanisms should be validated in stroke patients suffering from motor deficits. NCT02453906.
醒脑开窍针刺法是一种用于中风患者的针刺技术。在24名健康志愿者中,我们应用了这种复杂的针刺干预,它包括对五个穴位(单侧督脉26穴、双侧内关穴和三阴交穴)进行手动针刺刺激。将醒脑开窍针刺法与三种对照情况进行比较:(1)在醒脑开窍针刺穴位上插入针但不进行刺激;(2)对五个附近的非穴位进行手动针刺刺激;(3)在非穴位上插入针但不进行刺激。在一项被试内设计中,我们通过数据驱动的特征向量中心性(EC)方法研究静息态功能磁共振成像(fMRI)中的功能连接变化。采用2×2被试内析因设计,有两个因素,即刺激(刺激与不刺激)和位置(穴位与非穴位),我们发现针刺刺激后楔前叶的EC降低(刺激<不刺激),而位置因素在EC上没有统计学上的显著差异。与在非穴位上进行针刺刺激相比,醒脑开窍针刺法主要在尾状核、丘脑底核和红核等皮质下结构中显示出EC降低。基于种子点的分析表明,EC的降低主要是由与初级感觉运动皮层的时间相关性降低所驱动。醒脑开窍针刺法与其他两种(非刺激)干预的比较在EC上没有显著差异。我们的研究结果支持了针刺干预中刺激成分的重要性,并提示醒脑开窍针刺法对功能连接的调节作用,特别是在涉及运动功能的区域。下一步,应在患有运动功能障碍的中风患者中验证类似的机制。 临床试验注册号:NCT02453906。