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非急性期坐骨神经痛患者接受针刺调节后静息态功能连接的变化：一项初步研究。

Changes in resting-state functional connectivity in nonacute sciatica with acupuncture modulation: A preliminary study.

机构信息

Department of Neurology, Lotung Poh-Ai Hospital, Ilan, Taiwan.

Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.

出版信息

Brain Behav. 2020 Feb;10(2):e01494. doi: 10.1002/brb3.1494. Epub 2020 Jan 10.

DOI:10.1002/brb3.1494
PMID:31922698
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7010574/
Abstract

AIMS

To investigate the functional connectivity (FC) in nonacute sciatica and the neuronal correlation of acupuncture analgesia.

METHODS

A prospective study employing resting-state functional magnetic resonance imaging was conducted. Twelve sciatica patients were enrolled to receive six or 18 acupoints of acupuncture treatment twice a week for 4 weeks. Regional homogeneity (ReHo) and seed-based FC were performed.

RESULTS

Regional homogeneity analysis demonstrated a greater alteration in the right posterior cingulate cortex (PCC) during the pre-acupuncture phase than during the postacupuncture phase. Compared to that of healthy controls, the PCC-seeded FC (default mode network, DMN) of sciatica patients exhibited hyperconnectivity of PCC-FC with the PCC-bilateral insula, cerebellum, inferior parietal lobule, right medial prefrontal cortex, and dorsal anterior cingulate cortex during the pre-acupuncture phase as well as hypoconnectivity of PCC-FC with the right cerebellum, left precuneus, and left dorsal medial prefrontal cortex during the postacupuncture phase. Correlation analysis between PCC-seeded FC and behavior measurements revealed a positive association with the duration of sciatica in the right inferior parietal lobule prior to acupuncture treatment.

CONCLUSIONS

Acupuncture in chronic sciatica patients is associated with normalized DMN activity and modulation of descending pain processing. The changes in the subclinical endophenotype of brain FC after acupuncture treatment may provide clues for understanding the mechanism of acupuncture-mediated analgesia in chronic pain.

摘要

目的

探讨非急性期坐骨神经痛的功能连接（FC）和针刺镇痛的神经元相关性。

方法

采用静息态功能磁共振成像进行前瞻性研究。纳入 12 例坐骨神经痛患者，每周接受 2 次 6 或 18 个穴位针刺治疗，共 4 周。进行局部一致性（ReHo）和种子点 FC 分析。

结果

ReHo 分析显示，针刺前阶段右侧后扣带回皮层（PCC）的改变大于针刺后阶段。与健康对照组相比，坐骨神经痛患者的 PCC 种子点 FC（默认模式网络，DMN）在针刺前阶段表现为 PCC-FC 与 PCC-双侧岛叶、小脑、下顶叶、右侧内侧前额叶和背侧前扣带回的过度连接，以及针刺后阶段 PCC-FC 与右侧小脑、左侧楔前叶和左侧背内侧前额叶的连接减少。PCC 种子点 FC 与行为测量之间的相关性分析显示，针刺治疗前右侧下顶叶的 PCC 种子点 FC 与坐骨神经痛的持续时间呈正相关。

结论

针刺慢性坐骨神经痛患者与 DMN 活动的正常化和下行疼痛处理的调节有关。针刺治疗后大脑 FC 的亚临床表型变化可能为理解针刺介导的慢性疼痛镇痛机制提供线索。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/738e/7010574/cb05589d4262/BRB3-10-e01494-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/738e/7010574/419323219120/BRB3-10-e01494-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/738e/7010574/06c1cd49ec47/BRB3-10-e01494-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/738e/7010574/79c41be61106/BRB3-10-e01494-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/738e/7010574/cb05589d4262/BRB3-10-e01494-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/738e/7010574/419323219120/BRB3-10-e01494-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/738e/7010574/06c1cd49ec47/BRB3-10-e01494-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/738e/7010574/79c41be61106/BRB3-10-e01494-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/738e/7010574/cb05589d4262/BRB3-10-e01494-g004.jpg

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