Peng Jing, Su Jiaming, Song Lei, Lv Qiuyi, Gao Ying, Chang Jingling, Zhang Hua, Zou Yihuai, Chen Xing
Department of Encephalopathy, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, People's Republic of China.
Department of Nephrology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, People's Republic of China.
Neuropsychiatr Dis Treat. 2023 Jan 25;19:233-245. doi: 10.2147/NDT.S391616. eCollection 2023.
Limb numbness is a frequent symptom of post-stroke somatosensory dysfunction, which may be alleviated by non-invasive therapy such as acupuncture. However, the precise mechanism via acupuncture remains unknown. The goal of this study was to investigate how the amplitude of low-frequency fluctuations (ALFF) and functional connectivity (FC) changed between stroke patients with limb numbness and healthy people, as well as how acupuncture might work.
24 stroke sequelae patients with unilateral limb numbness and 14 matched healthy controls were enrolled in the study. The patients with limb numbness received acupuncture therapy three days a week for four weeks. We mainly assessed the clinical outcomes via the visual analogue scale (VAS). In addition, fMRI data from patients with unilateral limb numbness at baseline and after treatment (4th week) were collected, as well as data from healthy controls at baseline.
Compared with the healthy subjects, the patient group demonstrated significantly decreased ALFF in several brain regions, mainly associated with the sensorimotor network (SMN) and default mode network (DMN), including left superior frontal gyrus (SFG), right temporal fusiform cortex (TFC), right middle frontal gyrus (MFG), bilateral middle temporal gyrus (MTG), right putamen (PUT), right precentral gyrus (preCG), right planum polare (PP), and left supplementary motor area (SMA). These regions were chosen as the seeds for investigating the FC alteration induced by acupuncture. Several sensorimotor-related brain regions were activated by acupuncture, and the FC of the left supramarginal gyrus (SMG) with right MTG, as well as brain-stem, cerebellum vermis 9 with right MFG showed enhancement following acupuncture in the patient group, which had a significant correlation with clinical outcomes.
Acupuncture treatment may be used to stimulate brain areas associated with somatosensory processing and to strengthen the FC of sensorimotor and cognitive brain networks in order to achieve therapeutic effect.
肢体麻木是中风后体感功能障碍的常见症状,针刺等非侵入性治疗可能会缓解该症状。然而,针刺的确切机制尚不清楚。本研究的目的是调查肢体麻木的中风患者与健康人之间低频振幅(ALFF)和功能连接(FC)的变化,以及针刺可能的作用机制。
本研究纳入了24例单侧肢体麻木的中风后遗症患者和14例匹配的健康对照者。肢体麻木的患者每周接受三次针刺治疗,共四周。我们主要通过视觉模拟量表(VAS)评估临床疗效。此外,收集了单侧肢体麻木患者在基线和治疗后(第4周)的功能磁共振成像(fMRI)数据,以及健康对照者在基线时的数据。
与健康受试者相比,患者组在几个脑区的ALFF显著降低,主要与感觉运动网络(SMN)和默认模式网络(DMN)相关,包括左侧额上回(SFG)、右侧颞梭状回(TFC)、右侧额中回(MFG)、双侧颞中回(MTG)、右侧壳核(PUT)、右侧中央前回(preCG)、右侧颞极平面(PP)和左侧辅助运动区(SMA)。选择这些区域作为种子来研究针刺引起的FC改变。针刺激活了几个与感觉运动相关的脑区,患者组针刺后左侧缘上回(SMG)与右侧MTG以及脑桥、小脑蚓部9与右侧MFG之间的FC增强,且与临床疗效显著相关。
针刺治疗可用于刺激与体感处理相关的脑区,增强感觉运动和认知脑网络的FC,以达到治疗效果。