传统中医手法推拿重塑腰椎间盘突出症患者默认模式网络的功能。
Traditional Chinese Manual Therapy (Tuina) reshape the function of default mode network in patients with lumbar disc herniation.
作者信息
Chen Xiao-Min, Wen Ya, Chen Shao, Jin Xin, Liu Chen, Wang Wei, Kong Ning, Ling Dong-Ya, Huang Qin, Chai Jin-Er, Zhao Xiao-Lei, Li Jie, Xu Mao-Sheng, Jiang Zhong, Du Hong-Gen
机构信息
Department of Tuina, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.
Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.
出版信息
Front Neurosci. 2023 Mar 15;17:1125677. doi: 10.3389/fnins.2023.1125677. eCollection 2023.
PURPOSE
Investigating the changes of regional homogeneity (ReHo) values and both static and dynamic functional connectivity (FC) before and after Traditional Chinese Manual Therapy (Tuina) in patients with lumbar disk herniation (LDH) through resting-state functional magnetic resonance imaging (RS-fMRI). Based on this, we observe the effect of Tuina on the above abnormal changes.
METHODS
Patients with LDH ( = 27) and healthy controls (HCs) ( = 28) were recruited. The functional magnetic resonance imaging (fMRI) scanning was performed two times in LDH patients, before Tuina (time point 1, LDH-pre) and after the sixth Tuina (time point 2, LDH-pos). And for one time in HCs which received no intervention. The ReHo values were compared between LDH-pre and HCs. The significant clusters detected by ReHo analysis were selected as seeds to calculate static functional connectivity (sFC). We also applied the sliding-window to perform dynamic functional connectivity (dFC). To evaluate the Tuina effect, the mean ReHo and FC values (both static and dynamic) were extracted from significant clusters and compared between LDH and HCs.
RESULTS
In comparison to HCs, LDH patients displayed decreased ReHo in the left orbital part middle frontal gyrus (LO-MFG). For sFC analysis, no significant difference was found. However, we found decreased dFC variance between LO-MFG and the left Fusiform, and increased dFC variance in the left orbital inferior frontal gyrus and left precuneus. Both ReHo and dFC values revealed after Tuina, the brain activities in LDH patients were similar to HCs.
CONCLUSION
The present study characterized the altered patterns of regional homogeneity in spontaneous brain activity and those of functional connectivity in patients with LDH. Tuina can reshape the function of the default mode network (DMN) in LDH patients, which may contribute to the analgesic effect of Tuina in LDH patients.
目的
通过静息态功能磁共振成像（RS-fMRI）研究腰椎间盘突出症（LDH）患者接受中医推拿治疗前后局部一致性（ReHo）值以及静息和动态功能连接（FC）的变化。在此基础上，观察推拿对上述异常变化的影响。
方法
招募LDH患者（n = 27）和健康对照者（HCs，n = 28）。对LDH患者进行两次功能磁共振成像（fMRI）扫描，分别在推拿前（时间点1，LDH-pre）和第六次推拿后（时间点2，LDH-pos）。HCs未接受干预，仅进行一次扫描。比较LDH-pre和HCs之间的ReHo值。将通过ReHo分析检测到的显著簇作为种子来计算静态功能连接（sFC）。我们还应用滑动窗口来进行动态功能连接（dFC）。为了评估推拿效果，从显著簇中提取平均ReHo和FC值（包括静态和动态），并在LDH患者和HCs之间进行比较。
结果
与HCs相比，LDH患者左侧眶部额中回（LO-MFG）的ReHo降低。对于sFC分析，未发现显著差异。然而，我们发现LO-MFG与左侧梭状回之间的dFC方差降低，左侧眶部下额回和左侧楔前叶的dFC方差增加。推拿后，LDH患者大脑活动的ReHo和dFC值均显示与HCs相似。
结论
本研究描述了LDH患者自发脑活动中局部一致性的改变模式以及功能连接的改变模式。推拿可以重塑LDH患者默认模式网络（DMN）的功能，这可能有助于推拿对LDH患者的镇痛作用。
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