Department of Traditional Chinese Rehabilitation Medicine, The Second Rehabilitation Hospital of Shanghai, Shanghai, China.
Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China.
Brain Behav. 2023 Sep;13(9):e3174. doi: 10.1002/brb3.3174. Epub 2023 Jul 31.
Tuina is currently one of the popular complementary and alternative methods of rehabilitation therapy. Tuina can improve patients' pain and mobility function. However, the underlying physiological mechanism remains largely unknown, which might limit its further popularization in clinical practice. The aim of this study is to explore the short-term and long-term changes in brain functional activity following Tuina intervention for peripheral nerve injury repair.
A total of 16 rats were equally divided into the intervention group and the control group. Rats in the intervention group received Tuina therapy applying on the gastrocnemius muscle of the right side for 4 months following sciatic nerve transection and immediate repair, while the control group received nerve transection and repair only. The block-design functional magnetic resonance imaging scan was applied in both groups at 1 and 4 months after the surgery. During the scan, both the injured and intact hindpaw was electrically stimulated according to a "boxcar" paradigm.
When stimulating the intact hindpaw, the intervention group exhibited significantly lower activation in the somatosensory area, limbic/paralimbic areas, pain-regulation areas, and basal ganglia compared to the control group, with only the prefrontal area showing higher activation. After 4 months of sciatic nerve injury, the control group exhibited decreased motor cortex activity compared to the activity observed at 1 month, and the intervention group demonstrated stronger bilateral motor cortex activity compared to the control group.
Tuina therapy on the gastrocnemius muscle of rats with sciatic nerve injury can effectively alleviate pain and maintain the motor function of the affected limb. In addition, Tuina therapy reduced the activation level of pain-related brain regions and inhibited the decreased activity of the motor cortex caused by nerve injury, reflecting the impact of peripheral stimulation on brain plasticity.
推拿是目前流行的康复治疗辅助和替代方法之一。推拿可以改善患者的疼痛和活动功能。然而，其潜在的生理机制在很大程度上尚不清楚，这可能限制了其在临床实践中的进一步推广。本研究旨在探讨推拿干预周围神经损伤修复后短期和长期脑功能活动的变化。
将 16 只大鼠等分为干预组和对照组。干预组大鼠在坐骨神经横断后立即修复的右侧腓肠肌上接受推拿治疗 4 个月，而对照组大鼠仅接受神经横断和修复。在手术后 1 个月和 4 个月时，两组均应用块设计功能磁共振成像扫描。在扫描过程中，根据“boxcar”范式分别对受损和未受损的后足进行电刺激。
当刺激未受损的后足时，与对照组相比，干预组的体感区、边缘/边缘区、疼痛调节区和基底节的激活明显较低，仅前额叶区的激活较高。坐骨神经损伤 4 个月后，与 1 个月时的活动相比，对照组运动皮层的活动减少，而干预组表现出比对照组更强的双侧运动皮层活动。
推拿治疗坐骨神经损伤大鼠的腓肠肌可有效缓解疼痛，维持患侧肢体的运动功能。此外，推拿疗法降低了与疼痛相关的大脑区域的激活水平，并抑制了神经损伤引起的运动皮层活动的减少，反映了外周刺激对大脑可塑性的影响。
