Zhou Yihao, Dai Anhong, Feng Sifeng, Zhu Tao, Liu Meifang, Shi Jing, Wang Dongyan
Heilongjiang University of Chinese Medicine, Harbin, China.
The First Affiliated Hospital of Yunnan University of Chinese Medicine, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China.
Front Neurosci. 2024 Jan 5;17:1297149. doi: 10.3389/fnins.2023.1297149. eCollection 2023.
Acupuncture is widely utilized as a beneficial intervention for the treatment of motor dysfunction after stroke, and its effectiveness depends on the stimulation dose. Manipulation time is an important factor affecting the dose. This trial aimed use fMRI to explore the immediate neural effects in stroke patients with motor dysfunction by different acupuncture manipulation times, to reveal the neural mechanism of acupuncture manipulation.
Thirty participants were divided into three groups according to different acupuncture times. Each group received the same acupoint prescription, although the continuous manipulation time of each acupoint in three groups was 1-min, 2-min, and 3-min, respectively. The NIHSS, FMA and fMRI-BOLD in each participant we obtained before and after acupuncture manipulation. Then, we used the regional homogeneity (ReHo) algorithm to analyze the changes of brain function and to compare the neural effects at different acupuncture manipulation times.
There were no significant differences in NIHSS and FMA scores between and within groups. Longitudinal analysis of ReHo values indicated that the right inferior frontal gyrus was activated in the 1-min group, the right insula in the 2-min group, and the right inferior temporal gyrus in the 3-min group. Compared with the 1-min group, the 2-min group showed the ReHo values of the right precentral gyrus was decreased, and the 3-min group showed the left cerebellum posterior lobe was increased, the right posterior cingulate gyrus and the right anterior cingulate gyrus were decreased. Compared with the 2-min group, the 3-min group showed the ReHo values of the right cerebellum anterior lobe was increased.
Our findings suggest that acupuncture at different manipulation times caused different changes of the neural effects in stroke patients, and the volume of activated voxel clusters is positively correlated with the manipulation time. Longer acupuncture manipulation could drive SMN and DMN in stroke patients, which may be the potential neurological mechanism of acupuncture manipulation affecting the recovery of motor dysfunction.
针灸作为治疗中风后运动功能障碍的一种有益干预手段被广泛应用,其疗效取决于刺激剂量。手法操作时间是影响剂量的一个重要因素。本试验旨在利用功能磁共振成像(fMRI)探讨不同针灸手法操作时间对中风后运动功能障碍患者的即时神经效应,以揭示针灸手法的神经机制。
30名参与者根据不同的针灸时间分为三组。每组接受相同的穴位处方,尽管三组中每个穴位的持续手法操作时间分别为1分钟、2分钟和3分钟。我们在针灸手法操作前后获取了每位参与者的美国国立卫生研究院卒中量表(NIHSS)、Fugl-Meyer评估量表(FMA)和功能磁共振成像血氧水平依赖性功能磁共振成像(fMRI-BOLD)数据。然后,我们使用局部一致性(ReHo)算法分析脑功能变化,并比较不同针灸手法操作时间的神经效应。
组间和组内的NIHSS和FMA评分均无显著差异。ReHo值的纵向分析表明,1分钟组右侧额下回被激活,2分钟组右侧脑岛被激活,3分钟组右侧颞下回被激活。与1分钟组相比,2分钟组右侧中央前回的ReHo值降低,3分钟组左侧小脑后叶的ReHo值升高,右侧后扣带回和右侧前扣带回的ReHo值降低。与2分钟组相比,3分钟组右侧小脑前叶的ReHo值升高。
我们的研究结果表明,不同手法操作时间的针灸在中风患者中引起了不同的神经效应变化,激活体素簇的体积与手法操作时间呈正相关。较长时间的针灸手法操作可驱动中风患者的运动感觉网络(SMN)和默认模式网络(DMN),这可能是针灸手法影响运动功能障碍恢复的潜在神经机制。