电针改变亚急性期脑卒中患者的脑网络功能连接：一项随机交叉试验。

Electroacupuncture alters brain network functional connectivity in subacute stroke: A randomised crossover trial.

机构信息

Taihe Hospital, Hubei University of Medicine, Shiyan, China.

College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China.

出版信息

Medicine (Baltimore). 2024 Apr 5;103(14):e37686. doi: 10.1097/MD.0000000000037686.

BACKGROUND

Electroacupuncture (EA) is a promising rehabilitation treatment for upper-limb motor recovery in stroke patients. However, the neurophysiological mechanisms underlying its clinical efficacy remain unclear. This study aimed to explore the immediate modulatory effects of EA on brain network functional connectivity and topological properties.

METHODS

The randomized, single-blinded, self-controlled two-period crossover trial was conducted among 52 patients with subacute subcortical stroke. These patients were randomly allocated to receive either EA as the initial intervention or sham electroacupuncture (SEA) as the initial intervention. After a washout period of 24 hours, participants underwent the alternate intervention (SEA or EA). Resting state electroencephalography signals were recorded synchronously throughout both phases of the intervention. The functional connectivity (FC) of the parietofrontal network and small-world (SW) property indices of the whole-brain network were compared across the entire course of the two interventions.

RESULTS

The results demonstrated that EA significantly altered ipsilesional parietofrontal network connectivity in the alpha and beta bands (alpha: F = 5.05, P = .011; beta: F = 3.295, P = .047), whereas no significant changes were observed in the SEA group. When comparing between groups, EA significantly downregulated ipsilesional parietofrontal network connectivity in both the alpha and beta bands during stimulation (alpha: t = -1.998, P = .049; beta: t = -2.342, P = .022). Significant differences were also observed in the main effects of time and the group × time interaction for the SW index (time: F = 5.516, P = .026; group × time: F = 6.892, P = .01). In terms of between-group comparisons, the EA group exhibited a significantly higher SW index than the SEA group at the post-stimulation stage (t = 2.379, P = .018).

CONCLUSION

These findings suggest that EA downregulates ipsilesional parietofrontal network connectivity and enhances SW properties, providing a potential neurophysiological mechanism for facilitating motor performance in stroke patients.

背景

电针（EA）是一种有前途的上肢运动恢复康复治疗方法，适用于中风患者。然而，其临床疗效的神经生理机制尚不清楚。本研究旨在探讨 EA 对脑网络功能连接和拓扑性质的即时调节作用。

方法

这是一项在 52 例亚急性皮质下中风患者中进行的随机、单盲、自身对照两周期交叉试验。这些患者被随机分配接受 EA 或假电针（SEA）作为初始干预。洗脱期 24 小时后，参与者接受了交替干预（SEA 或 EA）。在整个干预过程中，同步记录静息状态脑电图信号。比较了两个干预过程中整个过程的顶-额网络功能连接和全脑网络小世界（SW）属性指数。

结果

结果表明，EA 显著改变了同侧顶-额网络在α和β频段的连接（α：F=5.05，P=0.011；β：F=3.295，P=0.047），而 SEA 组则无明显变化。组间比较时，EA 在刺激期间显著下调了同侧顶-额网络在α和β频段的连接（α：t=-1.998，P=0.049；β：t=-2.342，P=0.022）。SW 指数的时间和组×时间交互作用的主效应也存在显著差异（时间：F=5.516，P=0.026；组×时间：F=6.892，P=0.01）。在组间比较方面，EA 组在刺激后阶段的 SW 指数显著高于 SEA 组（t=2.379，P=0.018）。