Zha Bixiang, Zhang Yating, Shi Feifei, Cheng Ling, Rong Zhihao, Yu Leiyu, Liu Wanting, Xue Qiuju, Ye Min, Yang Jinying, Qiu Bensheng, Yang Jun
The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China.
The First School of Clinical Medicine, Anhui University of Chinese Medicine, Hefei, China.
Front Neurol. 2024 Mar 22;15:1373390. doi: 10.3389/fneur.2024.1373390. eCollection 2024.
To explore the modulations of electroacupuncture in subjective tinnitus (ST) by comparing the difference of functional connectivity (FC) in ST patients and healthy volunteers between the insular (INS) and the whole brain region.
A total of 34 ST patients were selected into electroacupuncture group (EG) and 34 age- and sex-matched normal subjects were recruited into control group (CG). The EG received acupuncture at SI19 (), GB11 (), TE17 (), GV20 (), GV15 (), GV14 (), SJ13 (), among which the points of SI19 and GB11 were connected to the electroacupuncture instrument with the density wave of 2/50 Hz, and 3 treatments per week for 10 sessions in total. The severity of tinnitus was evaluated by Tinnitus Handicap Inventory (THI), the hearing status was recorded using pure tone audiometry, and resting-state functional magnetic resonance imaging (rs-fMRI) was performed on the brain before and after treatment, the CG received no intervention yet only rs-fMRI data were collected.
With the electroacupuncture treatment, the total THI score, average air conduction threshold of patients of EG were significantly lower than before ( < 0.01), and the total effective rate was 88.24%. Compared with CG, FC of ST patients between INS and left superior temporal gyrus and right hippocampal significantly decreased before treatment, while FC of ST patients between INS and right superior frontal gyrus, left middle frontal gyrus and right anterior cuneus significantly decreased after treatment (voxel < 0.001, cluster < 0.05, corrected with GRF). FC of ST patients between the INS and right middle frontal gyrus, left superior frontal gyrus and right paracentral lobule showed a significant decrease after treatment (voxel < 0.001, cluster < 0.05, corrected with GRF). In addition, THI score in EG was negatively correlated with the reduction of FC value in INS-left superior frontal gyrus before treatment ( = -0.41, = 0.017). Therefore, this study suggests that abnormal FC of INS may be one of the significant central mechanisms of ST patients and can be modulated by electroacupuncture.
Electroacupuncture treatment can effectively reduce or eliminate tinnitus symptoms in ST patients and improve the hearing by decreasing FC between the INS and the frontal and temporal brain regions.
通过比较主观性耳鸣（ST）患者与健康志愿者脑岛（INS）与全脑区域功能连接（FC）的差异，探讨电针治疗ST的调节作用。
选取34例ST患者纳入电针组（EG），选取34例年龄、性别匹配的正常受试者纳入对照组（CG）。EG组针刺听宫（SI19）、率谷（GB11）、耳门（TE17）、百会（GV20）、神道（GV15）、大椎（GV14）、外关（SJ13），其中SI19和GB11连接电针仪，采用疏密波2/50Hz，每周治疗3次，共治疗10次。采用耳鸣残障量表（THI）评估耳鸣严重程度，采用纯音听力计记录听力状况，治疗前后对脑部进行静息态功能磁共振成像（rs-fMRI），CG组未接受干预，仅收集rs-fMRI数据。
电针治疗后，EG组患者THI总分、平均气导阈值均显著低于治疗前（P<0.01），总有效率为88.24%。与CG组相比，治疗前ST患者INS与左侧颞上回、右侧海马之间的FC显著降低，治疗后ST患者INS与右侧额上回、左侧额中回、右侧前楔叶之间的FC显著降低（体素P<0.001，簇P<0.05，经GRF校正）。治疗后ST患者INS与右侧额中回、左侧额上回、右侧中央旁小叶之间的FC显著降低（体素P<0.001，簇P<0.05，经GRF校正）。此外，EG组治疗前THI评分与INS-左侧额上回FC值降低呈负相关（r=-0.41，P=0.017）。因此，本研究提示INS的FC异常可能是ST患者重要的中枢机制之一，电针可对其进行调节。
电针治疗可有效减轻或消除ST患者的耳鸣症状，并通过降低INS与额叶和颞叶脑区之间的FC来改善听力。
