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针刺对运动功能障碍中风患者的神经效应:一项激活可能性估计荟萃分析。

Neural effects of acupuncture on stroke patients with motor dysfunction: an activation likelihood estimation meta-analysis.

作者信息

Li Dongxia, Wang Dongyan, Zhou Yihao, Zhang Yuan, Yang Siyu, Dong Xu, Cai Shaojie, Zhang Ruiting

机构信息

The Second Clinical Medical College of Heilongjiang University of Traditional Chinese Medicine, Harbin, China.

The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China.

出版信息

Front Neurol. 2024 Sep 25;15:1453935. doi: 10.3389/fneur.2024.1453935. eCollection 2024.

Abstract

BACKGROUND

Functional magnetic resonance imaging has been used in many studies to explore the neural mechanism of acupuncture in patients with post-stroke motor dysfunction. Inconsistent results have been found in these studies, however. This activation likelihood estimation (ALE) meta-analysis was designed to quantitatively integrate changes in brain activity and the neurological effects of acupuncture on patients with motor dysfunction after stroke.

METHODS

We searched PubMed, Embase, Web of Science, the Cochrane Library, China Science and Technology Journal Database, the China Biology Medicine, the China National Knowledge Infrastructure, and Wanfang Data Knowledge Service Platform for literature from the establishment of the database until March 21, 2024. Research papers were selected, data extracted, and quality assessment was done independently by two researchers. The GingerALE software was used for meta-analysis, and Jackknife sensitivity analysis was employed to assess result robustness.

RESULTS

We ended up analyzing 14 studies that included 235 patients and 100 healthy people. ALE meta-analysis showed that Compared with healthy people, the enhanced brain region in poststroke patients with motor dysfunction was located in the left posterior lobe of the cerebellum, the left inferior frontal gyrus, and the left precuneus ( < 0.001). After acupuncture, the activated regions were mainly located in the left posterior lobe of the cerebellum, the right lentiform nucleus putamen, the right medial frontal gyrus, the right inferior frontal gyrus, the left precuneus, the right middle temporal gyrus, the left claustrum, the left cerebellar tonsil, the right superior marginal gyrus, the inactivated area is located in the right medial frontal gyrus the left precentral gyrus and the right precuneus ( < 0.001).

CONCLUSION

Acupuncture can reestablish motor function by causing extensive changes in the brain function of patients with stroke, which may be the neurological effect of acupuncture therapy on stroke patients.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/, identifier CRD42024526263.

摘要

背景

功能磁共振成像已在许多研究中用于探索中风后运动功能障碍患者针刺的神经机制。然而,这些研究中发现了不一致的结果。本激活可能性估计(ALE)荟萃分析旨在定量整合中风后运动功能障碍患者大脑活动的变化以及针刺的神经学效应。

方法

我们检索了PubMed、Embase、Web of Science、Cochrane图书馆、中国科技期刊数据库、中国生物医学数据库、中国知网和万方数据知识服务平台,检索从数据库建立至2024年3月21日的文献。由两名研究人员独立选择研究论文、提取数据并进行质量评估。使用GingerALE软件进行荟萃分析,并采用留一法敏感性分析来评估结果的稳健性。

结果

我们最终分析了14项研究,其中包括235例患者和100名健康人。ALE荟萃分析表明,与健康人相比,中风后运动功能障碍患者大脑增强区域位于小脑左后叶、左额下回和左楔前叶(<0.001)。针刺后,激活区域主要位于小脑左后叶、右侧豆状核壳核、右侧额内侧回、右侧额下回、左楔前叶、右侧颞中回、左屏状核、左小脑扁桃体、右侧缘上回,失活区域位于右侧额内侧回、左侧中央前回和右侧楔前叶(<0.001)。

结论

针刺可通过引起中风患者大脑功能的广泛变化来重建运动功能,这可能是针刺疗法对中风患者的神经学效应。

系统评价注册

https://www.crd.york.ac.uk/prospero/,标识符CRD42024526263。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e11b/11461336/4a34c75931c1/fneur-15-1453935-g001.jpg

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