针刺风池穴即刻后效应与视觉皮层功能相关的静息态fMRI研究
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摘要
目的运用静息态功能磁共振(rsfMRI)技术,观察针刺风池穴即刻后脑效应,探索其调制视觉中枢的脑功能机制。方法招募11名健康志愿者,均先后接受左侧风池穴手法针刺及表皮触觉对照刺激,以随机数字表法决定受试者接受2种剌激的先后顺序。每次刺激时间为30 s,频率60次/min。刺激前、即刻后均行6 min脑rsfMRI扫描。采用DPABI4.3软件对rsfMRI数据进行统计学分析,包括比率低频振幅(fALFF)、局部一致性(ReHo)、度中心(DC)分析局部脑活动变化;种子点双侧后扣带皮质(PCC)、腹内侧前额叶(VMPFC)分析全脑功能连接,观察针刺风池穴后的即刻脑功能及全脑功能连接的变化。结果与表皮触觉刺激比较,针刺左侧风池穴视觉相关脑区右侧楔叶、楔前叶局部活动增强(体素水平P<0.01,簇水平P<0.05),双侧种子点PCC与左侧顶下小叶脑功能连接增强,种子点VMPFC与右侧楔前叶脑功能连接降低(体素水平P<0.01,簇水平P<0.05)。结论风池穴可以调节视觉中枢及邻近脑区功能活动,调制默认网络脑功能连接,可能是其治疗眼部疾病等临床适应证的重要脑功能基础。
Objective To observe the immediate brain sustained effects of acupuncture at Fēngchí(GB 20)by using resting-state functional magnetic resonance imaging(rsfMRI)technique and explore the brain functional basis of acupuncture at GB20 for regulating visual cortex.Methods 11 healthy subjects randomly received acupuncture or Von Frey filaments(control)at left GB20.The stimulation time was 30 s and the frequency was 60 times/min.fMRI scan was conducted before and immediately after stimulation for 6 min.MATLAB-based DPABI4.3 software was used to analyze rsfMRI data,including fALFF,ReHo,DC for local brain activity changes,as well as the seed point bilateral posterior cingulate cortex(PCC)and the ventral medial prefrontal(VMPFC)for whole brain functional connectivity and observe the immediate brain sustained effect and whole brain functional connectivity after acupuncture at GB20.Results Compared with the tactile stimulation of Von Frey filaments,acupuncture at left GB20 could clearly modulate the right cuneus and right precuneus which involved to the visual function(voxel P value<0.01, cluster P value <0.05).The FC between PCC and inferior parietal lobule(BA7, 39, 40)were enhanced, and the FC of the VMPFC and the right precuneus(BA7)were decreased(voxel P value<0.01, cluster P value<0.05).Conclusion Acupuncture at GB20 could modulate the visual center and adjacent brain regions,as well as the default network,which may be an important brain function basis for the treatment of eye diseases.
Objective To observe the immediate brain sustained effects of acupuncture at Fēngchí(GB 20)by using resting-state functional magnetic resonance imaging(rsfMRI)technique and explore the brain functional basis of acupuncture at GB20 for regulating visual cortex.Methods 11 healthy subjects randomly received acupuncture or Von Frey filaments(control)at left GB20.The stimulation time was 30 s and the frequency was 60 times/min.fMRI scan was conducted before and immediately after stimulation for 6 min.MATLAB-based DPABI4.3 software was used to analyze rsfMRI data,including fALFF,ReHo,DC for local brain activity changes,as well as the seed point bilateral posterior cingulate cortex(PCC)and the ventral medial prefrontal(VMPFC)for whole brain functional connectivity and observe the immediate brain sustained effect and whole brain functional connectivity after acupuncture at GB20.Results Compared with the tactile stimulation of Von Frey filaments,acupuncture at left GB20 could clearly modulate the right cuneus and right precuneus which involved to the visual function(voxel P value<0.01, cluster P value <0.05).The FC between PCC and inferior parietal lobule(BA7, 39, 40)were enhanced, and the FC of the VMPFC and the right precuneus(BA7)were decreased(voxel P value<0.01, cluster P value<0.05).Conclusion Acupuncture at GB20 could modulate the visual center and adjacent brain regions,as well as the default network,which may be an important brain function basis for the treatment of eye diseases.
引文
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[16] Dhond RP,Yeh C,Park K,et al.Acupuncture modulates resting state connectivity in default and sensorimotor brain networks[J].Pain,2008,136(3):407-418.
[17] 汪林英,徐春生,朱一芳,等.针刺左、右侧合谷穴脑功能偏侧性的fMRI研究[J].中国针灸,2015,35(8):806-811.
[2] 中国国家标准化管理委员会.腧穴名称与定位(GB/12346-2006)[S].北京:中国标准出版社,2006:32-33.
[3] 卢阳佳,黄泳,陈俊琦,等.基于静息态fMRI研究针刺激活关键脑区的思路[J].中国针灸,2011,31(4):367-370.
[4] Yan CG,Zang YF.DPARSF:a MATLAB toolbox for "pipeline" data analysis of resting-state fMRI[J].Front Syst Neurosci,2010,4(13):13.
[5] Qin Y,Yuan W,Deng H,et al.Clinical Efficacy Observation of Acupuncture Treatment for Nonarteritic Anterior Ischemic Optic Neuropathy[J].Evid Based Complement Alternat Med,2015(1):1-6.
[6] Broadmann K.Vergleichende lokalisationslehre der grobhirn-rinde[M].England:Leipzig,1999:106-118.
[7] Cavanna AE,Trimble MR.The precuneus:a review of its functional anatomy and behavioural correlates[J].Brain,2006,129(3):564-583.
[8] 王葳,李坤成,单保慈,等.针刺太冲穴的脑功能MRI研究[J].中华放射学杂志,2006,40(1):29-35.
[9] Cho ZH,Chung SC,Jones JP,et al.New findings of the correlation between acupoints and corresponding brain cortices using functional MRI[J].Proc Natl Acad Sci U S A,2006,103(27):105-127.
[10] Fang J,Jin ZY,Li K,et al.The salient characteristics of the central effects of acupuncture needling:limbic-paralimbic-neocortical network modulation[J].Hum Brain Mapp,2010,30(4):1196-1206.
[11] Li G,Cheung RT,Ma QY,et al.Visual cortical activations on fMRI upon stimulation of the vision-implicated acupoints[J].Neuroreport,2003,14(5):669-673.
[12] Siedentopf CM,Golaszewski SM,Mottaghy FM,et al.Functional magnetic resonance imaging detects activation of the visual association cortex during laser acupuncture of the foot in humans[J].Neurosci Lett,2002,327(1):53-56.
[13] 刘颖,李银官,曹代荣,等.针刺太冲穴激活视皮层的脑功能磁共振研究[J].中国中西医结合影像学杂志,2011,9(2):97-100.
[14] 管永清,杨新治.电针刺激视觉相关穴位光明穴的脑BOLD-fMRI研究[J].河北中医,2008,30(10):1065-1068.
[15] 方继良,金真,王寅,等.针刺太冲及其临近穴脑反应区功能磁共振成像比较[J].中国医学影像技术,2005,21(9):1332-1336.
[16] Dhond RP,Yeh C,Park K,et al.Acupuncture modulates resting state connectivity in default and sensorimotor brain networks[J].Pain,2008,136(3):407-418.
[17] 汪林英,徐春生,朱一芳,等.针刺左、右侧合谷穴脑功能偏侧性的fMRI研究[J].中国针灸,2015,35(8):806-811.