【摘要】 目的利用磁共振成像(MRI)平面回波序列(EPI)的血氧水平依赖(BOLD)技术分别对足少阳胆经光明穴和假穴进行电针刺激的脑功能成像研究,观察大脑功能区反应的异同,探寻针刺治疗眼病的中枢机制。方法选择国人健康志愿者12例,分别接受电针刺激真穴(光明穴)和假穴的两步脑功能磁共振成像实验。实验采用组块设计,静息相(R)与刺激相(S)交替进行,重复5次,即"RSRSRSRSRS"模式。采用SPM2分析软件将实验所得数据进行处理。将激活区叠加于(加拿大蒙特利尔神经研究所montreal neurologic institute,MNI)标准三维模板脑,脑功能区域的解剖位置、Broadmann区(BA)定位、中心坐标由平均脑功能图得出。观察有统计学意义的体素大小(P<0.001,k>20)、所在脑区及其坐标(MNI坐标)。记录激活区的激活体积(clus-ter)及激活强度(用t-检验统计值"T"表示,T值越大,强度越高)。结果①电针刺真穴(光明穴)脑区激活的位置主要为额叶上、中、下回(Brodmann10、11、45、47区);颞上回(Brodmann38区);楔叶和枕叶舌回(Brodmann18、19区)。②电针刺激假穴(光明穴前开0.5寸)脑区激活的位置主要为顶上小叶、顶下小叶(Brodmann7、40区);额叶中、上回(Brodmann10、46区);颞上回(Brodmann22区);边缘叶后联合(Brodmann29区)。结论①与视觉相关的穴位和大脑的视觉中枢存在特殊的对应关系,穴位有其独立的、特殊的属性。②电针刺激视觉相关穴位引发的临床效应的中枢机制与高级视觉中枢的调节有特异关系。③电针刺激光明穴所引发的脑功能区激活的神经机制不是简单的穴位-视区对应,而是调动了多个脑区参与的复杂的过程。更多还原

【Abstract】 Objective To discuss the effects of electroacupuncture at Guangming acupoint and sham acupoint on activating effects in various cerebral areas using magnetic resonance imaging (MRI),blood oxygenation level dependent (BOLD) of echo planar imaging (EPI) sequence,and try to explore the impossible cortical mechanisms of acupuncture treatment in the ophthalmic field.Methods Twelve right-handed volunteers without any symptom and sign of the central nervous system (male 5,female 7; age ranged 20 to 40 years old, average age is 27.5) who were studying as postgraduates or working as doctor in our hospital were selected to take part in our studies. The corrected vision of them was better than 1.0. every one of these 12 volunteers was performed our electroacupuncture stimulating two times, the first is true acupoint (GB37) stimulating and the second is sham acupoint stimulating. The BOLD-fMRI Images were required on a 1.5-T unit; For electroacupuncture, Device BT701-1A was used; The silver no-magnet acupuncture needles (Φ0.30 mm×25 mm) was used in our study. A block design as "RSRSRSRSRS" was adopted for the study. The fMRI Data were analyzed by using Statistical Parametric Mapping software implemented within Matlab. The datasets were normalized to a standard space within SPM2. For all studies, statistical thresholding at significance level of P<0.001 and k>20 was initially used to determine significant activation for each vexol.Results ①Electroacupuncture stimulation of GB37 produced major hemodynamic signal change in the superior, middle, inferior frontal gyrus (Broadmann 10,11,45,47); superior temporal gyrus (Broadmann 38); cuneus and lingual gyrus of occipital lobe (Broadmann 18,19).②Electroacupuncture stimulation of false acupoint produced major hemodynamic signal change in the superior, inferior parietal lobule (Broadmann 7, 40); superior, middle frontal gyrus (Broadmann 10,46);superior temporal gyrus (Broadmann 22); limbic lobe,posterior cingulated (Broad mann 29).Conclusions ①There is a special relationship between the acupoint related visual and the braincortices realated visual, and acupoints have their own attributes.②The cortical mechanisms of clinical effects induced by electroacupuncturing the acupoint related visual are related with accommodating the senior visual cortex.③The cortical mechanisms of electroacupuncturing true acupoint are not simple correspondence between acupoints and areas of brain visual cortex, and it should be a complex process mobilizing the more areas of brain cortices to take part in.更多还原