【作者】 许可； 李小娇； Mostafizi Narjes； 陈丽梅； 高德强； 王燕平； 方继良；

【Author】 XU Ke;NARJES Mostafizi;LI Xiaojiao;WANG Yan Ping;FANG Jiliang;Department of Radiology,Guang An Men Hospital,China Academy of Chinese Medical Sciences;Acupuncture and Moxibution College,Beijing University of Chinese Medicine;

【机构】 中国中医科学院广安门医院； 北京中医药大学；

【摘要】 目的:运用功能磁共振(fMRI)技术,观察手针针刺风池穴与触觉刺激对照的脑功能成像特点,分析风池穴即时脑中枢后效应与视觉脑区的关系。方法:录入11名健康者参与左侧风池穴的f MRI试验。受试者随机先后接受手针与表皮(Von Frey触觉)刺激,并记录刺激时的感觉。刺激前后均进行f MRI扫描。f MRI数据采用基于MATLAB平台DPABI软件进行处理,分析刺激在脑功能区、及其之间的功能连接(FC)的效应。(p<0.01 GRF校正)。结果:针刺的酸痛,钝痛,沉重,胀满的得气感觉强度、频率均强或高于表皮刺激(P<0.05),其他感觉差异无统计学意义(P>0.05)。与表皮刺激对照,手针左侧风池穴可引起对侧脑区楔叶(BA19区)、楔前叶(BA7区)活动增强。分别取左侧后扣带皮质(PCC_L)与右侧后扣带皮质(PCC_R),腹内侧前额叶(VMPFC)作为种子点做FC,结果显示PCC与左顶下小叶(BA7,39,40)FC均增强,VMPFC与右侧楔前叶(BA7区)FC降低。将针感与脑区进行相关性分析后发现,手针组针刺激后,右侧楔叶中心度的增加与针感强度呈显著正相关(r=0.716,P=0.03),而表皮刺激组,种子点双侧后扣带回与左侧顶下小叶的功能连接刺激后增强与针感强度呈正相关(r=0.72,P=0.029; r=0.687,P=0.041)。结论:刺激风池穴能引起默认网络下楔叶,楔前叶,顶下小叶的脑活动增加,这些脑区与视觉功能关联,可能是针刺风池穴即时后效应区域。更多还原

【Abstract】 Objective This study aimed to explore the neural correlates of needling sensations when puncturing at Fengchi point(GB20) at the back of neck. Methods Eleven healthy subjects were enrolled in the study of fMRI when needling at the acupoint of left GB20.All subjects randomly received acupuncture and Von Frey stimuli(tactile control). The resting state f MRI(rs-fMRI)data were collected before and after 30 seconds stimulations, and the stimulations’ sensations were recorded after fMRI. All rs-fMRI data were processed by DPABI.The functional connectivity(FC) was analyzed and compared between two groups(p<0.01 GRF correction). Finally, the correlation was investigated between the change of brain function and stimulations’ sensations. Results Compared with the control stimulation, acupuncture caused the increased FC in the cuneus(BA19) and precuneus(BA7). The FC between posterior cingulate cortex(PCC,seeding) and Inferior Parietal Lobule(BA7, 39, 40) was enhanced, but the FC was decreased between the ventral medial prefrontal cortex(VMPFC, seeding) and the right precuneus(BA7). The intensity and frequency of acupuncture sensations including soreness, dull pain, heaviness, fullness were stronger than tactile stimulation’s individually(P<0.05). The increased Degree Centrality of the right cuneus and the total score of acupuncture sensations was positively correlated(R = 0.716, P = 0.03).For the control group, the enhancement of the FC between the bilateral PCC and the left inferior parietal lobule was positively correlated with the total score of Von Frey sensations(R = 0.72, P = 0.029; R = 0.687, P = 0.041). Conclusion Acupuncutre at GB20 elicited more reactions in visual and parietal areas. Stimulation sensations are correlated with the activity of the visual center and regions in the default mode network(DMN).These phenomenon may be involved in the potential mechanisms for its diversiform indications including eye diseases.更多还原