赵义，王苇，周龙江，李澄，杜芳，李华东，李郑，孙琛.针刺健康志愿者合谷和外关的脑功能磁共振成像初步研究[J].中华物理医学与康复杂志,2017,39(5):355-360
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| 针刺健康志愿者合谷和外关的脑功能磁共振成像初步研究 |
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| DOI： |
| 中文关键词: 针刺 合谷 外关 功能磁共振成像 |
| 英文关键词: Acupuncture Hegu Waiguan Functional magnetic resonance imaging |
| 基金项目:扬州市重点研发计划-社会发展项目（YZ2016073），扬州大学科技创新培育基金（2016CXJ114） |
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| 中文摘要: |
| 目的利用血氧水平依赖性功能磁共振成像（BLOD-fMRI）技术观察针刺健康志愿者合谷及外关时大脑皮质功能激活区的分布情况，并初步探讨针刺的神经作用机制。 方法纳入20例健康志愿者作为研究对象，行针刺左侧合谷和外关组块模式的BOLD-fMRI检查，运用SPM8等软件处理后，观察脑功能激活区分布情况，重点观察运动相关脑功能区激活情况。 结果针刺健康志愿者左侧正激活脑区中左额中回、额下回有明显激活区，左岛叶有大量激活区，此外在左小脑、左中央前回、左中央后回、左顶下小叶、左额内侧回、左楔叶、左前扣带回、左屏状核亦见少量激活区分布。右侧正激活脑区主要分布在右额中回和右额内侧回；此外右顶下小叶、右中央前回有部分激活区，右颞中回、右颞上回、右岛叶、右额下回、右中央后回有少量激活区分布。负激活区主要位于两侧边缘叶海马回、海马旁回及扣带回，左颞极颞上回、颞中回及右额中回亦见少量负激活区分布。 结论针刺健康志愿者合谷和外关除引起对侧初级运动区部分激活外，双侧次级运动区可见明显激活，同侧小脑亦可见部分激活，可能是其作为运动功能障碍疾病治疗取穴的神经病理学基础。BOLD-fMRI成像技术可直观显示生理状态下针刺的神经效应，亦可为研究病理状态下针刺的神经效应提供基础及对照。 |
| 英文摘要: |
| Objective To observe the cortical functioning of healthy volunteers during acupuncture as a way of exploring acupuncture′s neural mechanisms. MethodsTwenty healthy volunteers received acupuncture applied to the left hegu and waiguan acupoints while their cortical activity was examined using blood oxygenation level-dependent functional magnetic resonance imaging (BOLD-fMRI). Brain activation, especially of the regions related to motor function, were observed and analyzed. ResultsAcupuncture applied to the left hegu and waiguan acupoints was observed to significantly activate the left middle frontal gyrus and the inferior frontal gyrus, with many activated regions in the left insula and a few in the left cerebellum, the left precentral gyrus, the left postcentral gyrus, the left inferior parietal lobule, the left medial frontal gyrus, the left precuneus, the left anterior cingulate gyrus and the left claustrum. The right side of the brain was excited mainly in the right middle frontal gyrus and the right medial frontal gyrus. The right inferior parietal lobule and the right precentral gyrus were also activated to some extent. There was slight activation of the right middle temporal gyrus, the right superior temporal gyrus, the right insula, the right inferior frontal gyrus and the right postcentral gyrus. The negatively activated regions were mainly located on both sides of the limbic lobe, including the hippocampus, the parahippocampal gyrus and the cingulate gyrus. The left superior temporal gyrus, the left middle temporal gyrus and the right middle frontal gyrus also had small negative activation zones. ConclusionsIn brain regions associated with motor function, in addition to partial activation of the contralateral primary sensorimotor area, acupuncture at these two points clearly generates bilateral activation of secondary motor areas with some activation in the ipsilateral cerebellum. This may serve as a neuropathological basis for acupuncture treatment of motor dysfunction. BOLD-fMRI imaging displays the neural effects of acupuncture in an intuitive way. It can be a useful technique for further study of the neural effects of acupuncture on pathological conditions. |
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