Research On The Inlfluence Of Acupuncture On The Brain Function And Brain Structure In The Resting-state Of The Patients With Ischemic Stroke

ObjectiveTaking the complex brain function and brain structure in the resting-state as an entry point, taking healthy volunteers and patients with ischemic stroke as the research subjects, The research explored the central mechanisms of ischemic stroke from the perspective of brain function and brain structure, aiming at providing evidences for acupuncture to treat ischemic stroke.Methods1. BOLD-fMRI technology was adopted and regional homogeneity was observed in the research. We choosed10healthy volunteers (A group) and20patients with ischemic stroke as participants. The20paralytics were divided into acupuncture treatment group (B group) and traditional treatment group (C group), observe the dynamic change of regional homogeneity of the whole brain for both B and C groups before and after treatment. compared A with B and C group.Then correlation analysis was carried for the brain region of ischemic stroke with sinificant Reho change and NDS、FMA scale index, aiming at explore the brain mechanisms for acupuncture to treat ischemic stroke from the brain function perspective.2.Based on VBM measurement technology, Cerebral gray matter concentration was measured, and the reasearch object、groups division and treatment were the same as part one. observe the dynamic change of gray matter concentration of the whole brain and various encephalic regions for both B and C groups before and after treatment. compared A with B and C group. Then correlation analysis was carried for the brain region of ischemic stroke with sinificant gray matter concentration change and NDS、FMA、Barthel scale index, aiming at analyzing the brain mechanisms for acupuncture to treat ischemic stroke from the brain structure perspective and providing inportant material basis for acupuncture influencing alteration of brain function. Results1. Results for clinical evaluation scales for both B and C groups①Intragroup comparision:as for the clinical evaluation indexes (NDS, FMA, Barthel), there was significant difference statistically between before and after treatment for both B and C groups (P<0.01). the intragroup improvement indexes of NDS and FMA scale were also significant statistically12weeks later (P<0.01), but not for Barthel indexes (P>0.05).②ntergroup comparision:There was no significant difference between B and C group before treatment as for.the indexes of NDS, FMA and Barthel (P>0.05); After the treatment, there was no significant difference for NDS scale index (P>0.05). As for FMA and Barthel indexes, the difference was significant statistically (P <0.05). the intergroup improvement indexes of NDS and FMA scale were also significant statistically12weeks later (P<0.01; P<0.05), but not for Barthel indexes (P>0.05).2. Results of acupuncture influencing alteration of brain function, before treatment, compared with healthy volunteers (A group), the abnormality of regional homogeneity occurred in many encephalic regions for both B and C groups. After treatment, compared with healthy volunteers (A group), regional homogeneity signal changed obviously in SG and cerebellum,M1, PMA, SMA and IPL for both B and C groups. SG、cerebellum、M1、SMA、PMA and IPL were chosen as important encephalic regions in the research, aiming at exploring the correlation of Reho signal in the above-mentioned sections and clinical scale (NDS、FMA) between B and C groups. Results indicated:there was negative correlation between the signal change of SG and cerebellum and NDS scale indexes (P<0.05;(P<0.01). There were positive correlations between the signal change of many encephalic regions (such as M1、 PMA, SMA, IPL) and NDS scale indexes (P<0.05; P<0.01).The Reho signal change of M1、SMA and IPL was negatively correlated with FMA scale indexes (P<0.05; P<0.01). Whereas the ReHo signal of PMA%SG and cerebellum were irrespective of FMA scale indexes (P>0.05).3. Results of acupuncture influencing alteration of brain structure:before treatment, compared with healthy volunteers (A group), the abnormality of cerebral gray matter concentration occurred in many encephalic regions for both B and C groups, the abnormality of the gray matter concentration occurred in such encephalic regions as precentral gyrus (BA4)、inferior parietal lobule (BA40)、cuneus (BA18), precuneus (BA7)、cingulate gyrus (BA24、32). After treatment, the gray matter concentration in the above-mentioned encephalic regions improved for both B and C groups. The correlation analysis was carried between the gray matter concentration alteration in many encephalic regions (such as SG、BA4、BA24、BA32、 BA18).and clinical scale indexes (such as NDS、FMA and Barthel) for both B and C groups. Results indicated:the gray matter concentration alteration in BA4and BA18were positively correlated with NDS scale index (P<0.01; P<0.05), whereas the gray matter concentration alteration in SG and BA24.,32were negatively correlated with NDS scale index (P<0.01; P<0.05). There was negative correlation between gray matter concentration alteration in BA18and FMA, Barthel scale indexes (P<0.01). the gray matter concentration change in SG was positively significantly correlated with FMA、Barthel scale indexes (P<0.01), whereas the gray matter concentration alteration in BA4and BA24%32were irrespective of FMA、Barthel scale indexes (P>0.05).Conclusion1. Based on the evaluation of clinical scale, the conclusion that the efficacy of traditional and acupuncture treating ischemic stroke was superior to traditional treatment only.2. Abnormality of regional homogeneity in the resting-state occurred in many encephalic regions of patients with ischemic stroke, SG was the main encephalic region which resulted in motor function injuries, thus became the main theraputic target.3.M1、PMA、SMA and IPL were the critical regions for patients with ischemic stroke to accomplish reorganization and compensation of the brain function in the resting-state, thus which became the important focus for acupuncture treating patients with ischemic stroke.4. The abnormality of brain structure in the resting-state occurred commonly among patients with ischemic stroke, the abnormal alteration of gray matter concentration was the main characteristic among the abnormality of brain structure of patients with ischemic stroke, which also became the material basis of the abnormality of brain function.5. The modulation of gray matter concentration in the rest-state in critical regions such as "default network" and "motor network" was the core mechanism for acupuncture treating patients with ischemic stroke.