| Traditional Chinese medicine is a great creation of the Chinese nation and has made great contributions to the prosperity of the Chinese nation.Among them,acupuncture stimulates the acupoint of human,channels meridians and regulates Qi and blood to promote the balance of Yin and Yang,and the functions of the internal organs to be harmonized,so as to achieve the purpose of preventing and treating diseases,such as acupuncture treatment for pain,palsy and tinnitus and so on.Due to the problems of acupuncture such as infection,pain and inconsistent stimulation parameters,some alternative stimulation methods of acupuncture have recently developed,such as ultrasound,electrical and laser stimulation.Some clinical studies have shown that electroacupuncture(EA)and ultrasound stimulation(US)at acupoint can produce similar therapeutic effects compared with manual acupuncture(MA).However,the activation pattern on brain induced by US at acupoint and the sustained effect on brain induced by EA at acupoint are still unclear;further,the neural substrate of acupuncture for treating tinnitus,a centrally related diseases,is also unclear.Therefore,this study uses modern magnetic resonance imaging methods to explore the brain function activation pattern produced by ultrasound and electrical stimulation at acupoint and to explore brain function changes produced by acupuncture treatment for tinnitus.First,this study based on task-state functional magnetic resonance imaging(fMRI)investigates the brain activation pattern on human brain induced by US at Zusanli(ST 36).This study recruited 16 normal subjects who randomly underwent US and MA(the control group)procedures in an interval of more than one week.This study used block design model to set the onset and offset of stimulation;meanwhile,recorded the fMRI data;then used the general linear model(GLM)to analyze stimulation-related brain activation pattern.The results showed that both US and MA activated somatosensory and limbic/para-limbic regions(postcentral gyrus,insula,middle prefrontal cortex and anterior cingulate cortex).Second,this study based on task-and resting-state fMRI investigates the acute and sustained effects on human brain induced by EA at ST 36.12 normal subjects randomly participated in EA and MA(the control group)procedures in an interval of more than one week.Meanwhile,this study recorded the fMRI data and used multi-condition GLM to analyze the acute and sustained effects on human brain induced by EA and MA during stimulation and post-stimulation periods.The results indicated that the somatosensory area,the limbic/paralimbic regions,the prefrontal lobe and the superior temporal gyrus on human brain were deactivated in both EA and MA during stimulation period.Overall,MA produced more complicated brain activity than EA in the post-stimulation period.These results indicate that EA and MA produce similar acute effect during acupuncture period,but different sustained effect during post-acupuncture period.Finally,this study based on resting-state fMRI investigates abnormal dynamic functional connectivity(DFC)in chronic tinnitus patients and the neural mechanism of acupuncture treatment for tinnitus.This study recruited 17 chronic tinnitus patients and 22 age-and sex-matched normal subjects(the control group),and hearing levels and tinnitus-related tests for chronic tinnitus patients were measured.This study recorded the fMRI data of chronic tinnitus patients before and after acupuncture(4 weeks,3 times/1 week)and that of the control group,then respectively applied the sliding-window and k-means clustering methods to calculate DFC and perform clustering analyses.Compared to the control group,the finding revealed higher time variability of DFC between the supplementary motor area and the medial part of the superior frontal gyrus in chronic tinnitus patients,which positively correlated with hearing loss.Clustering analysis showed higher transition probability for connection state in chronic tinnitus patients,which was positively associated with the severity of tinnitus.Furthermore,the findings showed that acupuncture treatment improved tinnitus.DFC between the posterior cingulate gyrus and the angular gyrus in chronic tinnitus patients after acupuncture showed significantly decreased,which was positively associated with the improvement of tinnitus.Clustering analysis showed acupuncture treatment might promote chronic tinnitus patients under lower DFC state,which was also positively associated with the improvement of tinnitus.This study suggests that(1)US may be a possible non-invasive alternative method to MA due to their similar activation patterns;(2)the investigation of EA-induced sustained brain response using neuroimaging techniques may facilitate the understanding of the neural mechanism for EA in clinical practice;(3)acupuncture might improve tinnitus by reducing the time variability of DFC in chronic tinnitus patients. |
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