Effect Of Acupuncture Influence On Cerebral Blood Flow In Patients With Primary Dysmenorrhea:An ASL-MRI Sdudy

Objective:Primary dysmenorrhea was used as the carrier in this study and Arterial Spin Labeling Magnetic Resonance Imaging was used to observe the resting cerebral blood flow of PDM patients,in order to explore part of the possible central mechanism in acupuncture treat PDM.Methods:In this study,15 PDM subjects and 15 health volunteer were included.After baseline observation of 1 menstural cycle,PDM patients received acupuncture treatment at Guanyuan and Sanyinjiao for 3 menstrual cycles,while healthy subjects did not receive treatment.There would be Visual Analogue Scale,the COX Menstrual Symptom Scale,Self-rating Anxity Scale,Self-rating Depression Scale,and ASLMRI scanning before and after the acupuncture treatment.Healthy subjects and PDM patients before acupuncture received SAS,SDS scores and ASL-MRI scans at the same time.By comparing the VAS and CMSS scores of PDM patients before and after acupuncture,the improvement degree of acupuncture on pain,accompanying symptoms and onset time of PDM patients was evaluated.The improvement of anxiety and depression in PDM patients by acupuncture was evaluated by analyzing SAS and SDS scores before and after acupuncture in the two groups at baseline and PDM patients.Cerebral blood flow values were measured according to the ASL-MRI images.Changes in CBF of PDM patients and healthy subjects were compared and analyzed to screen abnormal brain areas related to PDM conditions.Meanwhile,The differences in CBF between PDM patients and healthy subjects were analyzed.Results:1.There were no significant differences in baseline demographic characteristics(e.g.,age,height,weight,etc.)between PDM patients and healthy subjects,which iscomparable.2.Comparing the VAS score and CMSS score before and after acupuncture in PDM patients: VAS score was significantly reduced after acupuncture,and the difference was statistically significant(p < 0.05).The average severity of the accompanying symptoms score was significantly decreased after acupuncture,and the difference was statistically significant(p<0.05).There was no significant difference in total attack time of concomitant symptom score after acupuncture(p>0.05).3.Comparing the SAS and SDS scores in PDM patients and healthy subjects,there was statistically significant difference(p < 0.05);There was no significant difference in SAS and SDS scores between PDM patients before and after acupuncture(p>0.05).4.Changes of cerebral blood flow in PDM patients and healthy subjects:compared with healthy subjects,CBF of brain areas in left medial frontal gyrus,left inferior frontal gyrus of the triangle,right posterior central gyrus,left middle temporal gyrus,and left middle occipital gyrus had increased and in right inferior temporal gyrus and right middle temporal gyrus had decreased in PDM patients.5.Changes of cerebral blood flow in PDM patients before and after acupuncture:compared with before acupuncture,CBF of brain areas in left hippocampus/parahippocampal gyrus,right precuneus,left precuneus,right middle temporal gyrus,right inferior temporal gyrus,and right middle occipital gyrus had increased and in left medial frontal gyrus,left triangle inferior frontal gyrus,left thalamus,left medial cingulate gyrus,right anterior central gyrus,right inferior parietal lobule,and left angular gyrus had decreased after acupuncture.Conclusion:1.Acupuncture of sanyinjiao and guanyuan can significantly reduce the average severity of pain and accompanying symptoms in PDM patients.2.Comparing PDM patients with healthy subjects,SAS and SDS have significant differences,indicating that PDM patients are more prone to depression and anxiety;There was no significant difference in SAS and SDS between PDM patientsbefore and after acupuncture,indicating that the improvement of anxiety and depression was not significant in PDM patients after acupuncture in this selected acupoint scheme.3.Changes in cerebral blood flow in the prefrontal cortex,posterior central gyrus and temporal cortex may be related to the central mechanism of PDM.4.Acupuncture therapy regulates cerebral blood flow of PDM patients in prefrontal cortex,temporal cortex,limbic system and other regions,which may be the central mechanism of acupuncture treat PDM.