Based On TMS To Explore The Effect Of Acupuncture At Jiaji Acupoint On The Excitability Of Upper Limb Motor Pathway In Patients With Upper Limb Dysfunction After Stroke

Objective:To observe the changes of latency and amplitude of motor evoked potentials(MEP)of abductor pollicis brevis and abductor digiti minimi muscles in patients with upper limb dysfunction after stroke by acupuncture at Jiaji acupoint by transcranial magnetic stimulation(TMS),and the upper limb function scale was used to evaluate its effect on upper limb function and excitability of upper limb motor pathway.Methods:62 patients were randomly divided into Jiaji acupuncture group and ordinary acupuncture group by randomized control method,with 31 cases in each group,and 28 cases in each group after 3 cases in each group were lost due to illness,economy and other reasons.The control group was treated with routine medical treatment,acupuncture and rehabilitation training,while the Jiaji acupuncture group was treated with acupuncture at C4-T5 Jiaji on the affected side on the basis of the control group.Both groups were treated for 4 weeks,5 days a week,and once a day.The motor evoked potential(MEP)of abductor pollicis brevis and abductor digiti minimi,Fugl-Meyer assessment-upper extremity(FMA-UE),Modified Barthel index(MBI)and Wolf motor function test(WMFT)were compared between the two groups before and 4 weeks after treatment.Results:1.Results of MEP study of abductor pollicis brevis and abductor Digiti minimi: Compared with those before treatment,the amplitudes of abductor pollicis brevis and abductor digiti minimi after treatment in both groups were higher than those before treatment(P < 0.01),and the latent periods were shorter than those before treatment(P < 0.01),and the effect of acupuncture at Jiaji acupoint on the amplitude and latency was better than that in the control group(P < 0.05).2.Scale score results: Compared with that before treatment,the upper limb FMA-UE,MBI and WMFT scores of the two groups were improved after 4 weeks of treatment(all P < 0.01);and the scores of each scale in the Jiaji acupuncture group were significantly higher than those in the control group(all P < 0.01).Conclusions:1.Acupuncture at Jiaji acupoint can increase the MEP amplitude of abductor pollicis brevis and abductor Digiti minimi and shorten the latency of MEP in patients with upper limb motor disorder after stroke,increase the scores of FMA-UE,MBI and WMFT,improve the excitability of motor nerve pathway of upper limb after stroke,promote the recovery of motor function of upper limb and improve the quality of life of patients.2.The changes of MEP amplitude and latency of abductor pollicis brevis and abductor digiti minimi induced by TMS can be used to observe the effect of acupuncture at Jiaji acupoint on the neural pathway of upper limb,which provides an objective basis for acupuncture at Jiaji acupoint from the point of view of electrophysiology and neuroregulation.