Exploring The Changes Of Brain Structure And Function Of Patients With Post-stroke Sensory Impairment Induced By Acupuncture Based On Graph Matching Metho

Objective:Based on the graph theory,this study used a graph matching method to analyze the wholebrain structural and functional connectomes of patients with post-stroke somatosensory deficits and healthy subjects before and after acupuncture treatment,and to analyze the underlying mechanism of acupuncture effect on large-scale brain structural and functional reorganization in stroke patients.Methods:This study included 25 chronic ischemic stroke patients with unilateral limb somatosensory deficits and 22 age and gender matched healthy subjects as controls.At enrollment,demographic information was collected from both groups of subjects,and several clinical scales were used to assess the overall mental,motor,and sensory function of the stroke patients.Subjects in both groups received acupuncture treatment 3 times a week for 1 month.Diffusion tensor imaging(DTI)and functional magnetic resonance imaging(fMRI)data were collected from both groups before and after acupuncture treatment,and clinical scales were used to evaluate the sensory function of the stroke patients after acupuncture treatment.Using DTI and fMRI data,whole brain structural and functional connectomes were constructed for stroke patients and healthy subjects before and after acupuncture,respectively.The structural and functional connectomes were analyzed by applying a graph matching algorithm to obtain structural and functional remapping results for different brain regions.The results of healthy subjects were most controlled,and the corresponding thresholds were set and removed in the results of stroke patients.The graph matching results of structural and functional connectomes in stroke patients were analyzed from multiple per_spectives at the individual level,brain network level and brain region level,and the graph matching results were correlated with the results of clinical scales of sensory function.Results:(1)After acupuncture,the outcome of clinical sensory scales stroke patients(p=9.6e-06)were significantly improved compared with those before acupuncture.The differences of each subdivision including light touch(p=0.00078),temperature(p=0.00034),pinprick(p=0.00052),pressure(p=0.00158),and position(p=0.00046)were statistically significant compared with those before acupuncture treatment.(2)At the individual level,the occurrence of structural(p=0.04913)and functional(p=0.00243)remapping had a linear relationship with sensory function recovery scores,and a linear regression model with interpretability(R2=0.4014)was fitted between the frequency of structural remapping and the frequency of functional remapping as dependent variables and the sensory function recovery scores.(3)At the brain network level,self-remapping was a common feature of both structural and functional connectives,but only the frequency of self-remapping of functional connectives was significantly and positively correlated with sensory function recovery scores(r_s=0.4414,P=0.02718),and it was mainly concentrated in the ipsilesional default mode network(r_s=0.5844455,P=0.002155)and the contralesional visual network(r_s=0.5960624,P=0.001665),and the contralesional sensorimotor network(r_s=0.5715967,P=0.002838).In addition,eponymous brain network remapping across the hemispheres was also a prominent feature in functional connectomes,where the ipsilesional-contralesional sensorimotor network(r_s=0.5241263,P=0.007159)as well as the contralesional-ipsilesional sensorimotor network(r_s=0.6157546,P=0.00105)were significantly and positively correlated with sensory function recovery scores.(4)A significant positive correlation between structural self-remapping frequency and functional self-remapping frequency could be found at the brain region level((r=0.2930893,p=4.379e-10).Conclusions:The results showed that acupuncture treatment significantly improved post-stroke somatosensory deficits,with statistically significant improvements in the scores of deep and superficial sensory deficits,such as light touch,pressure,pinprick,temperature and position perception.After acupuncture treatment,remapping of brain regions in their own brain networks was found in most brain networks in both structural and functional connectomes,and the occurrence of this self-remapping in functional connectomes can be considered to be based on structural self-remapping.Functional self-remapping may be one of the mechanisms of sensory function recovery after acupuncture,which may be due to the localized brain regions of the lesion acting as functional compensator_s.In addition to this,acupuncture treatment triggered eponymous network remapping across the hemispheres in the functional connectome,suggesting that acupuncture treatment may induce functional remodeling in the bilateral cerebral hemispheres.After remapping occur_s in the bilateral brain via the corpus callosum pathway,the interhemispheric imbalance caused by stroke can be corrected to achieve sensory function recovery.Among all brain networks,self or cross-hemispheric homonymous remapping of the sensorimotor network can be considered as a key mechanism for the onset of acupuncture,which may be a compensatory mechanism for the damaged sensory system.These results provide new insights into neuroplasticity mechanisms and potential therapeutic strategies targeting specific brain regions from the per_spective of structural and functional remapping.