| 1 Objective To explore the neurophysiological mechanism of traditional Chinese medical theory of “Link of HEGU(L14)with the face and mouth” and effect of acupuncture on cortical reorganization of patients with peripheral facial paralysis by task-state functional MRI during finger movements and lip pursing movements,and provide more evidence in support of clinical treatment of peripheral paralysis by acupuncture.2 MethodsThe study was divided into two parts:(1)Study of cortical reorganization of peripheral facial paralysis during acupuncture treatment by finger and lip pursing movements task-state f MRI.20 cases of peripheral facial paralysis were recruited in our study and they all signed the CRF.The whole trial was divided into three stages: before treatment,mid-term treatment and after clinical recovery.Patients with peripheral facial paralysis were assessed by HBS facial nerve functional classification of clinical efficacy.When the HBS facial nerve function grading advanced a level,it was regarded as mid-term treatment;HBS facial nerve function grade to grade ?,it was regarded as been after clinical recovery.The finger and lip pursing movements task-state f MRI was scanned three times,respectively,before treatment,mid-term treatment and after clinicalrecovery,the task of f MRI were the finger and lip pursing movements.All data were analyzed by AFNI software program(Monte Carlo correction,p = 0.05,? <0.05),and the results were analyzed and compared.(2)Cortical reorganization of patients with peripheral facial paralysis compared to healthy volunteers based on lip pursing and finger movements task-state f MRI: they were divided into facial paralysis group and healthy control group.Subjects of facial paralysis group was the same with part one,20 cases.Health control group(20)cases,without the inclusion criteria and signed informed consent.Facial paralysis group f MRI was scanned three times,the same with the part one;healthy control group was scanned once.The results of f MRI in the facial paralysis group were compared with the healthy control group before treatment,mid-term treatment and after clinical recovery.All data were analyzed by AFNI software program(Monte Carlo correction,p = 0.05,? <0.05),and the results were analyzed and compared.3 results(1)Cortical reorganization in patients with peripheral facial paralysis during acupuncture treatment based on finger and lip pursing task-state f MRI(1)peripheral facial paralysis in patients with acupuncture before treatment and treatment of medium-term movement based on the finger movement task of the state of the f MRI results,did not show the activation area;during lip pursing movement,the right side of the cerebellum,island leaves,central back,And the anterior cingulate gyrus showed decreased signal,the left central front appeared to be increased signal.(2)Comparison of the f MRI results between the mid-term and after clinical recovery of patients with peripheral facial paralysis: as conducting finger movements,the left anterior lobe of the anterior wedge appears to be increased signal,and the left and right sides of the hippocampus were decreased signal.As conducting lip pursing movements,the right side of the pillow back,cerebellum,wedge anterior lobe,left cerebellum,the central back,the middle of the back negative reaction,the right side of the island,cerebellum,both sides of the hippocampus were increased signal.(3)Comparison between mid-term treatment and after clinical recovery: During finger movements,the right side of the occipital back,central back,cerebellum,frontal gyrus and left temporal gyrus,fusiforme,wedge leaves were increased signal.During lip pursing movements,the right side of the wedge before the leaves,cerebellum,buckle back,the left side of the amount were showed decreased signal,the right side of the amount of back was increased signal.(2)Cortical reorganization in patients with peripheral facial paralysis compared to healthy control group during acupuncture treatment based on finger and lip pursing task-state f MRI(1)Differences between two groups before acupuncture treatment: During finger movement,the left cingulate gyrus and the right frontal gyrus showed increased signal and the left cerebellum showed decreased singal.During lip pursing movement,wedge leaves,fusiform gyrus,left posterior cingulate gyrus,temporal gyrus,wedge anterior leaves showed decreased signal.(2)Differences between two groups in the mid-term:During finger movement,the right side of the cingulate gyrus and the left side of the cerebellum showed increased signal.During lip pursing movement,the left side of the MI and the amount of medial back showed increased signal,the right side of the cerebellum,temporal gyrus,island leaves,the middle of the middle and both sides of the hippocampus showed decreased signal.(3)Differences between two groups after clinical recovery:During finger movement,left posterior cingulate gyrus,wedge anterior lobe,temporal gyrus,cingulate gyrus,right middle posterior gyrus,MI,temporal gyrus showed increased signal;right hippocampal gyrus showed decreased singal.During lip prusing movement,the right side of the wedge leaves,shuttle back,left back button back,temporal transverse,wedge anterior showed decreaed singal.4 Conclusion(1)Peripheral facial paralysis will lead to the reorganization of brain function in patients with acupuncture in the process of brain function continued to occur;After clinical,recovery,BP patients even if the clinical symptoms have been restored,but its brain function is still in the reorganization.(2)Patients with facial paralysis,Cortical areas related to facial movement can not complete its normal function,cortical areas related to hand movement through the compensatory enhancement to promote the recovery of facial function,which may be one central mechanism of acupuncture treatment on peripheral facial paralysis.(3)The cortical reorganizaition in patients with peripheral facial paralysis may be one of the central mechanisms of acupuncture in the treatment of peripheral facial paralysis.The reorganization of the related brain regions in the hand movement and sensation reflects the central mechanism of “link of HEGU(l14)with the face and mouth”. |
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