| Objective:Based on resting fMRI and graph theory,this study analyzed the difference of the pathogenesis between the patients with wind phlegm blocking collaterals syndrome and the patients with Qi deficiency and blood stasis syndrome in the acute stage of cerebral infarction,and the effect of Huatan Tongluo Decoction on the changes of brain network in the patients with wind phlegm blocking collaterals syndrome.The purpose of this study is to explore the characteristics of brain network in different syndromes of cerebral infarction and the mechanism of neural network effect of Huatan Tongluo decoction.Methods:This study was divided into two parts.26 cases of acute cerebral infarction were included in the study 1,including 17 cases of wind phlegm obstruction syndrome and 9 cases of qi deficiency and blood stasis syndrome.At the same time,10 healthy subjects matched by gender and age were included.The general data of patients were collected and the patients were examined by fMRI.Study 2 included 18 patients with wind phlegm obstruction syndrome of acute cerebral infarction,randomly divided into experimental group and control group.The experimental group was treated with western medicine and Huatan Tongluo decoction.The control group was only treated with conventional western medicine.On the day of enrollment and 10 days after intervention,the scale was evaluated and two fMRI scans were performed before and after treatment.Based on the graph theory analysis method,the AAL standard brain partition template was used to construct the brain function network and calculate the global topological attributes and node attributes of the brain network.By comparing and analyzing the syndrome of wind phlegm blocking collaterals,Qi deficiency and blood stasis and healthy subjects,we discussed the difference of brain network among different syndrome types of acute cerebral infarction.Through the comparative analysis of brain network before and after the treatment of wind phlegm Blocking Collaterals syndrome and the control group,we explored the effect mechanism of Huatan Tongluo Decoction on brain function network of patients with acute cerebral infarction.Results:Study 1 1.Analysis of global topological properties of brain function network:The small world attribute a of brain network in patients with wind phlegm obstruction of collaterals and Qi deficiency and blood stasis of acute cerebral infarction was greater than 1,which still had the characteristics of small world network,but both of them are significantly lower than the healthy subjects in the range of partial sparsity threshold.And the patients with Qi deficiency and blood stasis were significantly lower than the patients with wind phlegm obstruction of collaterals in the range of partial threshold.The levels of ?,Cp,Eg and Eloc in patients with Qi deficiency and blood stasis syndrome were significantly lower than those in healthy subjects at partial threshold,and ?,Lp were significantly higher than those in healthy subjects at partial threshold.The Cp and Eg of the patients with the syndrome of wind phlegm blocking collaterals were significantly lower than those of the healthy subjects at the partial threshold,and the Lp was significantly higher than those of the healthy subjects at the partial threshold.There was no significant difference in X,Cp,Lp,Eg and Eloc between the two syndromes.2.Attribute analysis of brain function network nodes:The nodal degree and the betweenness centrality of some brain regions in patients with cerebral infarction have changed,and there were differences in the brain regions with different syndrome types.The brain areas with decreased nodal degree in patients with wind phlegm obstruction syndrome were all located on the right side,while those with Qi deficiency and blood stasis syndrome were located on the left and right hemispheres.This suggested that the damage of brain network in patients with Qi deficiency and blood stasis may be more extensive.Study 2 1.Analysis of functional connection of brain network:There were significant subnetworks between the patients with cerebral infarction and the healthy subjects,which mainly showed that the functional connections of left anterior cingulate gyrus and its paraccingulate gyrus with left posterior central gyrus and left paracentral lobule were decreased.2.Analysis of global topological properties of brain function network:After treatment,the values of ?,?,Eg,Eloc in the experimental group were significantly higher than those before treatment,and ?,Lp were significantly lower in the range of individual thresholds.There was no statistical difference in ?,?,? before and after treatment in the control group.After treatment,the value of ?,in the experimental group was significantly lower than that in the control group.3.Attribute analysis of brain function network nodes:Before and after treatment,the nodal degrees of the core nodes and some brain regions in the experimental group and the control group changed.Before and after treatment in the experimental group and compared with the control group,the brain areas with higher nodal value were located in the right hemisphere,while the brain areas with lower nodal value were mainly located in the left hemisphere.This shows a partial lateralization effect.Before and after treatment,the connector hubs of the experimental group and the control group and the betweenness centrality of some brain areas changed.In the experimental group,some brain areas related to emotional and cognitive functions were increased in a central way.After treatment,the node efficiency of some brain areas in the experimental group was significantly higher than that before treatment,and there was no brain area with node degree value decreasing in the experimental group.Compared with the control group,the brain regions with higher node efficiency were located in the right hemisphere,while the brain regions with lower node efficiency were located in the left hemisphere.4.Modular analysis:Qfc and Qi in the experimental group were significantly higher than those before treatment.After treatment,the ability of module division and module division fine ability of the experimental group were higher than before treatment.5.Correlation analysis:There was a negative correlation between the difference of ? before and after treatment and the difference of BI scale.There was a negative correlation between the difference of Eg and the difference of NIHSS before and after treatment.There was a positive correlation between the difference of Lp and the difference of NIHSS before and after treatment.The improvement of neurological function after cerebral infarction may be related to the increase of information transmission efficiency.There was a positive correlation between the change of nodal degree of right putamen and the difference of BI before and after treatment.Conclusions:The brain function network of the patients with the syndrome of wind phlegm blocking collaterals and the syndrome of qi deficiency and blood stasis still has the characteristics of small world network,but its small world attributes are damaged.The damage degree of small world attribute of qi deficiency and blood stasis syndrome is higher than that of wind phlegm obstruction syndrome.The nodal degree and betweenness centrality of some brain areas in patients with cerebral infarction have changed.There are also differences in the brain regions with different syndrome types.Western medicine combined with Huatan Tongluo can improve the ability of integration and separation of brain functional network in patients with cerebral infarction,showing partial lateralization effect and the overall regulatory effect on brain functional network in terms of node attributes.Huatan Tongluo Decoction can reduce the characteristic path length of brain network in patients with acute cerebral infarction and enhance the ability of global information processing of brain network,which may be one of the mechanisms of Huatan Tongluo Decoction to promote the recovery of functional network after cerebral infarction. |
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