A Study On The Network Effect Of Acupuncture Intervention On The Cerebral Hemisphere Function Of Healthy And Affected Side Of Stroke Patients Based On Graph Theory

Objective:Stroke disease seriously affects human life,and acupuncture therapy can promote the recovery of stroke disease,but its curative effect mechanism is still not clear.Yanglingquan is one of the most frequently used acupoints for the treatment of stroke.In this study,the left and right cerebral hemisphere functional networks of patients and healthy subjects were constructed separately.Based on graph theory,the topological characteristic of large-scale functional networks was analyzed,and the pathological manifestations of the affected and uninfected functional networks were described from a macro perspective.Study the adjustment effect of the instant brain effect of acupuncture on the functional network,and preliminarily uncover the mechanism of traditional acupuncture remodeling the network topology.Method:A total of 62 stroke patients whose infarct focus was located on the right side of the motor pathway and 41 healthy subjects were enrolled in this trial.The selected acupoint for acupuncture was Yanglingquan on the left.The research used functional magnetic resonance imaging(fMRI)to collect data before and after acupuncture in the resting state,construct the functional network of the left and right cerebral hemispheres of the two groups of subjects.Based on the graph theory analysis,calculated global properties,functional laterality and nodal properties of functional networks in the hemisphere.The independent-sample t-test was used to compare the network metrics between groups,and the paired-sample t-test was used to compare the network metrics before and after acupuncture intervention in the groups.Result:1.The instant brain effect of acupuncture intervention adjusted the global properties of the cerebral hemisphere functional network on the affected side(right side)and the uninfected side(left side).In the resting state before acupuncture intervention,the small-worldness of the brain hemisphere functional network on the affected side and the uninfected side was significantly lower than that of healthy subjects.In the resting state after acupuncture intervention,the area under the curve(AUC)of the uninfected functional network clustering coefficient and the clustering coefficient under certain sparsity thresholds were significantly higher than before the acupuncture intervention.Before acupuncture intervention,the average local efficiency of the brain hemisphere functional network of the affected side and the uninfected side in the resting state was lower than that of healthy subjects.In the resting state after acupuncture intervention,the average local efficiency of the uninfected side functional network was significantly higher than that before acupuncture intervention.2.Influence of the instant brain effect of acupuncture intervention at Yanglingquan acupoint on the laterality of brain function network.In the resting state before the acupuncture intervention,the physiological laterality of the brain function of healthy subjects existed,but the laterality of the brain function of the patient was not obvious.In the resting state after acupuncture intervention,the laterality of some patients was significantly enhanced compared with that before acupuncture intervention,while the laterality of healthy subjects was significantly weakened.3.Intervention of instant effects of acupuncture on the features of brain regions in the functional network of the ipsilesional and contralesional cerebral hemispheres.In the resting state before acupuncture intervention,patients with lesions on the right motor pathway were compared with healthy subjects.Some brain regions in sensorimotor(bilateral cingulate gyrus),default mode(bilateral inferior temporal gyrus),vision(contralesional lateral occipital gyrus)functional networks as well as extrapyramidal(bilateral basal ganglia,ipsilesional thalamus)had a significant decrease in the degree;while in these dorsal attention(ipsilesional upper frontal gyrus),default mode(contralesional hippocampus),executive control(contralesional parietal inferior lobule),vision(ipsilesional lateral occipital gyrus)functional networks,the degree of brain regions in functional networks was significantly increased.In the resting state after acupuncture intervention,advanced functional neural networks such as dorsal attention(ipsilesional inferior parietal lobules,middle frontal gyrus)and sensorimotor(ipsilesional central posterior gyrus),executive control(contralesional orbital gyrus),part of the brain regions in the functional network became the hub,the loss of the status of the hub brain regions mainly involves sensorimotor(ipsilesional anterior central gyrus),auditory network(contralesional middle temporal gyrus),and dorsal attention(contralesional middle occipital gyrus).In the resting state before the acupuncture intervention,the betweenness centrality of the brain regions in the cerebral hemispheric functional network of the patient was compared with that of the healthy subjects,among those sensorimotor(ipsilesional cingulate gyrus),executive control(ipsilesional inferior parietal lobules,)vision(contralesional lateral occipital lobe)and extrapyramidal(bilateral basal ganglia),the betweenness centrality of some brain regions was significantly decreased.The betweenness centrality of the brain regions in the functional network of sensorimotor(contralesional central posterior gyrus)and default mode(contralesional hippocampus)increased significantly.After acupuncture intervention,in the resting state,some brain regions in the executive control(bilateral orbital gyrus)and auditory(contralesional insula)networks became new connector hubs.In the resting state before the acupuncture intervention,the average local efficiency of the brain regions in the ipsilesional brain hemisphere functional network was significantly lower than that of the contralesional side.The local efficiency of the ipsilesional sensory motor mainly(ipsilesional middle frontal gyrus,inferior frontal gyrus,and contralesional inferior frontal gyrus)and executive control(ipsilesional orbital gyrus)in the local brain regions decreased significantly.In the resting state after acupuncture intervention,the sensory movement in the contralateral functional network(contralesional anterior central gyrus,paracentral lobules,inferior frontal gyrus,superior temporal gyrus)and executive control(contralesional orbital gyrus)functional network inner brain regions the local efficiency was significantly improved.Conclusions:Stroke causes damage to the topological organization of the large-scale functional network of the affected and uninfected cerebral hemispheres,and the small-world properties was reduced.The instant brain effect of acupuncture intervention promotes the restoration of the small-worldness.This might be the key brain effect of acupuncture therapy to regulate the functional network topology of the brain.According to this speculation,acupuncture intervention may directly affect the sensory motor and executive control functional networks in the interhemispheric cortex through the corpus callosum,forming a compensation mechanism for the contralesional cerebral hemisphere functional network.The contralesional central anterior gyrus and orbital gyrus may be important brain regions for acupuncture at Yanglingquan to promote stroke recovery.The improvement of the local efficiency of the brain regions in the functional network of the contralesional cerebral hemisphere may be one of the main mechanisms of acupuncture in the treatment of stroke.