| Objects:Compare the abnormal sites of functional strength in local brain between patients with ischemic stroke and healthy person and observe the change of local functional strength before and after acupuncture treatment by resting-state fMR1and regional homogeneity. Aim to provide new ideas and basis for clinical diagnosis, forecast and therapeutic evaluation through discussion on the key pathological process of ischemic stroke and the primary target of acupuncture.Methods:Gathered the scanning data of11patients with ischemic stroke before and after acupuncture treatment and of15healthy persons, analyzed the data by using regional homogeneity data analysis methods, and compared the differences in ReHo between the ischemic stroke patients without acupuncture treatment and the healthy persons, and the changes in ReHo of the ischemic stroke patients before and after the treatment.All subjects in the group were fMRI scanned. Conventional resting scanning mode and the GRE-EPI sequence were adopted while scanning. Subjects in the normal control group were scanned once, while subjects in the acupuncture treatment group, continuing their conventional medical treatment, began to receive acupuncture treatment the next day after scanning. After4courses, subjects in the treatment group were rescanned.Acupuncture points include Baihui (GV20), Fengchi (GB20), Hegu (LT4), Quchi (LT11), Zusanli (ST36), Yanglingquan (GB34), Xuanzhong (GB39), sanyinjiao (SP6). Patients were acupunctured once daily for a course of5days and4constant courses, with2-day rest between courses.Dosages of conventional medical treatment for the patients were adjusted according to the patients’conditions by clinicians during the treatment period.Results:1.The score of the Neurological Deficit Score (NDS) decreased significantly (P=0.000<0.05);and the Simplified Fugl-Meyer Motor Function Rating Scale (FMA) and Modified Barthel Index(MBI) increased (P=0.000<0.05),there was significant difference statistically between before and after treatment for the patients with ischemic stroke.2.Comparing the acupuncture treatment group with normal control group found that patients’ regional homogeneity lower than healthy person in anterior cingutate and Cercbelum_L(P<0.001);and higher in Cerebelum, Precuneus_L, Frontal_Inf_Tri_L,Temporal_Inf_R,Temporal_Inf_L,Cingulum_Post_L(P<0.001).3.Acupuncture treatment group compared before and after treatment:patients’ regional homogeneity was increase in Precuneus_R, Anterior Cingulate, Parallippocampal_L, Insula_R, SupraMarginal_R, SupraMarginal_L,Parietal_Inf_L, Frontal_Mid_R before treatment (P<0.001),and increase in Precentral_L, BA6, Precentral_R, Angular_L, Angular_R, Frontal_Mid_R, Occipital_Mid_R,Precuneus_L,Temporal_Sup_R, Temporal_Sup_L after treatment.Conclusions:1. There was difference in local brain functional strength between the patients with ischemic stroke and healthy person;the ReHo of brain regions in patients’affected side was decrease may associated with basal ganglia region injury in affected side;and the ReHo of the cognitive function related brain areas in unaffected side and the sports-related brain areas increased may associated with these brain areas participate in Functional reorganization of human motor cortex.2. Ischemic stroke patients had difference in local brain functional strength before and after acupuncture treatment. The secondary motor area and cognitive brain areas were activated before acupuncture treatment,and the cerebral cortex motor area was activated widely after acupuncture treatment,the compensation of the brain areas related to cognitive function was weakened.3.The effectiveness of acupuncture treatment on ischemic stroke may relate to the increase of the ReHo in cortical motor areas and cognitive function related brain areas of the ischemic stroke patients. |
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