The Regulation Effect Of Acupuncture On ST25for Diarrhea-predominant Functional Bowel Disorders Patients:a FMRI Study

Objective:To observe the regulation effect of acupuncture at ST25for diarrhea-predominant functional bowel disorders (FBDs) patients in brain amplitude of low-frequency fluctuation (ALFF) by using functional magnetic resonance imaging (fMRI), and to discuss the central modulating mechanism.Methods:1.50patients are matched the inclusion criteria received acupuncture intervention including25cases of diarrhea-predominant FBDs group (group A) and25cases of healthy group (group B). The observation period lasted3weeks:1week for baseline and2weeks for intervention. Both group A and group B are accepted5sessions per week(10sessions total) of acupuncture intervention period. The acupuncture treatment was performed on ST25, which is the most commonly used acupoint for diarrhea. The clinical outcome included the following items:the times of defecation and the score of the Bristol stool form scale as the gut symptom assessments were evaluated throughout the baseline week as well as the second week of intervention, Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) as the physical assessments were evaluated at the same time only for group A.2.2times of fMRI scanning were adopted including once in3days before the course of intervention and once after the course of treatment.Results:1. After a period of treatment, the defecation frequency decreased and the score of the Bristol stool form scale were more close to normal in group A (P<0.01); and the SAS score and SDS score were not significant in group A (P>0.05). The change in defecation frequency and the score of the bristol stool form scale were not significant after acupuncture (P>0.05).2. Compared to group B, group A showed increased ALFF in bilateral Midcingulate Cortex (MCC)(BA24), left Primary Sensorimotor Cortex (SI), right Supplementary Motor Cortex (SMA), bilateral Temporal Lobe, bilateral Occipital Lobe and decreased ALFF in right MCC (BA31), Second Primary Sensorimotor Cortex(Sâ…¡), bilateral Dorsolateral Prefrontal Cortex(DLPFC), bilateral Orbitofrontal Cortex (OFC), right Inferior Parietal Lobule and Cerebellum (P<0.005).After the course of intervention, the ALFF in right Anterior Cingulate Cortex (ACC), bilateral MCC (BA31), bilateral Insula Cortex (IC), bilateral DLPFC, bilateral OFC, right Inferior Parietal Lobule, Cerebellum were increased statistically, and the ALFF in right MCC (BA24), bilateral parahippocampal gyrus, bilateral SMA, bilateral SI, bilateral Temporal Lobe, bilateral Occipital Lobe, Thalamus and Cerebellum were decreased significantly in group A (P<0.005).The ALFF in left Amygdala, left Lenticular Nucleus, left IC, right Occipital Lobe, Thalamus, Cerebellum were increased statistically and the ALFF in right DLPFC were decreased significantly in group B (P<0.005).Conclusions:1. The clinic symptoms were relieved after acupuncturing at ST25in group A, and it showed no evident effect in group B. The improvement of SAS score and SDS scores were not significant in group A.2. The changes of resting brain ALFF before and after acupuncture between two groups were significant differently. Altered brain regions in group B after acupuncture were fewer and narrower. The central mechanism of acupuncturing at ST25for treating diarrhea-predominant FBDs could be closely connected with the regulation function of the disease-related key regions.