The MRI Study Of Brain Functional Connectivity About Combining Acupuncture With Medicine In Treating Parkinson’s Disease

ObjectiveTo study the conditions of brain functional connectivity in the resting state in PD patients treated combining acupuncture with medicine by using fMRI, and investgating the mechanism of acupuncture doing in PD, in order to give the imaging evidence of acupuncture in the treatment of PD.MethodsAll the study cases were recruited from PD special clinic department of Guangdong Province Hospital of Traditional Chinese Medicine. The 30 PD patients meeting the conditions were allocated randomly to 2 groups. The 2 groups include the acupuncture group (treated by acupuncture and taking levodopa) and the control group (treated by sham acupuncture and taking levodopa).collecting the brain functional images in the resting state of 2 groups PD patients. SPSS19.0 was used to analyze the patients’basic information datas and scale scores which included gender, age, family history, Minimum Mental State Examination (MMSE), Beck Depression Inventory (BDI), UPDRS Ⅱ,UPDRS Ⅲ and PDQ39 score of before and after treatment. Making preprcessing and relevant statistical analysis for the brian functional images with Statistical Parametric Mapping (SPM8), Res ting-state fMRI data analysis toolkit(REST), Data Processing Assistant for Resting-State fMRI (DPARSF) and other standard data processing software. Then selected bilateral putamens as the seed point, using the functional connectivity method to analyze the change of 2 groups patients, whose functional connectivity of bilateral putamen connecting with whole brain before and aftertreatraent. Lastly the functional connectivity result were compared within and between 2 groups.Results1. The score datas of patients’age, gender, family history,MMSE, BDI, UPDRSII, UPDRSIII and PDQ39 were compared between the 2 groups. It showed that there was not any significant difference among the datas, so the study baseline was uniform.2. Respectively compared the clinical outcomes of UPDRSⅡ, UPDRSⅢ and PDQ39 scores of 2 groups before and after treatment. The result showed that it was statistically significant in the acupuncture group, but not in the control group.3. Compared the clinical outcome indicators of 2 groups after treatment. Results showed that there was a significant difference in the UPDRSIII and PDQ39 index between two groups, and there was no significant difference in the UPDRS Ⅱ indexes between the two groups.4. Selected the bilateral putamens as Seed point, and then compared the brain functional connectivity outcome within group and between 2 groups after treatment.(1)The comparison within group before and after treatment:The functional connectivity with the bilateral putamens was negative in the brain areas of Precentral_R, Postcentral_R, SupraMarginal_R, Paracentral_Lobule_R, Supp_Motor_Area_R and Precuneus_R in the acupuncture group, but no significant statistical difference in the sham acupuncture group.(2)The comparison between groups before and after treatment:Compared the difference value of brain functional connectivity of the 2 groups before and after treatment, the result showed that there is no significant statistical difference.Conclusion1. Results showed that there was a significant difference in the UPDRSⅢ and PDQ39 index between two groups after acupuncture treatment, it means that combining acupuncture with medicine doing in the treatment of PD is better than medicine does, so we can know that the acupuncture can improve the motor function of PD patients, and the acupuncture can do well in the adjuvant treatment of PD.2. Acupuncture adjuvant treatment can cause difference of brain functional connectivity change in PD patients.3. Acupuncture as the adjuvant treatment of PD may play a part in the Cortex-Striatum loop and Substantia nigra-Striatum loop which precentral gyrus,paracentral lobule and supplementary motor area all haved Participated to adjust the motor function of patients.4. Acupuncture as the adjuvant treatment of PD may through the role of the postcentral gyrus and paracentral lobule to adjust somatosensory function of the patients.5.Acupuncture as the adjuvant treatment of PD may through the role of the precuneus and supramarginal gyrus of default mode brain network to adjust the advanced cognition and emotional function of the patients.