Recurrence-remission-type Multiple Sclerosis TCM Deficiency And Cold Syndrome Syndrome And Imaging Correlation Study

Multiple Sclerosis(MS)is a kind of autoimmune disease and the main pathological characteristic is central nervous system(CNS)inflammatory demyelinating.With the development of Western medicine examination means in recent years,the incidence and the detection rate of MS increase constantly.However the understanding of etiology and pathogenesis in MS is not clear.Western medicine has shown limitations on the cure of MS.So it is a hot topic for Chinese medicine physicians to study of MS.Now,they have formed the theoretical research for MS in Chinese medicine.And there are many achievements,such as MS naming,the etiology and pathogenesis,and the treatment.But there are no unified standard and lack of objective evidence in many theories such as the traditional Chinese medicine dialectical.Based on above analysis,we combine western advanced imaging technology with TCM syndrome types,and analysis the correlation between image information and Chinese medical syndrome,so as to provide objective evidence for differentiation of syndrome in recurrence type MS(RRMS).Research purposes:With RRMS patients as the research object of this study,the use of resting state functional mri(fMRI)and diffusion tensor imaging(DTI)technique,the rating scale in patients with different syndromes,resting state functional magnetic resonance imaging(fMRI)and diffusion tensor imaging to observe,to explore different syndrome types reflect differences in the brain functional connectivity and structural,provide objective basis for TCM syndrome differentiation of MS.Research methods:By using the method of cross-sectional study accords with the standard set of RRMS patients in the groups on the day of gathering general information,infection situation and TCM four diagnostic information,related rating scale,dialectical classification,divided into deficiency syndrome and positive group,the cold syndrome and heat syndrome group,the line head MRI scanning,fMRI thalamus,obtain conventional MRI and fMRI and DTI data,statistical analysis of clinical data with SPSS20.0.Resting state functional imaging and diffusion tensor imaging by SPM8,FSL software for processing and statistical analysis.The results of the study:This study participants included RRMS patients 21 cases.Among them,10 cases of deficiency syndrome group,positive group of 11 cases;9 cases of cold syndrome group,heat syndrome group of 12 cases.Not out and fall off.By chi-square test,t-test,nonparametric test,virtual between empirical and fever syndromes in regional distribution,gender,age,EDSS score,Barthel index,HAMD scores,PDQ scores,MSQOL-54 rating etc.There was no significant difference(P>0.05),prompted comparable between groups.Resting state functional mri aspects,P<0.001,the cluster>50,it is found that heat the cold syndrome group thalamus FC increase areas of the brain including the edge on the right side,on the right side of the cerebellum posterior lobe of the last time.Cold syndrome group is heat syndromes FC increased brain regions include the right parietal lobe,right cingulate gyrus.Empirical group of the thalamus in the deficiency syndrome group FC increase areas of the brain including the cerebellum posterior lobe on the right side,on the left side of the top lobule.Deficiency syndrome group compared with the empirical thalamus FC increased brain areas include:the right parahippocampal cortex,right fusiform gyrus,right temporal lobe,right under the pillow in the back,on the right side of the parietal lobe,right cingulate gyrus,supplementary motor area on the right side.Different syndrome compared with normal control group,the results showed that normal control group specific heat syndrome group of the thalamus FC increased brain areas include:the right side of the edge of leaf,last time on the right side of the forehead,back on the right side of the forehead.Diffusion tensor imaging,P<0.001,cluster>50,found that this group of patients with different syndromes FA value in the normal control group were significantly reduced.Virtual type empirical comparison between,deficiency syndrome group FA value increased brain areas include:the right frontal lobe,right cerebellum cone.Research conclusions:1.By resting state fMRI and DTI technology,revealed the different TCM syndrome types RRMS patients with brain functional connectivity and structural differences.2.Compared with positive group,deficiency syndrome group under the resting state activated brain regions range increased obviously,involving the brain functional area is more extensive,hints deficiency syndrome RRMS patients with compensatory mechanism may be more perfect than positive patients.3.Compared with the empirical,FA values higher regions exist deficiency syndrome group,and the empirical group without FA value increased brain regions,patients with deficiency syndrome RRMS,the integrity of the fiber bundle is better,the empirical might be more obvious than deficiency syndrome fiber bundle damage tendency.