Altered Brain Regional Homogeneity Following Contralateral Acupuncture(CAT) Stimulation At Quchi(LI11) And Zusanli(ST36) In Stroke Patients With Left Hemiplegia:A FMRI Study

ObjectiveTo study the influence of contralateral acupuncture(CAT)at Quchi(LI 11)and Zusanli(ST36)on the unaffected limb of stroke patients with left hemiplegia that be based on Regional Homogeneity indices.To explore the central mechanism of CAT method in the pathological state,and to provide a preliminary imaging basis for the mechanism of CAT method.MethodsFrom October 2017 to December 2018,10 patients with left limb hemiplegia after ischemic stroke,mainly in the right basal ganglia region,were enrolled in the First Affiliated Hospital of Guangzhou University of Chinese Medicine.The experiment was completed in MR room of imaging department in the hospital.A patient laid on the MR examination bed,closed the audio-visual state,and after a five-minute break,the fMRI whole brain scan was performed in the non-intervention state,and the images were collected as a blank control.After the blank data scanning was completed,patient withdrew from the examination bed.After routine disinfection of right Quchi acupoint and Zusanli acupoint by two physicians,the needle was simultaneously injected with a tube.After removing the tube,stabbed the needle for 15±2mm,evenly lifted and inserted the needle while twirling for 15 minutes.The second fMRI scan was performed immediately after the needle was removed without bleeding.After scanning completed,the patient were asked to recall the needle sensation after exiting the examination bed.Acupuncture situation was recorded in detalis referring to the MASS record of acupuncture sensation in the acupuncture test of Massachusetts general hospital.Statistically,in MATLAB 7.8 platform,resting state fMRI processing assistant was used to preprocess fMRI data.ReHo was analyzed by using REST software.Slice Viewer Xjview graphics plug-in was used to identify the anatomical position and T value of the brain region coordinates activated in the MNI template.The single sample t test developed by SPM8 software was used to compare the ReHo values of brain regions before and after CAT.For needle sense,SPSS 22.0 software was used to conduct statistics on the needle sense score of Quchi(LI 11)and Zusanli(ST36)by using single sample t test to evaluate the difference of needle sense degree between the two points.As for the types of needling sensation,histogram was used to show the dominant needle sense.ResultsCAT at Quchi point and Zusanli point at the right side elicited increased ReHo value at the right precentral gyrus(BA4)and superior frontal gyrus(SFG.R),decreased ReHo value at right superior parietal lobule(BA7),left fusiform gyrus(BA37)and left Supplementary motor area(SMA.L)(P<0.05).ConclusionOur study demonstrates a potential neuroimaging outcome that acupuncture at one side could stimulate bilateral regions.The right precentral gyrus(BA4)may be the key brain region for CAT method at Quchi(LI11)and Zusanli(ST36).Compared to the pre-acupuncture stage,the right precentral gyrus(BA4)showed an increased ReHo in the stroke patients,suggesting that CAT is conducive to functional rehabilitation of the focal brain area.