FMRI Functional Connection Study Of Acupuncture Promoting Motor Function Recovery In Patients With Ischemic Stroke

Objective:Ischemic stroke is one of the most common causes of death and morbidity in the world.It is caused by inadequate blood supply to local or large areas of the brain tissue,which ultimately results in a sudden loss of motor control.Despite intensive rehabilitation,more than half of stroke patients show persistent dyskinesias.Previous studies have shown that structural and functional disorders exist in the peripheral and distal areas of the bilateral cerebral hemispheres after ischemic stroke.After functional recovery in stroke patients,increased activity was found in the primary motor cortex?M1 region?.However,the role of M1 in post-stroke exercise recovery remains controversial.M1 works with other sports and subcortical areas to participate in the planning and execution of operations.Therefore,determining the role of M1 in exercise recovery is a challenge in the current field of stroke.The connectivity-based approach will provide an opportunity to determine the role of M1 in post-stroke recovery.Previous studies have focused on changes in brain connectivity after stroke,but little attention has been paid to longitudinal changes in brain functional connectivity?FC?in patients with stroke after acupuncture.Resting-state functional magnetic resonance?rs-fMRI?was used to observe the change characteristics of cerebral FC in patients with ischemic stroke,and to explore the possible remodeling mechanism of acupuncture therapy in the recovery of motor function in stroke,so as to provide a research basis for optimizing the treatment scheme of hemiplegia after strokeMethods:This study included 21 patients with first stroke and motor limb dysfunction of the right limb?stroke group?,all of which were lesions of single subcortical motor pathway injury,and 18 healthy subjects?the healthy control group?with matching age,gender and educational level were recruited.All patients with stroke received acupuncture,routine drug therapy and rehabilitation training.The M1 was selected as the seed point to compare the differences of FC between the bilateral M1 region and the whole brain in two group.then Pearson correlation analysis was performed on the abnormal FCS and FMA scores.Results:?1?Compared with the healthy control group,the patients in stroke group before treatment showed the extensively weak FCS between the left M1 area and the right central anterior gyrus,the left central posterior gyrus,the right superior frontal gyrus,the right middle frontal gyrus,the right inferior frontal gyrus,the left inferior margin angular gyrus,the right insula,and Cerebelum₇b_R,but the Cerebelum_6L was enhanced.FCS were reduced between the right M1 region and the left central anterior gyrus,the right central anterior gyrus,the left central posterior gyrus,the right central posterior gyrus,the right orbital medial frontal gyrus,the right inferior marginal angular gyrus,the right inferior temporal gyrus,but the Cerebelum_Crus2_R was enhanced.?2?Compared with before and after acupuncture treatment in the stroke group,FCS were enhanced between the left M1 region and the right central anterior gyrus,the right frontal gyrus,but the left medial temporal gyrus and the left anterior cingulate and the paracingulate gyrus were reduced.FCS were enhanced between the right M1 region and the right anterior central gyrus,the right posterior central gyrus,the right orbital superior frontal gyrus and the right middle temporal gyrus,but the right hippocampus and the right amygdala were reduced.?3?FMA scores were significantly improved in stroke patients after acupuncture treatment?t=-8.595,P<0.001?.FCS of the right anterior central gyrus after acupuncture were positively correlated with FMA scores after treatment in the stroke group?r=0.523,P=0.015?.Conclusion:?1?The FC of bilateral M1 in patients with stroke was significantly weaker than that in the control group.These areas of weakened FC occurred not only in the brain regions directly related to exercise,but also in the brain regions related to cognitive function,which may be the neural basis for sports injury in stroke patients.?2?Acupuncture can effectively promote functional recovery in patients with ischemic stroke.Acupuncture significantly increased the FC of bilateral M1,which may be a remodeling mechanism of acupuncture to promote motor function recovery in patients with stroke.?3?The FC value of the right central anterior gyrus after acupuncture can be used as an important imaging index to evaluate the effect of acupuncture stroke recovery.