| Objective:The purpose of this study is to use a new imaging treatment method to study the brain function network of patients with ischemic stroke in acute stage,combined with the score of syndrome scale of traditional Chinese medicine,to explore the characteristics of homologous brain function network of sthenia syndrome and the mixed asthenia and sthenia syndrome,to provide preliminary imaging basis for syndrome differentiation of traditional Chinese medicine.Methods:Patients with acute ischemic stroke who were hospitalized in the first ward of Department of Encephalopathy,Dongzhimen Hospital of Beijing University of Chinese Medicine from November 2018 to February 2021 were collected.On the day of admission,the relevant data(including demographic information,stroke symptoms and concomitant symptoms,four diagnostic information)were collected,and the subjects were included according to the inclusion and exclusion criteria.Patients were diagnosed with TCM syndrome factors,and all patients were divided into sthenia group and the mixed asthenia and sthenia group according to the absence or presence of asthenia syndrome including qi deficiency,yin deficiency.All patients were evaluated by quantitative scale of syndrome factors of apoplexy,limb function was evaluated by score of National Institutes of Health Stroke scale(NIHSS),living ability was evaluated by BI index,MRI scan was performed,and nuclear magnetic resonance data of structural image and resting-state functional image were collected.The collected macroscopic data(demography,medical history,scale score)were statistically analyzed by SAS 9.4 and Excel 2020,and the collected NMR data were automatically processed by Freesurfer and fMRIPrep software package,the preprocessed data were projected onto fsaverage4,and the toolbox(matlab-based)for mapping homologous functional regions across individuals was used for personalized segmentation to extract homologous region of interest.The brain functional network was constructed by using the BrainNetClass package,and the network connections that contributed to the two groups were found and visualized.Results:A total of 46 patients with acute ischemic stroke were collected,and 5 patients were excluded because of unqualified imaging data.41 patients were included in the statistics,20 patients in the sthenia group and 21 patients in the mixed asthenia and sthenia group.The main results were as follows:(1)Among the 41 patients with acute ischemic stroke,there were 30 males and 11 females,the proportion of male patients was higher than that of female patients.The average age of males was(60.57±10.74)years,and the average age of females was(75.27±9.10)years,the age of female was significantly higher than that of male(P<0.01).(2)According to the statistical analysis of the general data of both sthenia group and the mixed asthenia and sthenia group,most of the male patients were classified into the sthenia group and the female patients were classified into the mixed asthenia and sthenia group(P<0.01).The age of the patients in the mixed asthenia and sthenia group was higher than that in the sthenia group(P<0.01).The number of patients who smoked into the sthenia group was more than that in the mixed asthenia and sthenia group(P<0.01).The lesion sites in the sthenia group were mainly concentrated in the left lateral paraventricular,followed by the left centrum ovale and the right posterior limb of internal capsule,while the lesion sites in the mixed asthenia and sthenia group were mainly concentrated in the right lateral paraventricular,followed by the right centrum ovale,the right posterior limb of internal capsule and the left lateral paraventricular,and the lesion range in the mixed asthenia and sthenia group was larger than that in the sthenia group.(3)In the acute stage of ischemic stroke,the frequency of syndrome factors from high to low is phlegm-dampness,internal wind,internal fire,blood stasis,qi deficiency,yin deficiency,and most of them are compound syndromes.In the combination of syndrome elements,the combination of internal wind+internal fire+phlegm-dampness+blood stasis is the most,followed by internal wind+internal fire+phlegm-dampness.The correlation analysis between the quantitative score of syndrome factors and NIHSS score between the two groups showed that there was no significant difference between the two groups(P>0.05).(4)A total of 114 pairs of meaningful network connections are obtained by using BrainNetClass software package,and the first 10 most characteristic network connections are selected to compare and analyze the two groups.It is concluded that the network connections related to sthenia group are as follows:the connection between the default network and the attention network,the visual network,the sensorimotor network,the connection between the attention network and the sensorimotor network,the central executive network,the connection between limbic network and sensorimotor network.The network connections related to mixed asthenia and sthenia group are:the connection within the attention network and the central execution network,the connection between the central execution network and the sensorimotor network,the connection between the attention network and the limbic network.Conclusion:There are some differences in brain function network between sthenia syndrome and the mixed asthenia and sthenia syndrome in acute stage of ischemic stroke,which are as follows:(1)the connection within the same network,especially within the attention network,is more specific for the syndrome of the mixed asthenia and sthenia,suggesting that patients in the group of mixed asthenia and sthenia syndrome are more sensitive to various stimuli and may be more prone to emotional changes.(2)the connection between the default network and its antagonistic network is more specific for sthenia syndrome,suggesting that the advanced neural function of sthenia syndrome is poor,and may be more prone to abnormal consciousness and cognition. |
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