| Objective:On the basis of affirming the clinical efficacy of acupuncture in the treatment of subjective tinnitus,this study explored the differences between subjective tinnitus patients’ salience network and healthy people through f MRI,and further explored the mechanism of acupuncture in the treatment of subjective tinnitus.Methods:Forty patients with subjective tinnitus were recruited according to the criteria,and 40 healthy people were matched with age,gender and other factors.Patients with subjective tinnitus were treated with acupuncture,and the treatment principle was Ningshen Tongqiao.The main acupoints were SI19,GV15,GB11,GB8,GV20.Before and after acupuncture,THI,TEQ,VAS clinical observation scale scores and f MRI data were collected.Healthy people underwent f MRI data acquisition once.Verification of the effectiveness of acupuncture in treating subjective tinnitus was achieved through the analysis of clinical symptom scales.The difference of salience network between subjective tinnitus before and after acupuncture treatment and healthy people was explored by FC analysis,and the mechanism of acupuncture therapy was discussed.Results:1.Clinical scales score results:The THI score of subjective tinnitus patients after acupuncture treatment(33.15±20.22)was significantly lower than that before acupuncture treatment(56.78±20.80),and the difference was statistically significant(P<0.01).And the effective rate was 90.0%.The TEQ score of subjective tinnitus patients after acupuncture treatment(8.03±4.03)was significantly lower than that before acupuncture treatment(13.34±3.13),and the difference was statistically significant(P<0.01).And the effective rate was 92.5%.The VAS score of subjective tinnitus patients after acupuncture treatment(3.17±1.73)was significantly lower than that before acupuncture treatment(5.40±1.63),and the difference was statistically significant(P<0.01).2.f MRI data analysis results:Subjective tinnitus patients before acupuncture treatment compared with healthy people,the FC between the right anterior cingulate gyrus and left middle temporal gyrus,left superior temporal gyrus,left superior frontal gyrus and right angular gyrus were decreased;the FC between left anterior cingulate gyrus and left posterior cingulate gyrus were decreased;the FC between the right insula and the left superior temporal gyrus,the right fusiform gyrus were decreased;the FC between the left insula and left superior temporal gyrus,right hippocampus were decreased.(voxel P<0.01,cluster P<0.05,corrected with GRF)Subjective tinnitus patients after acupuncture treatment compared with healthy people,the FC between the right anterior cingulate gyrus and the left middle frontal gyrus,the left angular gyrus and the right precuneus were decreased;the FC between left anterior cingulate gyrus and left middle frontal gyrus,left thalamus,left angular gyrus,right fusiform gyrus and left middle temporal gyrus were decreased;the FC between the right insula and left postcentral gyrus,left superior frontal gyrus,right paracentral lobule,right lingual gyrus and left fusiform gyrus were decreased;the FC between the left insula and left inferior frontal gyrus,left postcentral gyrus,right fusiform gyrus,right inferior frontal gyrus,right paracentral lobule and left lenticular nucleus were decreased.(voxel P<0.01,cluster P<0.05,corrected with GRF)Subjective tinnitus patients after acupuncture treatment compared with before acupuncture treatment,the FC between the right anterior cingulate gyrus and left lingual gyrus,left thalamus were decreased;the FC between the left anterior cingulate gyrus and the right middle frontal gyrus and right superior frontal gyrus were decreased;the FC between the right insula and right middle frontal gyrus were decreased;the FC between the left insula and left middle frontal gyrus,right superior frontal gyrus were decreased.(voxel P<0.01,cluster P<0.05,corrected with GRF)Conclusions:This study suggests that the abnormal FC of salience network may be one of the neural mechanisms of subjective tinnitus.Acupuncture can regulate salience network FC,promote the functional reorganization of auditory and emotion-related brain areas such as frontal lobe,temporal lobe and thalamus,and effectively improve the clinical symptoms of subjective tinnitus patients. |
