刘军平;徐春生;卢琦;李传富;杨骏;

• 1:安徽中医药大学第一附属医院影像中心
• 2:安徽中医药大学第一附属医院针灸康复科

摘要(Abstract)：

目的研究在静息状态下周围性面瘫患者临床针刺治疗不同病程状态下的脑区局部一致性(regional homogeneity,Re Ho)变化特点,探讨针刺治疗周围性面瘫的可能中枢整合机制。材料与方法采用静息态f MRI技术,采集32例健康志愿者及47例面瘫患者临床针刺治疗不同病程状态下(面瘫早期组、后期组及治愈组)的BOLD数据,采用Re Ho的数据后处理方法进行分析,将面瘫早期组、后期组及治愈组分别与健康志愿者Re Ho值比较,获取有统计学意义的差异脑区。结果 (1)面瘫早期组Re Ho增高的脑区有右侧额上回、额中回、额下回,左侧楔前叶、后扣带回和颞上回,Re Ho值减低脑区有右侧颞下回、楔叶和楔前叶;(2)面瘫后期组Re Ho增高的脑区有左侧SII、颞上回、额上回、中央旁小叶、楔叶、楔前叶和右侧额下回;(3)面瘫治愈组Re Ho增高的脑区有左侧中央旁小叶、梭状回和颞上回。结论大脑皮层运动前区(PMA)、辅助运动区(SMA)是周围性面瘫患者脑功能重组及代偿的关键区域,也是针刺治疗周围性面瘫患者重要的调制和关键代偿区域。

关键词(KeyWords)： 面神经麻痹;功能磁共振成像;针刺;脑

Abstract:

Keywords:

基金项目(Foundation): 国家“973”计划项目(编号:2010CB530505);; 国家自然科学基金项目(编号:81202768);; 安徽省教委重大科研项目(编号:KJ2011ZD05);; 安徽省自然科学基金项目(编号:1208085MH147);; 安徽中医学院青年科学临床基金(编号:2011qn022)

作者(Author): 刘军平;徐春生;卢琦;李传富;杨骏;

Email:

DOI:

参考文献(References)：

• [1]Vanderploeg K,Yi X.Acupuncture in modern society.J Acupunct Meridian Stud,2009,2(1):26-33.
• [2]Pandolfi M.The autumn of acupuncture.Eur J Intern Med,2012,23(1):31-33.
• [3]Deng XX,Jiang W,Wang J,et al.Investigation of brain motor functional connectivity in ischemic stroke patients after rehabilitative treatment with resting-state functional MRI.Chin J Magn Reson Imaging,2010,1(1):11-14.邓小湘,蒋雯,王君,等.利用静息态功能磁共振成像研究缺血性脑卒中患者康复治疗后运动功能网络连接的变化.磁共振成像,2010,1(1):11-14.
• [4]Zang Y,Jiang T,Lu Y,et al.Regional homogeneity approach to f MRI data analysis.Neuroimage,2004,22(1):394-400.
• [5]Oldfield RC.The assessment and analysis of handedness:the Edinburgh inventory.Neuropsychologia,1971,9(1):97-113.
• [6]Klingner CM,Volk GF,Maertin A,et al.Cortical reorganization in Bell’s palsy.Restor Neurol Neurosci,2011,29(3):203-214.
• [7]Klingner CM,Volk,Brodoehl S,et al.Time course of cortical plasticity after facial nerve palsy:a single-case study.Neurorehabil Neural Repair,2012,26(2):197-203.
• [8]Yang J,Li CF,Zhang QP,et al.Preliminary data analysis of f MRI in patients with peripheral facial palsy treated with Hegu acupuncture.J Changchun University Traditional Chin Med,2012,28(4):608-610.杨骏,李传富,张庆萍,等.合谷穴针刺周围性面瘫患者脑功能成像初步分析.长春中医药大学学报,2012,28(4):608-610.
• [9]Li C,Yang C,Sun J,et al.Brain responses to acupuncture are probably dependent on the brain functional status.Evid Based Complement Alternat Med,2013,2013:175278.
• [10]He X,Zhu Y,Li C,et al.Acupuncture-induced changes in functional connectivity of the primary somatosensory cortex varied with pathological stages of Bell’s palsy.Clin Neur,2014,25(14):1162-1168.
• [11]Yamamoto S,Takasawa M,Kajiyama K,et al.Deterioration of hemiparesis after recurrent stroke in the unaffected hemisphere:three further cases with possible interpretation.Cerebrovasc Dis,2007,23(1):35-39.
• [12]Feydy A,Carlier R,Roby-Brami A,et al.Longitudinal study of motor recover after stroke:recruitment and focusing of brain activation.Stroke,2002,33(6):1610-1617.
• [13]Yousry L,Naidich TP,Yonsry TA.Functional MRI:factors modulating the cortical activeation pattern of the motor system.Neuroimaging Clin N Am,2001,11(2):195-202.
• [14]Zhu YF,Li CF,Xu CS,et al.The study of resting-state f MRI in peripheral facial paralysis.Chin Imaging J Integrat Traditional West Med,2012,10(2):101-104.朱一芳,李传富,徐春生,等.周围性面瘫患者的静息态脑功能成像分析.中国中西医结合影像学杂志,2012,10(2):101-104.
• [15]Klingner CM,Volk GF,Maertin A,et al.Cortical reorganization in Bell’s palsy.Restor Neur Neurosci,2011,29(3):203-214.
• [16]Grefkes C,Nowak DA,Wang LE,et al.Modulating cortical connectivity in stroke patients by r TMS assessed with f MRI and dynamic causal modeling.Neuroimage,2010,50(1):233-242.
• [17]Cavanna AE,Trimble MR.The precuneus:a review of its functional anatomy and behavioural correlates.Brain,2006,129(3):564-583.
• [18]Torquati K,Franciotti R,Della Penna S,et al.Conditioning transcutaneous electrical nerve stimulation induces delayed gating effects on cortical response:a magnetoencephalographic study.Neuroimage,2007,35(4):1578-1585.
• [19]Phan L,Wager T,Taylor SF,et al.Functional neuroanatomy of emotion:a meta-analysis of emotion activation studies in PET and f MRI.Neuroimage,2002,16(2):331-348.