Effect of acupuncture therapy on cortical activation in stroke patients with hemiplegia based on fNIRS

ZHANG Simin; HUO Congcong; SHAO Guangjian; LIN Jun; LI Zengyong; ZHAO Haihong; ZHANG Xuemin

doi:10.16306/j.1008-861x.2024.04.003

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Effect of acupuncture therapy on cortical activation in stroke patients with hemiplegia based on fNIRS

Special column on acupuncture research | 更新时间：2024-08-13

- Effect of acupuncture therapy on cortical activation in stroke patients with hemiplegia based on fNIRS
- Academic Journal of Shanghai University of Traditional Chinese Medicine Vol. 38, Issue 4, Pages: 17-24(2024)
- 作者机构：
  
  1.国家康复辅具研究中心附属康复医院（北京　100176）
  2.国家康复辅具研究中心，民政部神经功能信息与康复工程重点实验室（北京　100176）
  3.佛山大学机电工程与自动化学院（广东　佛山　528000）
  4.佛山健翔骨伤医院（广东　佛山　　　　　　528200）
- 作者简介：
- 基金信息：
- DOI：10.16306/j.1008-861x.2024.04.003
  CLC：
- Published：25 July 2024，
  
  Received：11 December 2023，
  
  Revised：14 March 2024，
- 稿件说明：
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张嗣敏,霍聪聪,邵广健等.基于fNIRS探究针刺治疗对脑卒中偏瘫患者脑皮层激活的影响[J].上海中医药大学学报,2024,38(04):17-24.

ZHANG Simin,HUO Congcong,SHAO Guangjian,et al.Effect of acupuncture therapy on cortical activation in stroke patients with hemiplegia based on fNIRS[J].Academic Journal of Shanghai University of Traditional Chinese Medicine,2024,38(04):17-24.
张嗣敏,霍聪聪,邵广健等.基于fNIRS探究针刺治疗对脑卒中偏瘫患者脑皮层激活的影响[J].上海中医药大学学报,2024,38(04):17-24. DOI： 10.16306/j.1008-861x.2024.04.003.

ZHANG Simin,HUO Congcong,SHAO Guangjian,et al.Effect of acupuncture therapy on cortical activation in stroke patients with hemiplegia based on fNIRS[J].Academic Journal of Shanghai University of Traditional Chinese Medicine,2024,38(04):17-24. DOI： 10.16306/j.1008-861x.2024.04.003.

摘要

目的

基于近红外脑功能成像技术（fNIRS）观察脑卒中偏瘫患者肢体针刺治疗诱发脑皮层特异性激活响应的特征，初步探讨针刺疗法可能的神经机制。

方法

纳入19例脑卒中偏瘫患者，根据患者的运动功能障碍严重程度将其分为相对轻度受损组（MI组）10例和相对重度受损组（SI组）9例。所有患者均对患侧肢体进行针刺干预，分别于针刺前静息态及针刺治疗过程中运用32通道fNIRS系统检测患者的大脑双侧前额叶和运动相关皮层的脑血氧参数，采用时频分析方法计算fNIRS信号中感兴趣频段振荡幅值信息，以此分析肢体针刺诱发的脑功能激活响应特征。通过组内和组间比较，重点研究针刺诱发不同运动障碍严重程度患者的脑功能特异性响应特征。

结果

组内分析结果显示，与静息态相比，针刺状态下MI组患者非受累侧半球运动区的通道（Ch）26激活相应显著增加（

0.05）；针刺状态下SI组患者受累侧半球前额叶和运动区的Ch1、Ch3、Ch5、Ch14、Ch15激活响应均显著增加（

0.05），非受累侧半球前额叶和运动区的Ch11、Ch23激活响应亦显著增加（

0.05）。组间分析结果显示，SI组患者由针刺治疗诱发的大脑皮层激活响应在Ch11、Ch13、Ch24、Ch25均显著大于MI组。相关性分析结果显示，MI组患者由针刺治疗诱发的位于前额叶和运动区皮层的激活变化量与患者上下肢运动功能表现呈显著负相关。

结论

针刺治疗可诱发脑卒中偏瘫患者双侧大脑激活响应，且运动功能重度受损患者较轻度受损患者在针刺状态下其大脑皮层激活响应更为显著，尤其是受累侧半球。

Abstract

Objective： To observe the cortical specific activation response characteristics induced by limb acupuncture in stroke hemiplegic patients based on functional near-infrared spectroscopy （fNIRS）， and preliminarily explore the possible neural mechanisms of acupuncture therapy.

Methods

Nineteen stroke hemiplegic patients were included， who were divided into the relatively mildly impaired group （MI group， 10 cases） and relatively severely impaired group （SI group， 9 cases） according to the severity of motor dysfunction. All the patients were intervened by acupuncture on the affected side limb. In the resting state before acupuncture and during the acupuncture course， the cerebral blood oxygen parameters in the bilateral prefrontal and motor-related cortex of the patients were detected by 32-channel fNIRS system， and the interested oscillation amplitude in the fNIRS signal was calculated by time-frequency analysis method， in order to analyze the response characteristics of brain activation induced by limb acupuncture. Through intra-group and inter-group comparisons， the specific response characteristics of brain function induced by acupuncture in patients with different severity of movement disorders were focused on.

Results

The results of intra-group analysis showed that， compared with the resting state， the activation response of Channel （Ch）26 in the motor cortex of non-affected side was significantly increased in the MI group in the acupuncture state （

0.05）； in the acupuncture state， the activation responses of Ch1， Ch3， Ch5， Ch14 and Ch15 in the frontal lobe and motor area of affected side were significantly increased in SI group （

0.05）， and the activation responses of Ch11 and Ch23 in the frontal lobe and motor area of non-affected side were also significantly increased （

0.05）. The results of inter-group analysis showed that， the cortical activation responses of Ch11， Ch13， Ch24 and Ch25 induced by acupuncture in the SI group were significantly higher than those in the MI group. The results of correlation analysis showed that， the activation changes in the frontal lobe and motor area cortex induced by acupuncture in the MI group were significantly negatively correlated with the upper and lower limb motor function performance of the patients.

Conclusion

Acupuncture can induce a bilateral brain activation response in stroke hemiplegic patients， and the cortical activation responses in the acupuncture state of the patients with severely impaired motor function were more significant than those of the patients with mildly impaired motor function， especially in the affected hemisphere.

关键词

脑卒中偏瘫针刺脑功能成像激活响应中医康复

Keywords

stroke hemiplegiaacupuncturebrain function imagingactivation responserehabilitation of traditional Chinese medicine

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