针刺阳陵泉对中风偏瘫静息脑网络响应特征的多元Granger因果分析研究

发布时间：2018-06-11 11:28

本文选题：功能磁共振成像 + 静息态　；参考：《北京中医药大学》2016年博士论文

【摘要】：目的：本研究基于功能磁共振(fMRI)技术,以阳陵泉穴为切入点,从多个静息态脑网络层面,探讨针刺阳陵泉对中风偏瘫患者静息态的脑功能网络间效应连接的响应特征,以期为中医方法促进中风脑功能重塑研究提供数据支撑。方法：研究共纳入19例中风偏瘫患者,以及与之相匹配的健康受试者17例,其中中风患者分别进行静息态、针刺态的核磁扫描,健康受试者进行静息态扫描。应用独立成分分析提取静息态多个脑功能网络,并通过对比分析中风偏瘫患者和健康受试者脑网络内的功能连接的特点,探讨中风偏瘫患者脑功能网络变化的异常特征。在此基础上,采用格兰杰因果分析进一步探讨针刺对中风偏瘫多个脑网络间的调节效应。结果：1.本研究基于独立成分分析方法提取的静息态脑网络主要包括7个：左侧额顶叶网络(LPFN)、右侧额顶叶网络(RPFN)、前默认网络(aDMN)、后默认网络(pDMN)、感觉运动网络(SMN)、突显网络(SN)、视觉网络(VN)。2.中风偏瘫患者脑功能网络内功能连接的变化特征：与健康受试者相比,中风偏瘫患者脑功能网络内的功能连接度既有增强也有减弱,其中增强的脑区主要位于病灶侧,健侧脑只有左侧额顶叶网络和前默认网络少量脑区呈现功能连接增强,大部分均表现为功能连接减弱,并且不同的脑网络成分存在相同的脑区但(或)呈现不同功能连接的变化。3.中风偏瘫患者脑功能网络间效应连接的变化特征：与健康受试者相比,中风偏瘫患者脑网络间呈现了更加复杂的效应联系,其中在突显网络和感觉运动网络之间以及右侧额顶叶网络和前默认网络之间的因果效应与健康受试者存在显著性差异(P0.05)。4.针刺对中风偏瘫患者脑网络间的调节效应：针刺前中风偏瘫脑网络之间以左侧额顶叶网络输入信息最多,默认网络输出信息最多,而针刺后能翻转脑网络之间的这种因果联系,使左侧额顶叶网络输出信息最多,默认网络输入信息最多,具体表现为翻转了左侧额顶叶网络与前默认网络、后默认网络、突显网络的效应连接方向,翻转了后默认网络与左侧额顶叶网络、右侧额顶叶网络、突显网络的效应连接方向,同时减少了左侧额顶叶网络与右侧额顶叶网络、感觉运动网络的效应连接,减少了前默认网络与后默认网络、视觉网络的效应连接,增加了左侧额顶叶网络与视觉网络、前默认网络的效应连接,增加了前默认网络与感觉运动网络的效应连接,增加了感觉运动网络与突显网络的效应连接,增加了右侧额顶叶网络与视觉网络的效应连接；针刺后左侧额顶叶网络输出信息给前默认网络,前默认网络又将信息输出给感觉运动网络,由此形成部分信息传递环路；其中在左侧额顶叶网络和前默认网络、视觉网络和感觉运动网络、后默认网络和左侧额顶叶网络以及突显网络和后默认网络在针刺前后存在显著性差异(P0.05)。结论：中风偏瘫患者存在多个静息脑网络功能连接度的变化,既有增强也有减弱,在一定程度上反映了脑功能网络的损伤与重组并存；中风偏瘫患者在脑网络内和网络间均存在异常的变化特征,相同的脑区在不同的脑网络内的功能连接度呈现不同的变化特征,可能是脑网络间产生效应联系的基础；针刺对多个脑网络有调节效应,可能通过默认网络这个中继站进行高级认知网络和感觉运动网络之间的信息传递,从而对脑网络效应进行重新整合发挥调节作用。
[Abstract]:Objective: in this study, based on functional magnetic resonance (fMRI) technology and taking the Yang Mausoleum point as the breakthrough point, the response characteristics of the acupuncture of Yang Mausoleum to the resting state of apoplectic hemiplegia in the resting state of apoplexy patients were studied from the resting state brain network level, so as to provide data support for the study of the study of the reconstruction of stroke brain function by traditional Chinese medicine. A total of 19 patients with apoplectic hemiplegia and 17 healthy subjects matched with them, including resting state, acupuncture state magnetic scan and resting state scanning, were carried out by healthy subjects. Several brain functional networks were extracted by independent component analysis, and the patients with apoplectic hemiplegic and healthy subjects were compared and analyzed. On the basis of Grainger causality analysis, the effects of acupuncture on multiple brain networks of apoplectic hemiplegia were further investigated by Grainger causality analysis. Results: the rest of the rest state brain network based on independent analysis method was the main study. 7: left frontal lobe network (LPFN), right frontal parietal lobe network (RPFN), pre default network (aDMN), post default network (pDMN), sensorimotor network (SMN), network (SN), visual network (VN).2. patients with apoplectic hemiplegic brain functional network function connections: compared with healthy subjects, cerebral functional networks of stroke hemiplegic patients The functional connectivity is both enhanced and weakened. The enhanced brain area is mainly located on the lesion side. Only the left parietal lobe and a small number of brain areas in the front are enhanced, most of which show functional connectivity, and different brain networks have the same brain area but (or) different functions. Changes in the brain function connection between the stroke hemiplegic patients with.3. and the changes in the relationship between the brain function connections of the stroke hemiplegic patients: compared with the healthy subjects, the brain networks of the apoplectic hemiplegic patients have a more complex effect relationship, including the causal effects and health between the prominent network and the sensory network and the right frontal parietal network and the pre default network. The subjects have significant difference (P0.05).4. acupuncture on the brain network of stroke hemiplegic patients. Before acupuncture, stroke hemiplegic brain network input the most information with the left frontal parietal network, the default network output the most information, and after acupuncture can flip the causal link between the brain network and make the left frontal parietal network output letter. The default network input information is the most, which turns out to reverse the left frontal parietal network and the pre default network, and then the default network, which highlights the network effect connection direction, overturns the default network and the left frontal parietal network, and the right frontal parietal network shows the connection direction of the network, while reducing the left frontal lobar network and the network. The right frontal parietal network, the effect connection of the sensorimotor network, reduces the effect connection between the default network and the post default network, the effect connection of the visual network, increases the effect connection between the left frontal parietal network and the visual network, the pre default network, increases the effect connection between the pre default network and the sensorimotor network, and increases the sensorimotor network and the sudden outburst. The effect connection of the explicit network increases the effect connection between the right frontal parietal network and the visual network; after the acupuncture, the left frontal parietal network outputs information to the pre default network, and the former default network outputs the information to the sensorimotor network, thus forming a partial information transfer loop; in the left frontal parietal network and the former default network, vision There is a significant difference between the default network and the left frontal parietal network, the display network and the post default network before and after acupuncture (P0.05). Conclusion: the changes in the functional connectivity of multiple resting brain networks in patients with apoplectic hemiplegia are both enhanced and weakened to a certain extent, reflecting the loss of brain functional networks to a certain extent. The injury and reorganization coexist; the stroke hemiplegic patients have abnormal changes in the brain network and the network, and the functional connectivity of the same brain area in different brain networks is different. It may be the basis for the effect of the brain network, and the acupuncture has a regulatory effect on multiple brain networks, which may pass through the default network. The relay station carries out the information transmission between the advanced cognitive network and the sensory network, thereby reintegrating the brain network effect and playing a regulatory role.
【学位授予单位】：北京中医药大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R246.6

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