针刺风池对后循环缺血性眩晕患者脑部镜像同伦功能连接的影响

Effects of acupuncture at Fengchi (GB20) on voxel-mirrored homotopic connectivity in patients with posterior circulation ischemic vertigo

关键词:  风池  后循环缺血性眩晕  镜像同伦功能连接  功能磁共振

Key words:  Fengchi  posterior circulation ischemic vertigo  voxel-mirrored homotopic connectivity  Resting state functional MRI

摘要:

[目的] 基于静息态功能磁共振探讨针刺风池对后循环缺血性眩晕（PCIV）患者脑部镜像同伦功能连接（VMHC）的影响，探讨针刺风池治疗后循环缺血性眩晕的效应机制。[方法] 选取2021年1月—12月就诊于北京中医药大学东直门医院脑病科的后循环缺血性眩晕患者20例及健康对照组12例，采用眩晕障碍量表（DHI）对患者的眩晕程度进行评分，患者针刺双侧风池，针刺前、后行静息态功能磁共振扫描，健康对照组行单次静息态功能磁共振扫描；利用dpabi软件对图像进行统计学分析，采用T检验，比较患者针刺前后及与健康对照组相比脑镜像同伦连接变化，获得VMHC值有显著差异的脑区，分析差异脑区平均VMHC值与DHI评分的相关性。[结果] PCIV患者针刺后在颞下回、顶上回和楔前叶VMHC值显著升高；差异脑区平均VMHC值与DHI评分无显著相关性；PCIV患者与对照组相比，未发现VMHC值差异脑区。[结论] 针刺风池可调节前庭功能相关皮质脑部镜像同伦连接，可能是针刺风池治疗眩晕的脑功能效应机制之一。

Abstract:

[Objective] To explore the alterations in interhemispheric functional connectivity in patients with posterior circulation ischemic vertigo using resting-state functional magnetic resonance imaging (rs-fMRI) with voxel-mirrored homotopic connectivity (VMHC) algorithm,to study the effective mechanisms of Fengchi (GB20) in dealing with posterior circulation ischemic vertigo. [Methods] Twenty patients with posterior circulation ischemic vertigo and 12 healthy controls were enrolled,the patients wereto receive acupuncture at Fengchi (GB20) and rs- fMRI scans before and after the acupuncture. The healthy controls were preformed rs-fMRI scan only once. Dizziness Handicap Inventory scores(DHI) were used to evaluate the severity of vertigo in all patients. After the imaging preprocessing,VMHC values were obtained by Data Processing & Analysis for (Resting-State) Brain Imaging (DPABI) software. T test was used to compare VMHC in patients before and after needling Fengchi (GB20),and with healthy controls. Correlations were performed between VMHC values and DHI. [Results] Compared with VMHC maps before needling Fengchi (GB20),increased VMHC values were shown in inferior temporal gyrus,superior frontal gyrus and precuneus. There was no significant correlation between VMHC and DHI scores. No alteration of VMHC was found between PCIV patients and healthy controls. [Conclusion] The voxel-mirrored homotopic connectivity is different in areas connected with vestibular functions before and after needling Fengchi (GB20),indicating that may be one of the effective mechanisms for the treatment of vertigo in posterior circulation ischemic patients.