FUNCTIONAL CONNECTIVITY OF ANTERIOR CINGULATE CORTEX WITH SENSORIMOTOR AREAS INCREASES IN THE RECOVERY COURSE OF PATIENTS WITH BELL'S PALSY

Objective:Acupuncture is a popular choice for the treatment of Bell's palsy(BP).However, most patients with BP will recover naturally by themselves.Previous studies suggested that cortical reorganization played an important role in the course of recovery, and found that anterior cingulate cortex(ACC) was closely related to face movement.Considering the ACC's role in motor performance monitoring and error detection, we hypothesized that functional connectivity of ACC would be enforced in the process of natural recovery of Bell's palsy.Methods: Task-state fMRI data were acquired from 37 healthy subjects performing the task of face movement(mouth protruding).Seed points of both sides of ACC related to face movement were first extracted from the group analysis results of the healthy, and then functional connectivity of both sides of ACCs(ipsilateral and contralateral) was analyzed with resting-state fMRI data acquired from 130 patients with different BP onset time.The correlation between the degrees of ACC functional connectivity and the onset time was finally analyzed with ANCOVA.Results: It was demonstrated that the connectivity of both sides of ACC with sensorimotor areas was increasingly enforced as the onset time became longer, and the connectivity enforcement was more significant in the contralateral than in the ipsilateral side.Increased connectivity of contralateral ACC was found in inferior parietal lobule, postcentral gyrus, precentral gyrus, middle frontal gyrus and medial frontal gyrus while increased connectivity of ipsolateral ACC was found in inferior parietal lobule, and middle frontal gyrus.Conclusion: It was concluded that the enforcement of connectivity of ACC with the sensorimotor areas, especially the enforcement of connectivity of the contralateral, might result from a compensatory mechanism and play an important role in promoting the cortical reorganization of the natural recovery of BP.     

FUNCTIONAL MAPPING OF THE HUMAN BRAIN DURING ACUPUNCTURE WITH MAGNETIC RESONANCE IMAGING SOMATOSENSORY CORTEX ACTIVATION

1NTRODUCTIONHegu(Ll4)isoneofthemosteffectiveandmostfrequentlyusedacupointsintraditionalChineseacupuncture.ItisindicatedfOrpaininmanypartsofthebody,butisparticularlyeffec-tiveforheadache,migraine,toothache,sorethroatandotherd1sordersoftheheadandface.Manyanimalexperimentsindicatethathighercentersinthenervoussystemareinvolvedinacupunctureanalgesia["2]butdirectevidenceforhumansubjectsisdifficulttoobtainuntilthere-centadventofpowerfu1andn0n-invasivemeth-odsforneuroimaginginthe9O's.Werecentlya…     

ACUPUNCTURE EFFECT ON MOTOR FUNCTIONAL CONNECTIVITY CHANGE IN FACIAL PALSY:AN fMRI STUDY

Background: Bell's palsy(BP) is common peripheral idiopathic disease that affects the facial nerve(CN VII) and causes an inability to control facial muscles on the affected side and it was known to be treated by acupuncture.We investigated acupuncture effects on the resting state brain connectivity due to neuroplasticity in patients with BP.We hypothesized that BP and acupuncture modulates motor cortex regions connectivity with other brain regions during resting state.Methods: According to disease duration and House-Brackmann score(grade the degree of nerve damage in BP), we enrolled59 BP patients(treated by acupuncture in Hegu(LI4)) in three groups: early(within two weeks after onset), later(after two weeks before recovery) and healed(after recovery).Some patients participated multiple times in different groups.We had35 healthy(normal) volunteers as control group.Two fMRI scans(pre- and post-acupuncture) using 1.5T MR scanner(Siemens Symphony, Siemens Medical, Erlanger, Germany)were applied(10 minutes resting state with 3 second TR).We used seed voxel analysis approach for investigating functional connectivity of M1 regions of mouth and forehead with other brain regions from normal to healed group.We took 4 regionsof interest(ROI), 2 right and 2 left based on our previous motor task research.Results: There were differences between later and healed in left S2, left superior and middle temporal gyrus with right forehead ROI and DLPFC and middle cingulate gyrus for left mouth ROI.And there were differences between normal and healed in left supramarginal gyrus, left S1 and M1 facial regions, left and right cuneus, and left and right lingual gyrus.Conclusion: We found functional neuroplasticity changes of brain regions connectivity with our ROIs due to the BP and acupuncture.The resulted regions are related to sensorymotor regions, motor association regions, attention and motor learning.     

猫的十字沟前皮层和 SI 区参与对中央中核针刺镇痛效应的下行性调节

<正> 我们以往工作证明,猫的十字沟前皮层参与对丘脑中央中核(CM)伤害性反应的下行性调节。本文比较了用利多卡因局部改变十字沟前皮层和 SI 区机能状态前后电针对 CM 神经元伤害性反应的影响,以探讨十字沟前皮层和 SI 区是否参与对 CM 核电针效应的下行性调节。实验用猫,硫贲妥钠麻醉下开颅,暴露右侧十字沟周围皮层,于同侧 CM 核上方颅骨钻孔。分离左侧(?)浅神经,以便施以伤害     

LONG-TIME REPEATED ACUPUNCTURE STIMULATIONS INDUCE HABITUATION IN SOMATOSENSORY CORTEX

Objective: Many fMRI studies on acupuncture have been reported in recent years, but the mechanism underlying acupuncture therapeutic effects is still under debate since heterogeneous results were reported.Most of the previous studies about brain responses to acupuncture were designed to investigate the instant effects of acupuncture stimulation while the cumulative effect, which is more important, has seldom been investigated.In this study, cumulative effect of acupuncture was analyzed in order to find the possible acupuncture mechanism.Methods: Forty healthy volunteers were recruited to take part in the study in which more than 40 min of repeated acupuncture stimulation was implemented.Three runs of acupuncture fMRI data were acquired and each run consisted of two blocks of acupuncture stimulation.Besides GLM analysis to each block, acupuncture cumulative effects were analyzed with ANCOVA tofind the correlation between the degree of brain response in each stimulation block and the cumulative duration of acupuncture stimulation.Results: The brain response in the first block was the strongest although the brain response to acupuncture was time-variant.The habituated areas and the activated areas in the first block were overlapped in somatosensory areas, including bilateral middle cingulate cortex, bilateral paracentral lobule, right secondary somatosensory cortex and right thalamus.The brain response changes in the course of habituation were bimodal, i.e., positive response was presented at the beginning, and became negative at last.Conclusion: Habituation in somatosensory areas was found to be the features of acupuncture cumulative effect and its characteristic was the bimodal brain response.Considering the important role of somatosensory cortex in pain perception and the other characteristics of habituation, such as the generalization and long-term characteristics, it was suggested that the habituation might play an important role in acupuncture analgesia mechanism.     

电针“足三里”穴对体感皮层慢痛反应的影响

<正> 过去,在痛觉和针刺镇痛的研究中,多以强电脉冲刺激传入神经模拟伤害性刺激,并以此引起的反应作为疼痛的指标。但强电刺激常引起多种神经纤维包括与痛觉无关的Aαβ纤维、传导“快痛”的 Aδ纤维以及传导慢痛的 C 类纤维同时兴奋。当多种神经纤维的传入冲动同时进入神经中枢时,又常常发生相互影响,往往是传导速度快的 A 类纤维传入抑制了传导较慢的 C 类纤维传入。因此,以前所用的痛反应指标不反映慢痛。     

针刺对异常短潜伏期体感诱发电位的调整作用

<正> 研究资料证明,针刺的作用可以调整中枢神经系统的异常功能,功能增高者可使之减低,功能减低者可使之增高;针刺的调整作用,一方面决定于针刺作用的强度和时间,另一方面也决定于机体的功能状态。近年来由于电子计算机技术的发展,有时能利用平均技术无伤地从体表记录到体感诱发电位(SEPs)。     

THE EFFECTS OF ACUPUNCTURE TREATMENT IN IMPROVING SHEN OF PRIMARY INSOMNIA PATIENTS

Objective: To investigate how acupuncture treatment affects the sleeping quality of insomnia patients.Methods: According to Doctor Zhou's experience on acupuncture treatment of insomnia, we chose Baihui, Sishencong, Shenting, Benshen, and Shenmen for the study.We chose estazolam as the contraposition group.We used the randomized control trail and single-blind method.We used the Pittsburgh Sleep Quality Index to evaluate the patients before and after the treatment, and the SPSS software for statistical analysis.Results: The study results reflected that acupuncture treatment had proved positive effect in regulating sleep quality of insomnia patients.For the primary insomnia patients, acupuncture played a better role in dealing with daytime function and sleeping obstacle.The study results reflected that the score of acupuncture group was significantly lower than the estazolam group.Conclusion: Acupuncture indeed provides a new way to cure insomnia, especially for patient group who suffers from nighttime sleeping obstacle and awakening difficulty during the day.     

ANALYSIS ON THE EFFECT OF ACUPUNCTURE IN THE TREATMENT OF PERIPHERAL FACIAL PARALYSIS AT DIFFERENT STAGES

The use of acupuncture in treating peripheral facial paralysis has been well recognized, but the right time of giving the treatment remains disputable. The author has treated peripheral facial paralysis at different stages with acupuncture and analyzed its effect.     

用操作条件反射方法探讨大脑皮层在针刺镇痛中的作用

<正> 针麻的特点之一是病人在清醒状态下接受手术。近年来针刺镇痛的原理研究多在急性实验条件下进行,并获得一些可贵资料,阐明了中枢神经系统参与针刺镇痛。我们认为在清醒的不麻醉状态下进行慢性动物实验研究也可能是研究针麻原理的另一个方面,条件反射即为其中的方法之一。最早,条件反     

针灸治疗不同时期周围性面瘫的疗效分析

The use of acupuncture in treating peripheral facial paralysis has been well recognized, but the right time of giving the treatment remains disputable. The author has treated peripheral facial paralysis at different stages with acupuncture and analyzed its effect.     

THERAPEUTIC EFFECT OF SEVEN-STAR NEEDLE ACUPUNCTURE IN PATIENTS OF PEDIATRIC CEREBRAL PALSY

In this paper the therapeutic results of the seven-star acupuncture combined with bodyacupuncture in 260 patients of pediatric cerebral palsy are reported and the author claims that the cere-bral palsy is not an incurable disease and an ideal therapeutic result can be obtained if the treatmentcan be started early and continued persistently through a good co0peration between the patients andthe physicians.     

CLINICAL OBSERVATION ON THE APHAGIA OF PSEUDOBULBAR PALSY TREATED WITH ACUPUNCTURE

This paper presents clinical observation on 30 cases with aphagia of pseudobul-bar palsy treated by acupuncture. As a result, 16 cases (53.33%) were cured, 12 (40%) markedlyimproved and 2 (6.67%) ineffective, after one course (7 days). And 27 cases (90%) were curedand 3 (10%) improved markedly within one month.     

针刺对初级传入C纤维末梢兴奋性的影响

以往的研究已经说明针刺穴位可以抑制猫及大鼠脊髓背角神经元的伤害性反应。为确定针刺镇痛是否有突触前抑制的机理参与,我们记录了由脊髓表面刺激所诱发的腓肠传入神经逆向复合动作电位的C波,以此波大小的变化来反映传入C纤维中枢末梢兴奋性的改变。通过针刺穴位对初级传入C纤维末梢兴奋性的影响的观察,我们发现电针“环跳”、“内关”或“人中”穴均使腓肠神经逆向C波增大,分别增加49.98±2.46%(n=16),42.07±4.00％—(n=6)及43.08±2.87(n=10)。于T_(10)—L_2间横断脊髓后,电针“环跳”穴使逆向C波增大的效应比断脊前减小工7.63±2.92％(P<0.05,n=14),而“内关”及“人中”穴的效应消失。此外手捻针也有使腓肠神经逆向C波增大的效应。结果表明,无论电针还是手针、只要穴位刺激达到一定强度,则可使传入C纤维中枢端末梢产生去极化。针刺激活的下行抑制及节段抑制中均有突触前抑制的参与。突触前抑制可能是针刺镇痛的重要机理之一。     

伤害性刺激对躯体感觉皮层单位放电的影响及电针效应

<正> 大脑皮层在针刺镇痛中的作用是研究针刺镇痛原理的课题之一,以往我们曾在正常人、颅脑手术病人以及实验动物上,用大脑皮层诱发电为指标研究机体对痛刺激(或伤害性刺激)时的大脑皮层诱发电位,并观察某些镇痛药及针刺的影响。     

丘脑及大脑皮层在穴位电针抑制内脏神经-皮层诱发电位中的作用

<正> 我们曾报导了电针单侧“胃俞”、“足三里”穴可以不同程度地抑制电刺激内脏神经引起的皮层诱发电位,证明了这些诱发电位与内脏痛觉有关以及穴位存在相对特异性,并分析了电针“足三里”穴抑制内脏神经-皮层诱发电位的外周传入途径。为了进     

猫皮层 SI 区及十字沟前区对丘脑束旁核神经元针刺镇痛效应的下行性调节

<正> 在针刺镇痛原理研究方面曾有报道认为:丘脑束旁核(Pf)为接受痛觉冲动的结构。其神经元的痛放电可被针刺穴位所抑制。而传导痛觉的 C 类纤维的传入信号,可在皮层引起潜伏期较长的诱发电反应。本实验室也观察到:用2%利多卡因局部阻滞皮层体感(?)区(S(?))或给予 r-氨基     

循经感传过程中体觉系统中枢部位机能活动特点的观察

本文以短潜伏期皮层体觉诱发电位(SEP)为指标,对感传过程中皮层体觉区机能活动的特点进行了观察。观察对象为10名循经感传显著者和16名无感传者。以矩形波脉冲刺激侠溪或合谷穴,从对侧头皮体觉区下肢、上肢和头面部三个投射点引导 SEP,观察到针刺侠溪穴时无感传者 SEP C_2的振幅按下肢、上肢和面部三个投射点依次递减。针刺合谷时上肢投射点的 C_2振幅较下肢和面部者高,形成中间高两侧低的空间分布特点。而感传显著者,无论是针刺侠溪穴还是合谷穴 SEP C_2的振幅在三个投射点基本相同。结果提示,针刺时循经感传显著者的 S_1区各投射点出现了比较广泛的兴奋过程。     

针灸对免疫机能的调整功能

<正> 针灸治病的调整功能是多方面的,对免疫机能的调整是其中的一个方面,为了探讨针灸调整功能,本文从免疫学实验指标的变化,进行一些分析,现将所做细胞免疫和体液免疫两部分工作,整理报道如下: 一、针灸对细胞免疫的调整功能 1.淋巴细胞转化率测定:采用TC“199”液加PHA培养,收集细胞悬浮液,涂片染色,镜检计数,计算每个样品200个淋巴细胞,求出淋巴细胞转化率(％)。为了     

针刺镇痛过程中大脑皮层作用研究

本文就国内近年来研究大脑皮层在针刺镇痛中作用原理的文献作简要综述。针刺麻醉是在中医经络脏腑理论及针刺疗法的丰富实践,尤其是镇痛实践基础上发展起来的。众所周知针麻手术是在病人清醒状态下完成的。因此,这一课题在理论上和实践上都具有一定的意义。本文从临床和实验室,生理和生物化学等方面总结了针刺对大脑皮层功能活动影响的一些研究成果。结果表明大脑皮层参与针刺镇痛过程,在针刺镇痛过程中起一定的作用。当然,近年来做了一些研究工作,取得一定的成绩,但总的来说是不够的。进一步的研究将会对阐明针刺镇痛原理作出应有的贡献。参考文献约70篇。