针刺对慢性坐骨神经痛患者治疗后静息态脑默认网络影像的影响

目的观察慢性坐骨神经痛患者针刺前后静息状态（resting network states，RNS）脑默认网络（default mode network，DMN）的功能磁共振信息的变化，研究针刺镇痛后的持续效应及与脑默认网络的关系。方法选取患者患侧下肢的环跳、委中为主穴，进行针刺治疗（10次），运用RNS功能性磁共振成像技术（functional magnetic resonance imaging，fMRU全脑扫描，个体磁共振数据采用独立成分分析（independent component analysis，ICA）方法，提取DMN，进行分析两组受试者的脑DMN功能连接，并分别与健康人的DMN对照（无针刺治疗）。结果所有受试者RSN的fMRI数据经数据分析后均可获得DMN图像，坐骨神经痛患者较健康人的DMN差异主要显示于前额叶内侧皮层和前扣带皮层，表现为这些区域活动的下降，经针刺治疗后，这些DMN活动下降的区域基本恢复正常。健康人的静息fMRI显示的DMN，主要位于楔前回、BA7、BAIO和前扣带皮层。结论RNS脑DMN的MRI影像，能够反映慢性疼痛，适合针刺镇痛后效应的研究。

Effects of Acupuncture on Default Mode Network Images of Chronic Sciatica Patients in the Resting Network State

Objective To observe the functional magnetic resonance imaging （fMRI） data changes of default mode network （DMN） in chronic sciatica patients in the resting network state treated by acupuncture, and to study the correlation between DMN and the consisting effects after acupuncture analgesia. Methods Weizhong （BL40） and Huantiao （GB30） of the patients＇ lower limbs were selected as the main points to acupuncture for ten times. The whole brain was scanned using fMRI. The independent component analysis （ICA） was adopted to get DMN information. The brain DMN function link was analyzed in the two groups of subjects. Results The DMN images were obtained in all subjects after DMN fMRI data processing. The main DMN differences between the sciatica patients group and the healthy control group were demonstrated as decreased activities of DLPFC and anterior cingulate cortex （ACC）. After acupuncture, activities of these regions basically recovered to normal. The DMN of healthy volunteers shown by fMRI data in the RNS mainly existed in the precunes, BA7, BA10, and ACC. Conclusion MRI images of DMN in the RNS could reflect chronic pain, which was suitable for studies on the effects after acupuncture analgesia.