本文選題：功能磁共振成像 + 靜息態(tài)��； 參考：《北京中醫(yī)藥大學(xué)》2016年博士論文

【摘要】：目的：本研究基于功能磁共振(fMRI)技術(shù),以陽陵泉穴為切入點(diǎn),從多個(gè)靜息態(tài)腦網(wǎng)絡(luò)層面,探討針刺陽陵泉對中風(fēng)偏癱患者靜息態(tài)的腦功能網(wǎng)絡(luò)間效應(yīng)連接的響應(yīng)特征,以期為中醫(yī)方法促進(jìn)中風(fēng)腦功能重塑研究提供數(shù)據(jù)支撐。方法：研究共納入19例中風(fēng)偏癱患者,以及與之相匹配的健康受試者17例,其中中風(fēng)患者分別進(jìn)行靜息態(tài)、針刺態(tài)的核磁掃描,健康受試者進(jìn)行靜息態(tài)掃描。應(yīng)用獨(dú)立成分分析提取靜息態(tài)多個(gè)腦功能網(wǎng)絡(luò),并通過對比分析中風(fēng)偏癱患者和健康受試者腦網(wǎng)絡(luò)內(nèi)的功能連接的特點(diǎn),探討中風(fēng)偏癱患者腦功能網(wǎng)絡(luò)變化的異常特征。在此基礎(chǔ)上,采用格蘭杰因果分析進(jìn)一步探討針刺對中風(fēng)偏癱多個(gè)腦網(wǎng)絡(luò)間的調(diào)節(jié)效應(yīng)。結(jié)果：1.本研究基于獨(dú)立成分分析方法提取的靜息態(tài)腦網(wǎng)絡(luò)主要包括7個(gè)：左側(cè)額頂葉網(wǎng)絡(luò)(LPFN)、右側(cè)額頂葉網(wǎng)絡(luò)(RPFN)、前默認(rèn)網(wǎng)絡(luò)(aDMN)、后默認(rèn)網(wǎng)絡(luò)(pDMN)、感覺運(yùn)動(dòng)網(wǎng)絡(luò)(SMN)、突顯網(wǎng)絡(luò)(SN)、視覺網(wǎng)絡(luò)(VN)。2.中風(fēng)偏癱患者腦功能網(wǎng)絡(luò)內(nèi)功能連接的變化特征：與健康受試者相比,中風(fēng)偏癱患者腦功能網(wǎng)絡(luò)內(nèi)的功能連接度既有增強(qiáng)也有減弱,其中增強(qiáng)的腦區(qū)主要位于病灶側(cè),健側(cè)腦只有左側(cè)額頂葉網(wǎng)絡(luò)和前默認(rèn)網(wǎng)絡(luò)少量腦區(qū)呈現(xiàn)功能連接增強(qiáng),大部分均表現(xiàn)為功能連接減弱,并且不同的腦網(wǎng)絡(luò)成分存在相同的腦區(qū)但(或)呈現(xiàn)不同功能連接的變化。3.中風(fēng)偏癱患者腦功能網(wǎng)絡(luò)間效應(yīng)連接的變化特征：與健康受試者相比,中風(fēng)偏癱患者腦網(wǎng)絡(luò)間呈現(xiàn)了更加復(fù)雜的效應(yīng)聯(lián)系,其中在突顯網(wǎng)絡(luò)和感覺運(yùn)動(dòng)網(wǎng)絡(luò)之間以及右側(cè)額頂葉網(wǎng)絡(luò)和前默認(rèn)網(wǎng)絡(luò)之間的因果效應(yīng)與健康受試者存在顯著性差異(P0.05)。4.針刺對中風(fēng)偏癱患者腦網(wǎng)絡(luò)間的調(diào)節(jié)效應(yīng)：針刺前中風(fēng)偏癱腦網(wǎng)絡(luò)之間以左側(cè)額頂葉網(wǎng)絡(luò)輸入信息最多,默認(rèn)網(wǎng)絡(luò)輸出信息最多,而針刺后能翻轉(zhuǎn)腦網(wǎng)絡(luò)之間的這種因果聯(lián)系,使左側(cè)額頂葉網(wǎng)絡(luò)輸出信息最多,默認(rèn)網(wǎng)絡(luò)輸入信息最多,具體表現(xiàn)為翻轉(zhuǎn)了左側(cè)額頂葉網(wǎng)絡(luò)與前默認(rèn)網(wǎng)絡(luò)、后默認(rèn)網(wǎng)絡(luò)、突顯網(wǎng)絡(luò)的效應(yīng)連接方向,翻轉(zhuǎn)了后默認(rèn)網(wǎng)絡(luò)與左側(cè)額頂葉網(wǎng)絡(luò)、右側(cè)額頂葉網(wǎng)絡(luò)、突顯網(wǎng)絡(luò)的效應(yīng)連接方向,同時(shí)減少了左側(cè)額頂葉網(wǎng)絡(luò)與右側(cè)額頂葉網(wǎng)絡(luò)、感覺運(yùn)動(dòng)網(wǎng)絡(luò)的效應(yīng)連接,減少了前默認(rèn)網(wǎng)絡(luò)與后默認(rèn)網(wǎng)絡(luò)、視覺網(wǎng)絡(luò)的效應(yīng)連接,增加了左側(cè)額頂葉網(wǎng)絡(luò)與視覺網(wǎng)絡(luò)、前默認(rèn)網(wǎng)絡(luò)的效應(yīng)連接,增加了前默認(rèn)網(wǎng)絡(luò)與感覺運(yùn)動(dòng)網(wǎng)絡(luò)的效應(yīng)連接,增加了感覺運(yùn)動(dòng)網(wǎng)絡(luò)與突顯網(wǎng)絡(luò)的效應(yīng)連接,增加了右側(cè)額頂葉網(wǎng)絡(luò)與視覺網(wǎng)絡(luò)的效應(yīng)連接；針刺后左側(cè)額頂葉網(wǎng)絡(luò)輸出信息給前默認(rèn)網(wǎng)絡(luò),前默認(rèn)網(wǎng)絡(luò)又將信息輸出給感覺運(yùn)動(dòng)網(wǎng)絡(luò),由此形成部分信息傳遞環(huán)路；其中在左側(cè)額頂葉網(wǎng)絡(luò)和前默認(rèn)網(wǎng)絡(luò)、視覺網(wǎng)絡(luò)和感覺運(yùn)動(dòng)網(wǎng)絡(luò)、后默認(rèn)網(wǎng)絡(luò)和左側(cè)額頂葉網(wǎng)絡(luò)以及突顯網(wǎng)絡(luò)和后默認(rèn)網(wǎng)絡(luò)在針刺前后存在顯著性差異(P0.05)。結(jié)論：中風(fēng)偏癱患者存在多個(gè)靜息腦網(wǎng)絡(luò)功能連接度的變化,既有增強(qiáng)也有減弱,在一定程度上反映了腦功能網(wǎng)絡(luò)的損傷與重組并存；中風(fēng)偏癱患者在腦網(wǎng)絡(luò)內(nèi)和網(wǎng)絡(luò)間均存在異常的變化特征,相同的腦區(qū)在不同的腦網(wǎng)絡(luò)內(nèi)的功能連接度呈現(xiàn)不同的變化特征,可能是腦網(wǎng)絡(luò)間產(chǎn)生效應(yīng)聯(lián)系的基礎(chǔ)；針刺對多個(gè)腦網(wǎng)絡(luò)有調(diào)節(jié)效應(yīng),可能通過默認(rèn)網(wǎng)絡(luò)這個(gè)中繼站進(jìn)行高級認(rèn)知網(wǎng)絡(luò)和感覺運(yùn)動(dòng)網(wǎng)絡(luò)之間的信息傳遞,從而對腦網(wǎng)絡(luò)效應(yīng)進(jìn)行重新整合發(fā)揮調(diào)節(jié)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.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2016
【分類號】：R246.6

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