| Objective: To explore the brain network differences in small vessel disease(SVD)patients without cognitive impairment and healthy volunteers in resting state and post needing state at Taixi using functional magnetic resonance imaging(fMRI)technology,Amplitude of low frequency fluctuation(ALFF)and large-scale network connection analysis.Methods: From October to December 2019,20 patients with SVD(SVD group)were selected in the Department of Neurology,the Affiliated Hospital of Southwest Medical University,and 20 healthy young people and 20 healthy elderly people are included as healthy young group and healthy elderly group,respectively.In resting state,the SVD group compared with healthy elderly group,and healthy elderly group compared with healthy young group.Then post needing state at Taixi compared with resting state in three groups.All subjects had normal cognitive function as assessed by MMSE and MoCA scales.Subjects were performed in three phases.Firstly,T1 WI and resting state fMRI scan was conducted.Secondly,an acupuncture needle was inserted on the right side of Taixi.Thirdly,another fMRI was conducted.The fMRI data was pre-processed,and then the network connection analysis was performed: 1.Two-sample t test was used to compare the differences of resting state between SVD group and healthy elderly group,between healthy elderly group andhealthy young group in ALFF and large-scale brain network connections.2.Paired samples t test was used in three groups to compare the differences between resting state and post needing state in ALFF and large-scale network connections.Results: 1.Comparison of resting state ALFF results:(1)Compared with healthy elderly group,the ALFF in the SVD group was significantly decreased in left postcentral gyrus and left precentral gyrus,and increased in right posterior cingulate gyrus,cerebellar vermis region 10,left parahippocampal gyrus and right insula,which mainly located in subcortical areas.(2)Compared with young group,the ALFF in the healthy elderly group was significantly decreased in left cerebellar hemisphere region 4 and 5,left middle temporal gyrus,left posterior cingulate gyrus and left inferior parietal lobe,and increased in right superior frontal gyrus.2.Resting state fMRI large-scale network connection results:(1)Compared with the healthy elderly group,the SVD group increased subnetwork connections between the default mode network and sensory/somatomotor network,visual network.At the same time,compared with the healthy elderly group,the SVD group decreased a large number of subnetwork connections,such as between default mode network and sensory/somatomotor network,cingulo-opercular task Control network,auditory network,visual network,frontal-partial control network,salience network.In addition,average within subcortical network connection significantly decreased(P=0.01)when SVD group compared with the healthy elderly group.There was no significant difference in the other withinsubnetwork connection.(2)Compared with the healthy young group,the healthy elderly group increased a large number of subnetwork connections,such as between default mode network and visual network,between sensory/somatomotor network and frontal-partial control network.While there was some hypoconnections when healthy elderly group compared with the healthy young group,including between default mode network and sensory/somatomotor network,auditory network,ventral attention network,visual network,frontal-partial control network,between sensory/somatomotor network and visual network.3.ALFF analysis results after acupuncture at Taixi:(1)Compared with resting state,the ALFF in post needing state was significantly decreased in right cuneus,and increased in bilateral caudate in the SVD group.(2)Compared with resting state,the ALFF in post needing state was significantly decreased in left lingual gyrus,bilateral postcentral gyrus,left supplementary motor area and left superior partial lobe in healthy elderly group.(3)Compared with resting state,the ALFF in post needing state was significantly decreased in left middle occipital gyrus,right insula,right precentral gurus and left middle temporal gyrus,and increased in bilateral anterior cingulate gurus in healthy young group.4.Large-scale network connection analysis after acupuncture at Taixi:(1)When post needing state compared with resting state,a small number of subnetwork connections were increased in the SVD group,between subcortical network and frontal-partial control network,default mode network,while a large number of subnetwork connections were decreased,between ventral attention network andsensory/somatomotor network,cingulo-opercular task Control network,auditory network,frontal-partial control network,and so on.(2)When post needing state compared with resting state,the healthy elderly group was only increased subnetwork connection between default mode network and sensory/somatomotor network,while a large number of subnetwork connections were decreased.(3)When post needing state compared with resting state,a small number of subnetwork connections were increased in healthy young group,between sensory/somatomotor network and subcortical network,between default mode network and frontal-partial control network,ventral attention network,while a large number of subnetwork connections were decreased.5.Changes of average within and between subnetwork connections after acupuncture at Taixi:(1)When post needing state compared with resting state,the SVD group decreased average within sub-network connections in cingulo-opercular task Control network,auditory network,visual network,salience network and dorsal attention network(p<0.05).At the same time,the SVD group had some hypoconnections between ventral attention network and sensory/somatomotor network,cingulo-opercular task Control network,auditory network,frontal-partial control network,salience network,dorsal attention network,between cingulo-opercular task Control network and auditory network(p < 0.05),when post needing state compared with resting state.(2)When post needing state compared with resting state,the changes of average within and between subnetwork connections in the elderly group were decreased,which were similar to those in the SVD group.The average withinsubnetworks were decreased in sensory/somatomotor network,cingulo-opercular task Control network,auditory network,visual network,salience network and so on(p < 0.05).The average sub-network connections were decreased between default mode network and visual network,frontal-partial control network,salience network,ventral attention network,between frontal-partial control network and salience network,dorsal attention network,and so on(p < 0.05).(3)When post needing state compared with resting state,the changes of average within and between subnetwork connections in the healthy young group were different from SVD group and healthy elderly group.A large number of average subnetwork connections were significantly increased(p < 0.05).The average subnetwork connections were decreased between visual network and default mode network,ventral attention network,between salience network and dorsal attention network(p<0.05).Conclusion: 1.In resting state,the difference areas of ALFF between SVD patients and healthy elderly group included both cortical and subcortical areas,indicating that cortical and subcortical areas of SVD patients are damaged.2.In resting state,there were significant differences between SVD group and healthy elderly group in large-scale network connections and the major difference in average within subcortical network,which shows that the incidence of SVD patients accompanied by changes in brain network connections,and brain network connections have changed even in normal cognitive patients.3.Comparisons between healthy elderly group and the healthy young group have found that the changes of brain network connectionsaccompanied by brain aging and the default mode network presented differential changes during the brain aging.4.changes of brain network connections in elderly people and SVD patients may be related to functional remodeling during brain aging or brain diseases to maintain normal physiological function.5.When post needing state compared with resting state,all subjects showed hypoconnections or hyperconnections in ALFF and large-scale network connections in some brain areas,which suggests that acupuncture at Taixi has dual regulation and the regulation in different populations are different,which may be one of the stimulation mechanisms of acupuncture.In short,our study used fMRI to reveal the pathological changes of SVD and brain aging,show the effects of acupuncture at Taixi from perspective of brain network connections,and provide supporting evidence for clinical interventions including acupuncture for brain aging and SVD in the future. |
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