The Influence Of Acupuncture To Primary Motor Area Functional Connectivity Network Of The Patient With Refractory Peripheral Facial Paralysis On Rs-fMRI

ObjectiveTo preliminarily explore the central mechanism of acupuncture in the treatment of refractory peripheral facial paralysis by rs-fMRI technology combined with clinical observation.Method1.Twenty patients with refractory peripheral facial paralysis were as the research object,evaluated the score of clinical Sunnybrook facial nerve assessment system for patients before and after acupuncture treatment,to evaluated the clinical efficacy.2.Twenty patients with refractory peripheral facial paralysis were as the research object,and 20 healthy volunteers were as control.A rs-fMRI scan was performed to patients before and after the treatment and the healthy volunteers when entering the group.Functional changes of bilateral MI connectivity network between patients before treatment and healthy volunteers,patients before and after treatment,patients before treatment and healthy volunteers were compared.Results1.Sunnybrook of patients with refractory peripheral facial paralysis were statistical significance in comparison with before and after treatment of acupuncture(p<0.05).2.Compared with the healthy subjects,the increased functional connectivity of patients with refractory peripheral facial paralysis in LMI with the whole brain are bilateral medial temporal gyrus,bilateral medial upper frontal gyrus,bilateral middle frontal gyrus,left cuneate lobe,left upper apex gyrus,left orbital frontal gyrus,right fusiform gyrus,right central posterior gyrus,and right Roland Dick Island cover(p<0.001,cluster>34);the increased functional connectivity of patients with refractory peripheral facial paralysis in RMI with the whole brain are bilateral middle frontal gyrus,bilateral temporal gyrus,bilateral cerebellar lobe,right precuneus,right inferior temporal gyrus,right medial frontal gyrus,right dorsolateral frontal gyrus,right posterior central gyrus(p<0.001,cluster>36).3.Compared with refractory peripheral facial paralysis patients before treatment,the increased functional connectivity of patients in LMI with the whole brain is Left inferior frontal gyrus(p<0.001,cluster>30);the functional connectivity of patients in RMI with the whole brain has no obvious difference.4.Compared with the healthy subjects,after treatment the increased functional connectivity of patients with refractory peripheral facial paralysis in LMI with the whole brain are bilateral precuneus,bilateral middle frontal gyrus,bilateral temporal gyrus,bilateral angular gyrus,left medial frontal gyrus,left orbital frontal gyrus,right posterior central gyrus,right cerebellar lobe(p<0.001,cluster>35);the increased functional connectivity of patients with refractory peripheral facial paralysis in RMI with the whole brain are bilateral precuneus,bilateral middle frontal gyrus,bilateral fusiform gyrus,left occipital gyrus,right inferior frontal gyrus,right dorsolateral triangular frontal gyrus,right temporal gyrus,right cerebellar lobe(p<0.001,cluster>34).Conclusion1.Acupuncture has a good effect on the improvement of clinical symptoms of patients with refractory peripheral facial paralysis.2.Before acupuncture treatment,the brain function of patients with refractory peripheral facial paralysis has changed,which may be caused by reactive compensation of the brain.3.Acupuncture can enhance the connection between LMI and the left inferior frontal gyrus,thereby enhancing the compensatory response,which may be one of the central mechanisms of acupuncture in the treatment of refractory facial paralysis.