| ObjectiveThe plasticity of the motor cortex in patients with cerebral hemisphere stroke and dysphagia is crucial for the recovery of dysphagia and requires the combined effect of the uninjured area on the opposite side of the injured site and sensory afferent stimulation.This research is based on this point,to investigate whether the swallowing function of the human brain is lateral in the motor cortex under physiological conditions firstly;and then further study the effects of electro-acupuncture at Lianquan(CV23)and Fengfu(GV16),providing a certain physiological basis for the scientific hypothesis that"electric acupuncture stimulation-inducing the stimulation of corresponding functional regions of the contralateral Swallowing motor cortex-initiation of functional reorganization and promotion of brain plasticity formation" is one of the key mechanisms of its acupuncture effect.MethodsA total of 40 healthy subjects who met the inclusion criteria and exclusion criteria were included in this project.Two phases of trials were conducted.Trial 1:A lateralization study of bilateral swallowing motor cortex in healthy subjects.The surface electrode was placed on the skin above the mandibular hyoid muscle,and transcranial magnetic stimulation(TMS)single-pulse stimulation mode was used to stimulate the left/right swallowing motor cortex with the help of the neuroimaging navigation and positioning system.Record The resting motion threshold(RMT)and motor evoked potentials(MEP)of the swallowing motor cortex which the mandibular hyoid muscle was target muscle,and the optimal stimulation point of swallowing motor cortex was also recorded.Then use the single-pulse TMS of RMT and 110%RMT to stimulate the left and right optimal stimulation points of the motor cortex,and record the latency and amplitude of MEP.Trial 2:The study of the effects of electro-acupuncture at CV23 and GV16 on excitability and lateralization of swallowing motor cortex in healthy subjects.Forty healthy subjects in the same batch were randomly divided into the electro-acupuncture group and sham electro-acupuncture group,with 20 cases in each group.The electro-acupuncture group performed electro-acupuncture at CV23 and GV16 for 15 minutes,and the sham electro-acupuncture group used fake needles that were not connected to the power to stimulate CV23 and GV16 for 15 minutes.After the intervention,the method of trial one was used at the optimal stimulation point,and the latency and amplitude of MEP and RMT of the swallowing motor cortex of the left and right mandibular hyoid muscles as target muscles were recorded again.The differences of bilateral RMT and MEP in each group and between the groups were compared.From the aspect of the resting membrane potential and excitability of cortical neuron neurons,to reflect the effect of electro-acupuncture at CV23 and GV16 on excitability and lateralization of the swallowing motor cortex of the human brain.Results1.General information:A total of 40 healthy subjects who met the inclusion criteria and exclusion criteria were included in this study.All subjects successfully completed the trial.There was no significant difference in the composition of baseline data(gender,age,BMI,MMSE,Kubota drinking test and observation indicators before intervention)between the electro-acupuncture group and the sham electro-acupuncture group.2.The laterality of the bilateral cerebral swallowing motor cortex:TMS was used to detect the RMT and MEP of the bilateral swallowing cortex of the mandibular hyoid muscle as the target muscle in the physiological state of healthy subjects.By analyzing and comparing the excitability differences of bilateral swallowing motor cortex,it was found that the RMT(P<0.01)and MEP latency of the right swallowing motor cortex(P<0.05)were less than that of the left cortex;the amplitude of bilateral MEP had no statistical difference(P>0.05).3.The effect of electro-acupuncture at CV23 and GV16 on the excitement of swallowing motor cortex in healthy subjects:RMT,MEP latency and amplitude before and after the intervention of electro-acupuncture and sham electro-acupuncture were compared.After electro-acupuncture,the RMT(P<0.01)and MEP latency(P<0.01)of bilateral cerebral swallowing motor cortex decreased compared with the former,and the MEP amplitude(P<0.01)increased compared with the anterior.However,there was no statistically significant difference in the RMT and MEP of the motor cortex before and after sham electro-acupuncture(P>0.05).4.The effect of electro-acupuncture at CV23 and GV16 on the laterality of swallowing motor cortex in healthy subjects:Trial found that the excitability of the right swallowing cerebral cortex is higher than that of the left side under physiological conditions and electro-acupuncture against the swallowing motor cortex The excitability has a significant effect.From this,a further analyzing the effect of electro-acupuncture on the laterality of swallowing motor cortex had been done.After the electro-acupuncture intervention,the absolute value of the difference between the left-right RMT(P>0.05),the left-right MEP latency and the amplitude(P>0.05)has an increasing trend,but there is no statistical difference.ConclusionThe results of the study show that:1.The excitability of the human right cerebral swallowing motor cortex is higher than that of the left side in a resting state.It can be inferred that the human right swallowing motor cortex has a lateral advantage when there is no swallowing activity.2.Electro-acupuncture can specifically significantly enhance the excitability of human bilateral swallowing motor cortex which the mandibular hyoid muscle is target muscle.3.Electro-acupuncture regulating the laterality of swallowing motor cortex in healthy humans has no statistical significance,but it has a tendency to increase the change of the dominant side,suggesting that electro-acupuncture will not break the balance of the lateral superiority of the human brain swallowing function under physiological conditions.It can provide a certain scientific basis for the study of the mechanism of electro-acupuncture treatment of pharyngeal disorders in the subsequent pathological conditions. |
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