Discussion On The Correlation Between The Constitution Of Traditional Chinese Medicine And The Characteristics Of Resting State Functional Magnetic Resonance Imaging In Parkinson’s Disease

Objectives: To explore the imaging characteristics of Rest-state functional magnetic resonance imaging(RS-FMRI)in patients with Parkinson’s Disease(PD)of different TCM constitutions.It provides a basis for early diagnosis and objective differentiation of Parkinson’s disease.Methods:1.A total of 112 patients with Parkinson’s disease who met the inclusion criteria and visited the outpatient department and ward of the Neurology Department of the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine from September 2019 to January 2022 were collected as the research objects.The TCM Constitution Classification and Determination Table by Professor Wang Qi’s team was used as the discrimination basis of the patients’ constitution types.Patients with PD who met the inclusion criteria were classified,and 26 patients with biased PD who met the criteria were examined by resting state functional magnetic resonance.2.Basic health data of patients meeting inclusion criteria were collected.Rs-fmri imaging data were collected by GE Signa HDX 1.5T MAGNETIC resonance instrument,and general data were compared and analyzed by SPSS26.0.MATLAB(R2013b),SPM12 and r S-FMRI data processing assistant DPARsf V version 2.3software package were used to preprocess the collected original image data.DPARSF4.3 software calculated the low-frequency Amplitude of the included PD patients(ALFF),Fractional amplitude of low-frequency fluctuation(f ALFF)data were selected to use the two-sample T test,and it was concluded that compared with the normal brain area,ALFF,f ALFF increased and decreased brain area,To explore whether there is correlation between TCM constitution and imaging data of Parkinson’s disease patients,and whether there is difference in imaging imaging characteristics of patients with different TCM constitution types,REST1.8,SPM12 and XJVIEW were used to present the results.Results:1.A total of 112 subjects were included in this study,including 59 males and 53 females,with statistically significant gender differences(P < 0.01).Male patients tended to have Yin deficiency and qi deficiency,while female patients tended to have phlegm-dampness and qi deficiency.The physical distribution of male Parkinson’s disease patients was Yin deficiency > Qi deficiency > phlegm-dampness and heat > Yang deficiency,blood stasis,special nature > Qi stagnation > peace.The physical distribution of female Parkinson’s disease patients was as follows: phlegm-dampness >qi-deficiency > Yin-deficiency > Yang-deficiency,qi-stagnation > damp-heat,intrinsic quality > blood stasis > peaceful quality.2.The age range of Pd patients in this study was mainly 60-69 years old,with Yin deficiency and qi deficiency.Among the other age groups,the majority of PD patients aged 40-49 were qi stagnation and phlegm dampness.From 50 to59 years old,Yang deficiency,qi stagnation and phlegm-dampness were the main symptoms.Between 70 and 79 years old,Yin deficiency and qi deficiency were the main symptoms.From 80 to 85 years old,Yin deficiency was dominant.3.Through the resting state f MRI observation of the subjects with Yin deficiency and Qi deficiency that met the inclusion criteria,compared with the normal control group,it was found that the changes in the activity levels of different brain regions were correlated with the TCM constitution of Parkinson’s disease.Compared with normal control group,ALFF value in Yin deficiency group was significantly increased in right inferior temporal gyrus(BA90),bilateral fusiform gyrus,hippocampus(BA37),right posterior central gyrus(BA58)and left posterior central gyrus(BA57),and significantly decreased in the second half lobule,left complementary motor area(BA19)and cerebellar posterior lobe.Compared with the normal control group,ALFF values in the lower cerebellum(BA109),left inferior temporal gyrus(BA89)and left temporal pole in the q I-deficiency group were as follows: The brain regions of superior temporal gyrus(BA83),middle occipital gyrus and left central sulcus(BA17)were significantly increased,while the brain regions of left cerebellum(BA103),hippocampus(BA38),anterior cingulate gyrus,left thalamus(BA77),inferior parietal lobule and Rolandic insular gyrus(BA17)were significantly decreased.Conclusion:1.In this study,there was a correlation between the resting state functional magnetic resonance imaging data of pd patients and the distribution of TCM constitution types.Functional magnetic resonance(FMRI)showed significant difference in functional connection signals between brain regions of common partial constitution types of PD patients(Yin deficiency and qi deficiency)in resting state(P < 0.01).Most PD patients with Yin deficiency showed activation in brain regions of right inferior temporal gyrus(BA90),bilateral fusiform gyrus,hippocampus(BA37),right posterior central gyrus(BA58)and left posterior central gyrus(BA57).In the second half of the month,the lobule,the left supplementary motor area(BA19)and the cerebellar posterior lobe were inhibited.Patients with qi deficiency are mostly in the lower cerebellum(BA109),left inferior temporal gyrus(BA89)and left temporal pole:The brain regions of superior temporal gyrus(BA83),middle occipital gyrus,and left central sulcus(BA17)were activated,while the brain regions of left cerebellum(BA103),hippocampus(BA38),anterior cingulate gyrus,left thalamus(BA77),inferior parietal lobule,and Rolandic insular gyrus(BA17)were inhibited.2.The application of resting state functional magnetic resonance imaging has research significance in the diagnosis and differentiation of PD patients with different TCM constitutions,which is conducive to the early identification and diagnosis of PD,provides new ideas for the pathological mechanism,and is also expected to provide theoretical basis for integrated TCM and Western medicine treatment of PD patients.