Research On The Recovery Mechanism Of Aphasia Language Function After Acupuncture Intervention Based On Functional Magnetic Resonance

Stroke-related aphasia is a significant clinical problem persisting in one third of acute stroke patients and one fifth of chronic stroke patients.Research demonstrated that the best time for language recovery was four to ten weeks after onset of stroke.Chinese Medicine treatment on stroke has a long history with a favorable curative effect,meanwhile acupuncture is an important modality for aphasia rehabilitation.However,the underlying mechanism of language recovery is still inconclusive.Fast development of functional imaging brings the opportunity of research on language recovery and acupuncture mechanism.It provides potential support on cerebral functional change under normal and pathologic state.Our research focused on the recovery of aphasia as follows:Firstly,we applied functional connectivity analysis to find out the influence of electroacupuncture on Tongli and Xuanzhong in the proeess of language production.Compared to the control group,the group with electroacupuncture on Tongli and Xuanzhong showed a significant stronger functional connectivity between the language-related region in Brodnann 44,45 and the left supramarginal gyrus,postcentral gyrus,fusiform and the right precuneus,rolandic operculum.It suggested that acupuncture enhanced the functional connectivity of language-related region rather than activation of this region.Our research provided the evidence that Tongli and Xuanzhong could be used as the effective acupoints for treating aphasia following stroke.Secondly,we applied three methods of data analysis--regional homogeneity analysis,independent component analysis and graph theory analysis on aphasic patients to find out the abnormal of spontaneous brain activity and the change of intrinsic connectivity network in resting state fMRI data.(l)Compared to the control group,the aphasic patient group exhibited significantly reduced ReHo bilaterally in the putamen.The result showed a significant correlation between the right putamen ReHo value and expression score and after one month language recovery,there was also a significant association between the language expression improvement and corresponding right putamen regional coherence changes.(2)Compared to the control group,we found significantly reduced functional connectivity between the LFPN and the right middle frontal cortex,the medial frontal cortex,and the right inferior frontal cortex in aphasic patients.The results showed a strong correlation between the right middle frontal cortex and comprehension score and significant association between the medial frontal cortex and comprehension score.After one month language recovery,A marginally significant association between the LFPN and the right middle frontal cortex connectivity and comprehension score was found.(3)Compared to the control group,we observed a significant decrease in the LFPN connectivity of the patients.Correlation analysis showed a significant association between mean LFPN connectivity and comprehension score.The change in mean network connectivity index was marginally associated with the improvement of comprehension ability after one month language recovery.It helps us to understand the recovery mechanism underlying aphasia.In summary,combining the fMRI technology,these findings may be beneficial for understanding aphasia following stroke,as well as providing potential evidence for acupuncture treating post stroke aphasia.It is a successful multi-interdisciplinary attempt in Chinese medicine and neuroscience.