Effects Of Acupuncture At Back-shu And Front-mu Points Of Stomach On The Brain Functional Networks Of Subjects Under Gastric Distension Based On Resting State Functional Magnetic Resonance Imaging

1 ObjectiveTo investigate the effects on regional brain activity and functional connectivity of the healthy subjects under water load comparing acupuncture at Back-Shu and Front-Mu points of stomach with acupuncture at Back-Shu or Front-Mu points individually.To compare the different changes in the characteristics of brain functional network between acupuncture at combination acupoints and single acupoint.And the correlations between changes of brain functional and gastric motility were analyzed.To verify the major brain region in which information is converged or integrated after acupuncture signal of combination acupoints,and its possible mechanism.To preliminarily explicit the functional integration mechanism of acupuncture on the regulation of gastric motility.In order to provide an experimental basis for exploring the neural network mechanism of the Back-Shu or Front-Mu points,and to lay the foundation for further revealing the central integration mechanism of acupoint compatibility.2 Methods24 healthy subjects recruited by public recruitment,were divided into Weishu(BL21)group,Zhongwan(CV12)group and CV12 plus BL21 group for 3 times at different times,8 in each group every time.A total of 24 subjects were included in each group.All subjects under the water load condition respectively received acupuncture at BL21,CV12 and CV12 plus BL21,and were examined by resting-state functional magnetic resonance imaging(rs-fMRI)and gastric electrogram before and after acupuncture.The amplitude of low frequency fluctuation(ALFF)and regional homogeneity(ReHo)in brain were analyzed by Data Processing Assistant for Resting-State fMRI(DPARSF).The changes of ALFF and ReHo before and after acupuncture in different group were analyzed by Data Processing &Analysis for Brain Imaging(DPABI).The regions of interest(ROI)were selected by analyzing the different brain regions found in the previous experiments from the results of ALFF and ReHo and our previous research hypotheses and research results.The functional connectivity(FC)between ROI and the other brain regions of the whole brain were analyzed.The brain functional connectivity changes among acupuncture at CV12,BL21 and CV12 plus BL21 were compared.The correlations between the changes of the functional connectivity of ROI brain area and the changes of gastric motility before and after acupuncture were analyzed.The Alpha Sim multiple comparison correction were used and set a statistical threshold of 0.05 by DPABI view.Finally,the changes in the functional connectivity of the brain region are obtained,and the brain regions which have statistical significance were presented in the form of images.Paired t test was used before and after acupuncture,and ANOVA analysis was used in multiple groups.The SPSS17.0 statistical software was used statistical analysis of clinical data.The average time series of different brain regions of ALFF,ReHo and FC signals before and after acupuncture were extracted by Extract ROI Signals tool of Resting-State fMRI Data Analysis Toolkit.Correlation analysis between data was carried out by Pearson correlation analysis.3 Results(1)There were no statistical significance of initial gastric satiety threshold,initial gastric satiety time,maximal gastric satiety threshold,maximal gastric satiety time in water load test among three groups(P>0.05).Compared with before acupuncture,the amplitude of electrogastrogram decreased obviously after acupuncture(P<0.05).There are significant difference between the CV12 plus BL21 groups and CV12 group or BL21 group in the amplitude of the electrogastrogram(P<0.05).(2)Compared with before acupuncture,ALFF changed in different brain regions can be seen in different group after acupuncture,and acupuncture at CV12 plus BL21 could cause more extensive changes in the brain region.Compared with the acupuncture at single point,the ALFF value of the thalamus,insula,cingulate gyrus,medial frontal gyrus changed significantly in acupuncture at CV12 plus BL21.Correlation analysis shown that the changes of ALFF in the insula,amygdale,medial frontal gyrus were correlated with the change of electrogastrogram in acupuncturing at CV12 plus BL21 group.(3)Compared with before acupuncture,ReHo changed in different brain regions can be seen in different group after acupuncture.Compared with the acupuncture at single point,the ReHo value of the posterior cingulate gyrus,temporal pole changed significantly in acupuncture at CV12 plus BL21.Correlation analysis shown that the changes of ReHo in the posterior cingulate gyrus,thalamus,precuneus and temporal pole were correlated with the changes of electrogastrogram in acupuncturing at CV12 plus BL21 group.(4)The functional connectivity of between amygdala,thalamus,insula,posterior cingulated gyrus,nucleus tractus solitarii,hypotha Iamus and other brain region changed after acupuncture at CV12,BL21 and CV12 plus BL21.The functional connectivity of amygdale and medial prefrontal cortex,amygdale and cingulate gyrus,amygdale and occipital lobe,thalamus and medial prefrontal cortex,thalamus and frontal lobe,insula and medial prefrontal cortex,posterior cingulate and precuneus,nucleus tractus solitarii and temporal lobe,hypothalamus and hippocampus of acupuncture combination acupoints increased compared with single acupoints.Compared with acupuncture at CV12 or BL21,the functional connectivity of insula and cingulated gyrus,posterior cingulate and precuneus,nucleus tractus solitarii and temporal lobe of acupuncture at CV12 plus BL21 increased respectively.(5)It can be seen positive correlation between the change of gastric motility and the changes of functional connection in posterior cingulate gyrus and posterior cerebellar lobe,posterior cingulate gyrus and anterior cingulate gyrus,nucleus tractus solitarii and inferior parietal lobe,hypothalamus and brain stem,thalamus and anterior cingulate gyrus,thalamus and medial prefrontal cortex.The changes of functional connection in amygdala and postcentral gyrus,nucleus tractus solitarii and posterior cingulate gyrus,insula and medial prefrontal cortex have shown negatively correlated with the changes of gastric motility.4 Conclusions(1)The combination of Back-Shu or Front-Mu point has a synergistic effect on the regulation of gastric motility with healthy subjects under gastric distension.Acupuncture at CV12 plus BL21 could cause more extensive changes in the brain region of ALFF,ReHo and FC comparing with Acupuncture at CV12 or BL21.(2)Effects of acupuncture at CV12 plus BL21 on gastric motility related to the changes of ALFF in the insul,amygdale and medial frontal gyrus were,the changes of ReHo in the posterior cingulate gyrus,thalamus,precuneus and temporal pole,the changes of FC in amygdala,thalamus,insula,posterior cingulated gyrus,nucleus tractus solitarii,hypotha Iamus.(3)Acupuncture at Back-Shu or Front-Mu points significantly changed the ALFF of thalamus,insula,cingulate gyrus and medial frontal gyrus,the ReHo of posterior cingulate gyrus and temporal pole,and significantly enhanced the functional connectivity of insula and cingulated gyrus,posterior cingulate and precuneus,nucleus tractus solitarii and temporal lobe may be important neural basis of its synergistic effect.(4)The change of brain function caused by acupuncture at combination points is not a simple overlap of multiple acupoints,but a new network connection of some brain functional areas,so as to play a better acupuncture effect.The regulation of acupuncture on the default network,visceral sensorimotor network and emotional network may be an important mechanism of acupuncture regulating the synergistic effect of gastric motility.