Effect Of Acupuncture At Yanglingquan On Exercise - Related Brain Network In Stroke Patients With Hemiplegia

Dyskinesia is a primary reason of reducing life quality after stroke, especially limbs dysfunction. As hands, particularly thumb and index fingers, are playing important roles in fine motor skills, limbs rehabilitation is requisite for hemiplegic patients. Acupuncture therapy is helpful in neuro rehabilitation while increase widely in application. Yanglingquan(GB34) is a vital acupoint for musle and tendon function and proved by modern research.There are many different networks found according brain studies with functional megatic resonance imaging(fMRI) technique.And independent component analysis(ICA) is popular in methodology. Since previous researches had fixed on variation of acupuncture stimulation, our study assume that acupuncuring GB34 would regulate brain networks with passive movement taken in accordance with ICA method.Purpose:It is aimed at observing the effect on brain functional networks by acupuncturing GB34 or sham acupiont in 6 patients with whom left limb movement disorder after cerebral infarction, and contrasting changes of motor network, cerebella network, default mode network (DMN), inducing by passive movement of left fingers before and after acupuncture, to define the neuromechanism of acupuncture treatment on GB34.Methods:(1)Functional MR brain scans were obtained in six patients with left limbs dysfunction during the following steps.First step, move the patients’ left thumb and index fingers passively. Second, acupuncture GB34 or sham acupoint.Third, repeat passive finger movement as first step. And passive movement task was designed as Block Pattern. (2) Use DPARSF software to preprocess fMRI data, and use GIFT software to analyse group independent componets. Apply repeated measurement multi-factor analysis of variance to the data of motor network, cerebella network and default mode network.Then work out the main effect of each network, the interaction of acupuncture type and move phase.All these data analysis were carried out in SPM platform.Results:(1) In motor network, positive activation were found in bilateral lingual, cuneus gyrus, left fusiform gyrus after acupuncturing GB34 contrast with sham acupoint, while negative activation were in left precentral, postcentral and supramarginal gyrus. (2) In cerebellar network, right middle temporal gyrus, temporal pole and bilateral inferior tempotal gyrus were positively activated, and right precentral, postcentral, superior temporal gyrus were negatively activated. (3) In default mode network, positive activation were detected in the right cerebellum hemisphere, occipital gyrus, superior parietal, left anterior inferior frontal gyrus, and negative activation were in right orbital middle frontal, orbital inferior frontal, left insula inferior frontal, triangular inferior frontal and left inferior tempotal gyrus.Conclusion:The implementation of motor function is related to the regulation of brain networks. The regulation includes motor execution, motor coordination and cognition of motor task. Acupuncturing GB34 was to motivate visual imagery and suppressed nonparalyzed side’s motor execution, as well as strengthen motor coordination by averting ipsilateral synkinesis and enhancing memory. Contrast with sham acupoint, Acupuncture GB34 may help strengthen attentiveness and also enhance memory of coordination. These results suggest that acupuncturing GB34 could contribute to hemiplegic rehabilitation by regulating functional brain networks.