DTI Research On The Changes Of White Matter Network Before And After Acupuncture Treatment Of Acute Ischemic Stroke

Objective:To investigate the characteristics of structural brain network and related factors before and after acupuncture treatment of acute ischemic stroke(AIS)based on diffusion tensor imaging(DTI),and explore the therapeutic effect and imaging mechanism of AIS acupuncture.Methods:According to the inclusion and exclusion criteria,24 patients with AIS baseline status and receiving acupuncture treatment were collected,and 18 healthy volunteers were selected as healthy controls(HC)group.All subjects underwent 3D-T1 weighted imaging and DTI.The neurological dysfunction and activities of daily living of AIS patients were evaluated by national institute of health stroke scale(NIHSS),modified rankin scale(MRS),barthel index(BI)and Fugl-Meyer assessment(FMA).The data were preprocessed by PANDA software,and white matter networks were constructed and analyzed using PANDA and gretna software at both global and local levels.The differences between AIS group and HC group were compared,and a longitudinal study was conducted to compare the differences of AIS patients and acupuncture-treated AIS patients.Pearson correlation analysis was performed on topological properties and scale scores.Result:(1)The brain structure network of the three groups had small-world attributes.At the global network level,compared with HC group,the global efficiency(Eg),local efficiency(Eloc)and clustering coefficient(Cp)of AIS group were significantly reduced.And compared with the pre-treatment AIS group,Cp and Eloc decreased significantly in acupuncture-treated AIS patients.(2)At the local level,compared with HC group,AIS group had extensive changes of node attributes in the right brain area:the decreased node attributes were mainly distributed in prefrontal cortex,insula,paracentral lobule,lenticular putamen and thalamus.At the same time,the decreased node attributes were located in limbic system.Compared with the pre-treatment group,the areas of acupuncture-treated AIS group with enhanced nodal attributes were mainly distributed in bilateral prefrontal cortex and left middle temporal gyrus,while the areas with decreased nodal attributes were right anterior central gyrus,left paracentral lobule and right posterior cingulate gyrus.(3)There was significant difference in AIS before and after acupuncture treatment(P<0.05).Pearson correlation analysis showed that the degree centrality of right amygdala was negatively correlated with NIHSS(r=-0.406,P=0.049);the degree centrality of right inferior frontal gyrus was negatively correlated with BI in AIS group(r=-0.418,P=0.042),There was significant correlation between multiple node attributes of right paracentral lobule and NIHSS,BI,FMA(P<0.05).Pearson correlation analysis showed that there was a significant correlation between the multiple node attributes of the right posterior cingulate gyrus and BI,FMA evaluation of lower limbs in the AIS group(P<0.05).Conclusion:The white matter network efficiency is reduced after AIS,and the brain network connection is abnormal.Meanwhile,the different brain areas are closely related to the severity of AIS neurological dysfunction.Acupuncture is effective for facilitating recovery in AIS.The attributes of multiple nodes after acupuncture treatment are significantly different from AIS,and among them,the node attributes of the posterior cingulate gyrus can be used as the prognostic indicator of AIS.DTI can visualize and quantify the changes in AIS white matter structure,and can be used as an indicator of motor dysfunction and improvement in acupuncture.