| Objective:To observe the changes of low frequency amplitude(ALFF),fractional low frequency amplitude(fALFF)and local consistency(ReHo)in patients with hemiplegia after middle cerebral artery infarction by using resting state functional magnetic resonance technology rs-f MRI technology.To explore the different effects of Qixian Tongluo Decoction on patients with hemiplegia after cerebral infarction,and to explore the neural network regulation mechanism of Qixian Tongluo Decoction to improve motor function.To provide imaging basis for traditional Chinese medicine treatment of hemiplegia after cerebral infarction.Methods: A case-control study was conducted to include 14 patients with hemiplegia during the recovery period of cerebral infarction as the experimental group,and healthy(HC)subjects matching age,gender and education level were recruited.The experimental group was given the original prescription of Qixian Tongluo Recipe for 2 months.Functional magnetic resonance data were collected before and after intervention and motor function scale scores were performed.The DPARSF analysis software of Matlab R2017 a data processing platform was used to preprocess the rs-f MRI data,and then SPM12 analysis software was used to perform independent sample T test on the relevant statistics of each brain functional network in the experimental group and the healthy control group.The difference of brain function indexes before and after treatment in patients with cerebral infarction was analyzed by paired sample T test.The relevant indicators of the brain functional network were corrected by FDR(P < 0.05).The voxels with a threshold voxel P < 0.01 and cluster P < 0.01 were considered statistically significant for activation,showing meaningful activation of the brain region MNI coordinates,voxel number and t value.The main efficacy index Fugl-Meyer score and ALFF,fALFF,ReHo value were analyzed by person correlation.P < 0.05 was the threshold to determine whether there was a significant difference in order to explore its central effect mechanism.Results:1.After 8 weeks of treatment,the FMA score,TCM syndrome score of the patients treated with Qixian Tongluo Decoction were significantly higher than those before treatment,and there was statistical significance(P < 0.05).2.Compared with healthy controls,the brain regions with enhanced ALFF in patients with middle cerebral artery territory infarction were left middle occipital gyrus,left middle temporal gyrus,right middle temporal gyrus,right cuneus,right precentral gyrus and left postcentral gyrus;the brain regions with decreased ALFF were left orbital middle frontal gyrus,left medial superior frontal gyrus and right middle frontal gyrus.The regions with significantly enhanced fALFF were left middle occipital gyrus,left paracentral lobule,left superior occipital gyrus,right middle temporal gyrus,right postcentral gyrus and right calcarine fissure.The brain regions with decreased fALFF values were mainly : left orbital middle frontal gyrus,right hippocampus,and right middle frontal gyrus.The brain regions enhanced by ReHo were left middle temporal gyrus,left paracentral lobule and right calcarine fissure.The brain regions with decreased regional homogeneity mainly include : right middle frontal gyrus and left orbital middle frontal gyrus.3.The ALFF sequence results of the patient group before and after treatment with Qixian Tongluo Decoction showed that : left postcentral gyrus,medial superior frontal gyrus,right caudate nucleus;the ALFF value of the brain region was enhanced;ALFF in the left medial superior frontal gyrus,left superior marginal gyrus,left insula,left middle occipital gyrus,left middle frontal gyrus,right fusiform gyrus,right middle temporal gyrus and right lingual gyrus was significantly decreased.The fALFF comparison showed that the significantly enhanced brain regions included : left superior parietal gyrus,left postcentral gyrus,left superior occipital gyrus,right precuneus,and right medial superior frontal gyrus.Significantly weakened brain regions include : left insula,left superior temporal gyrus,left inferior occipital gyrus,right lenticular putamen,right inferior temporal gyrus,right lingual gyrus,right inferior parietal angular gyrus,right medial superior frontal gyrus,right postcentral gyrus;the brain area with significantly enhanced ReHo is the left supplementary motor area;re Ho significantly weakened brain regions including : left postcentral gyrus,left hippocampus,left orbital inferior frontal gyrus,right postcentral gyrus,right middle frontal gyrus,right olfactory cortex,right lingual gyrus,right temporal pole,middle temporal gyrus,etc.4.There was a linear positive correlation between the difference ofALFF in the postcentral gyrus,caudate nucleus and precuneus before and after treatment(r = 0.604,P = 0.025);there was a linear positive correlation between the difference of fALFF in the postcentral gyrus and cuneus and the difference(r = 0.564,P = 0.041).The ReHo difference in the left supplementary motor area was positively correlated with the FMA difference(r = 0.671,P = 0.023).Conclusion:1.The ALFF,fALFF and ReHo sequences of patients with middle cerebral artery infarcti on showed changes in the functional activity signals of different brain regions,which co nfirmed that the damage of infarct lesions or any structure or connection between any st ructures in the brain region would lead to the damage of motor function.To a certain e xtent,it reflects the damage and remodeling of spontaneous activity of cerebral motor co rtex after cerebral infarction.2.The brain regions with great significance for the change of brain function by Qixian Tongluo Decoction mainly include : central gyrus,superior frontal gyrus,middle frontal gyrus,orbital inferior frontal gyrus,supramarginal gyrus,superior occipital gyrus,middle occipital gyrus,inferior occipital gyrus,middle temporal gyrus,inferior temporal gyrus,s uperior parietal gyrus,hippocampus,right caudate nucleus,precuneus,etc.3.The mechanism of Qixian Tongluo Decoction in improving the motor function of hem iplegia after cerebral infarction may be closely related to the recovery of cortical functio nal reorganization after cerebral stroke. |
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