不同穴位电针对老年人吞咽功能影响的脑功能磁共振研究

目的 观察正常人在电针不同穴位后执行吞咽任务时脑部激活区的差异,研究影响吞咽功能穴位特异性可能的中枢机制.方法 招募10名老年健康志愿者,利用功能磁共振技术,抽签选取电针人迎穴和廉泉穴(治疗穴)或条口穴和地机穴(对照穴),电针穴位后取出电针,进行吞咽任务(包括吞咽准备及吞咽动作)扫描；3天后再选取另一组穴位电针后进行相同模式的扫描.分析治疗穴数据集和对照穴数据集,获得两组穴位电针后执行吞咽任务的差异脑功能激活区. 结果 治疗穴电针后执行吞咽准备时,脑激活区主要分布在两侧的中央前回、中央后回、额中回、颞中回、小脑、脑干、左侧的顶下小叶、缘上回；治疗穴电针后执行吞咽动作时,脑激活区分布在两侧的中央前回、右侧的颞上回和小脑.与对照穴比较,电针后治疗穴执行吞咽准备时的差异脑激活区为顶上小叶；执行吞咽动作时差异脑激活区集中在右侧梭状回、左侧枕中回、右侧舌回、后扣带回、楔叶.结论 电针人迎穴与廉泉穴可募集大脑对侧更多的脑区参与完成吞咽动作,提高全脑的协同性和代偿功能,从而改善吞咽功能.

Influence of Electro-Acupuncture at Different Acupoints on the Swallowing Function in the Elderly.A MRI Study

Objective To compare the difference of the brain activated regions when swallowing after electro-acupuncture on different acupoints in the healthy people and research the central mechanism of the specificity of acupoints affecting the swallowing function.Methods Ten elder healthy volunteers were recruited and received electro-acupuncture on the treatment acupoints of Renying(ST9) and Lianquan(RN23) or the control acupoints of Tiaokou(ST38) and Diji(SP8).Three days later,the acupoints exchanged.After each treatment,the volunteers were scanned by magnetic resonance imaging(MRI) while swallowing.The data sets of treatment acupoints and control acupoints were collected and analyzed by two-sample t-test.Results After electro-acupunture on the treatment acupoints,the brain activated regions were located in bilateral precentral gyrus,postcentral gyrus,middle frontal gyrus,middle temporal gyrus,cerebellum,brainstem,left inferior parietal lobule and supramarginal gyrus during the preparation of swallowing,while located in bilateral precentral gyrus,right superior temporal gyrus and cerebellum during the action of swallowing.Comparing with the control acupoints,the different brain regions were superior parietal lobule during the preparation of swallowing,while right fusiform gyrus,left middle occipital gyrus,right lingular gyrus,posterior cingulate gyrus and cuneus during the action of swallowing after electro-acupuncture on the treatment acupoints.Conclusion Electro-acupuncture on Renying(ST9) and Lianquan(RN23) could improve the swallowing function by activating more related brain regions of the opposite hemisphere to participate in swallowing and increasing the synergy and compensation of brain.