刺激穴位激活语言皮质的fMRI研究

目的用fMRI显示联合刺激通里和商丘两穴位时脑皮质功能区的激活情况,探讨其与语言皮质功能区的对应关系. 资料与方法 30名无语言障碍成年志愿者,将贴片电极分别置于志愿者双侧通里、商丘及右侧穴位旁1 cm处（非经络走行区）.实验采用组块设计模式,静息阶段与刺激阶段交替.实验依刺激阶段的任务不同而分成3组：对照组、右侧组和左侧组. 结果对照组激活了左侧中央前回、左侧中央后回、左侧枕叶及右侧枕叶.右侧组激活了左侧中央前回、左侧中央后回、左侧颞上回、左侧缘上回、左侧枕叶、左侧额极区、右侧枕叶、右侧缘上回及扣带回.左侧组激活了左侧中央后回、左侧颞上回、左侧枕叶、右侧颞上回、右侧枕叶、右侧中央前回、右侧中央后回、右侧缘上回、右侧额上回及扣带回.3组间脑功能区激活范围和T值的单因素方差分析显示在右侧中央前回、双侧中央后回、双侧颞上回及双侧缘上回差异均有显著性（P＜0.05）.而在左侧中央前回差异均无显著性（P＞0.05）.右侧组双侧大脑半球对称激活区之间进行配对t检验显示双侧中央后回、颞上回及缘上回的激活范围和T值之间比较差异均有显著性（P＜0.01）,左侧激活明显强于右侧;双侧中央前回的激活范围和T值之间比较差异无显著性（P＞0.05）.左侧组双侧大脑半球的对称激活区之间进行配对t检验,各部位的激活范围和T值之间比较差异均有显著性（P＜0.01）,右侧激活明显强于左侧. 结论电刺激通里和商丘与语言皮质功能区的激活具有相关性且其激活与肢体侧别交叉.

The fMRI Study of Cerebral Speech Cortex Activation by Electric Stimulating Tongli and Shangqiu

Objective To characterize the cerebral cortex activation by electric stimulating Tongli and Shangqiu using fMRI, and to evaluate the relationship between stimulating Tongli and Shangqiu and the reaction of cerebral speech cortex.Materials and Methods 30 healthy volunteers were included in this study which were inserted poles on the surface of acupoints Tongli and Shangqiu as well as non-acupoint surface, 1cm aside of the acupoints. A block design was applied in this study. Based on the different purpose of the stimulation, control group, right-side group andleft-side group were designed in the study.Results Left precental gyurs, left postcentral gyrus, left occipital lobe and right occipital lobe were activated in the control group. Left precentral gyrus, left postcentral gyrus, left superior temporal gyrus, left supramarginal gyrus, left occipital lobe, left frontal pole, right superior temporal gyrus, right occipital lobe, right supramarginal gyrus and cingulum were activated in the right-side group. Left postcentral gyrus, left superior temporal gyrus, left occipital lobe, right superior temporal gyrus, right ccipital lobe, right precentral gyrus, right postcentral gyrus, right supramarginal gyrus, right superior frontal gyrus and cingulum were activated in the left-side group. The result of one-way ANOVA among the three groups indicated significance of difference (P<0.05) in right pretcentral gyrus, bilateral postcentral gyrus, bilateral superior temporal gyrus and bilateral supramarginal gyrus, there was no significance difference in Left precentral gyrus (P>0.05). The result of paired t-test for dependent samples between the bilateral cerebral active cortex indicated significance of difference (P<0.01) in postcentral gyrus, superior temporal syrus and supramarginal gyrus in right group, there was no significant difference in bilateral precentral gyrus (P>0.05). There was significant difference in all areas in left group (P<0.01). Conclusion The results indicate that there are relevance between stimulationg of Tongli and Shangqiu by electric stimulus and the activation of cerebral speech cortex, and it implicates that stimulation affect mainly contralateral cerebral speech cortex.