中国中西医结合杂志2024，Vol.44Issue(1)：49-55,7.DOI:10.7661/j.cjim.20230731.285
基于静息态功能磁共振探讨杠杆定位手法治疗腰椎间盘突出症的即刻脑网络效应
Study on the Immediate Brain Network Effect of Lever Positioning Manipulation in the Treatment of Lumbar Disc Herniation Based on Resting State Functional Magnetic Resonance Imaging
摘要
Abstract
Objective To observe the effect of lever positioning manipulation(LPM)on the immediate brain network in patients with lumbar disc herniation(LDH)using resting state functional magnetic resonance imaging(rs-fMRI).Methods Totally 19 patients with LDH(the LDH group)and 20 healthy people(the healthy control group)in line with inclusion criteria were enrolled.Those in LDH group were treated with LPM for 30 min,and rs-fMRI was performed before and after treatment.Those in healthy control group were only scanned with rs-fMRI when included.Brain regions with statistical significance in the mean normalized low-frequency amplitude(mALFF)were analyzed between the LDH group and the healthy control group at enrollment.Functional connectivity(FC)changes in the LDH group before and immediately after treatment using statistically significant brain regions as regions of interest(ROI)were analyzed.Results Compared with the healthy control group,mALFF of left superior parietal gyrus,bilateral anterior cuneiform lobe,and right dorsolateral superior frontal gyrus were significantly enhanced in the LDH group before treatment.mALFF value in the left posterior central gyrus decreased significantly(P＜0.005).In different brain regions,the maximum mALFF value was in the right anterior cuneiform lobe.The right anterior cuneiform lobe mass peak coordinate was demarcated with a radius of 10 mm as the ROI for FC analysis.Compared with the healthy control group,the FC values in the right dorsolateral superior frontal gyrus,the left anterior central gyrus,and the left dorsolateral superior frontal gyrus were significantly enhanced in LDH group before treatment,and the FC values in the left medial and paracingulate gyrus were significantly lowered(P＜0.05).The right anterior cuneiform lobe was demarcated with a radius of 10 mm as ROI for FC analysis.Compared with before treatment,FC in left medial and paracingulate gyrus,left anterior cuneiform lobe,right posterior cingulate gyrus,right paracentral lobule,and left dorsolateral superior frontal gyrus were enhanced in LDH group after treatment(P＜0.05).Conclusions There existed significant activation of"default mode network-dorsolateral prefrontal cortex-S1"("DMN-dIPFC-S1")neural circuit in chronic pain of LDH patients.Executive control network-default mode network-dorsolateral prefrontal cortex(ECN-DMN-dIPFC)might be the key neural circuit for LPM to intervene LDH patients to exert immediate analgesia.关键词
推拿/杠杆定位手法/腰椎间盘突出症/功能磁共振/即刻脑效应Key words
massage(Tuina)/lever positioning manipulation/lumbar disc herniation/magnetic resonance imaging/Real-time brain activity引用本文复制引用
周星辰,吕智桢,黄玉波,吴双,洪泽,吕立江..基于静息态功能磁共振探讨杠杆定位手法治疗腰椎间盘突出症的即刻脑网络效应[J].中国中西医结合杂志,2024,44(1):49-55,7.基金项目
浙江省"尖兵""领雁"重大研发攻关项目(No.2022C03123) （No.2022C03123）
国家自然科学基金资助项目(No.82274672,No.81774442) （No.82274672,No.81774442）
