基于功能性近红外光谱技术探讨头皮针联合言语康复训练对脑卒中后失语症患者的影响OACSTPCD

Objective To explore the effect and its neurological mechanisms of scalp-acupuncture treatment combined with speech rehabilitation training on patients with post-stroke aphasia(PSA)based on functional near-infrared spectroscopy(fNIRS).Methods A total of 64 patients with PSA in the Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medi-cine from July 2022 to September 2023 were recruited and randomly divided into control group and observation group according to random number tables generated by SAS 9.1 statistical software,with 32 cases in each group.The control group received conven-tional speech rehabilitation therapy(speech training,language imitation,figure-word matching,numerical reading/writing/calculat-ing and social communication skills training,etc.),medication treatment and health education;the observation group received scalp-acupuncture in addition,targeting the language function area(2/5 below the anterior parietotemporal oblique line and the anterior temporal line),punctured horizontally or obliquely,and then retained for 30 minutes after needling bringing about the desired sensa-tion.The speech and language treatment were carried out by the speech rehabilitation therapists in the process of needle retention.Both groups were treated for 30 minutes a time,once a day,five times a week for four weeks.Before and after treatment,Beijing Medical University aphasia battery in Chinese(ABC)was used to evaluate language function;Chinese functional communication profile(CFCP)was used to evaluate speech and communication skills;fNIRS was used to evaluate the changes of cortical oxyhemo-globin(HbO2)and deoxyhemoglobin(HbR),and E-prime 3.0 software was used to evaluate verbal fluency.The correlation be-tween the activation of brain regions during the verbal fluency task and the verbal fluency scores in the observation group was ana-lyzed.Results(1)ABC,CFCP and verbal fluency scores:compared with that before treatment,ABC,CFCP and verbal fluency scores of both groups increased significantly after treatment,and the differences were statistically significant(P<0.05).Compared with the control group,the observation group did not show statistically significant differences in ABC and CFCP scores after treat-ment(P>0.05),but had significantly higher verbal fluency scores after treatment(P<0.05).The differences of ABC,CFCP and ver-bal fluency scores before and after treatment were all significantly higher in the observation group,and the differences were all statis-tically significant(P<0.05).(2)Brain area activation β-value difference during the verbal fluency task:compared with the control group,activation β-value difference in the posterior part of the left middle temporal gyrus in the observation group was significantly higher(P=0.037),activation β-value differences in the right inferior frontal gyrus triangular part(P=0.022)and the right posterior part of the middle temporal gyrus(P=0.049)in the observation group were significantly lower.(3)Correlation between the differences of the activation β-value of brain regions during the verbal fluency task and the verbal fluency scores:the difference of language flu-ency scores in the observation group was negatively correlated with the difference of activation β in the posterior part of the right middle temporal gyrus(r=-0.408,P=0.020)and the difference of activation β in the triangular part of the right inferior frontal gyrus(r=-0.423,P=0.016).Conclusion Scalp-acupuncture treatment combined with speech rehabilitation training can promote the recovery of language function of patients with PSA,and the improvement of verbal fluency may be related to the down-regulation of activation in the posterior part of the right middle temporal gyrus and the triangular part of the right inferior frontal gyrus in the brain area.