基于DTI探讨针刺干预对急性缺血性脑卒中运动功能障碍的神经重塑机制OA

Objective:To investigate the neuroplastic effects of acupuncture intervention on motor dysfunction in patients with acute ischemic stroke,and to evaluate the effects of acupuncture on the white matter fiber structure of the corticospinal tract(CST)using diffusion tensor imaging(DTI).Methods:A total of 16 patients with acute ischemic stroke(stroke group)and 16 healthy subjects(control group)were included.The stroke group received acupuncture treatment in addition to conventional Western medical treatment,and DTI was used to evaluate the changes in fractional anisotropy(FA)at each of the 100 nodes along the CST before and after treatment,as well as the correlations between FA and the scores of Fugl-Meyer assessment(FMA)and National Institutes of Health Stroke Scale(NIHSS).Results:The FA values of the affected CST in the stroke group were significantly lower than those in the control group(P<0.05).Compared with before treatment,after acupuncture treatment(90th day)in the stroke group,the FA values decreased in the middle segment of the affected side(nodes 40-46),while the FA values increased in the superior segment of the healthy CST(nodes 80-97)(all P<0.05,FDR corrected).Before and after treatment in the stroke group,the FA values of the affected CST were positively correlated with FMA scores(r=0.755,0.749,both P<0.05),and negatively correlated with NIHSS scores(r=-0.516,-0.652,both P<0.05).Conclusions:Acupuncture treatment can significantly improve motor function in patients with acute ischemic stroke by promoting neuroplasticity of CST.DTI provides imaging evidence for acupuncture treatment of motor dysfunction after stroke.