头穴丛刺联合太极拳对卒中后抑郁患者脑功能连接及网络拓扑的影响OA

Objective To explore the effect of cluster scalp acupuncture combined with Taijiquan training on depressive symptom,motor function,activities of daily living,serum markers,as well as brain functional connectivity(FC)and net-work topological properties in patients with post-stroke depression(PSD). Methods A total of 40 PSD patients in the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine from September,2022 to September,2023 were enrolled and randomly divided into control group(n=20)and experimental group(n=20).The control group received cluster scalp acupuncture alone,while the experimental group underwent Taijiquan training in addition,for four weeks.They were assessed with Hamilton Depression Scale-17(HAMD-17),Fugl-Meyer Assessment(FMA)and Barthel Index(BI)before and after treatment,while the serum levels of dopamine(DA),5-hydroxytryptamine(5-HT),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were detected with enzyme-linked immunosorbent assay.Resting-state functional magnetic resonance imaging(rs-fMRI)was applied to assess brain FC,as well as the global efficiency(Eg)and small-world property(σ)of brain networks. Results The scores of HAMD-17,FMA and BI improved in both groups(t>2.922,P<0.01)after treatment,and im-proved more in the experimental group than in the control group(t>2.517,P<0.05).The serum levels of DA and 5-HT increased in both groups(t>2.637,P<0.05),and increased more in the experimental group(t>2.192,P<0.05).The serum levels of IL-6 and TNF-α decreased in the experimental group after treatment(t>4.059,P<0.001),and they were less than those in the control group(t>2.154,P<0.05).FC between left mid-dle frontal gyrus and right anterior cingulate gyrus,as well as between left hippocampus and right precuneus were higher in the experimental group than in the control group after treatment(t>3.867,P<0.001),while Eg and σ increased in both groups(t>2.828,P<0.05),and they were higher in the experimental group(t>2.675,P<0.05). Conclusion Combination of Taijiquan training is more effective on depressive symptoms,motor function and activities of daily living in PSD patients,which may be related to up-regulation of serum DA and 5-HT,reduction of in-flammatory factors,enhancement of prefrontal-limbic system functional connectivity and optimization of brain network topological properties.