The modulation effect of longitudinal acupuncture on resting state functional connectivity in knee osteoarthritis patients.
The modulation effect of longitudinal acupuncture on resting state functional connectivity in knee osteoarthritis patients.
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DOI：
10.1186/s12990-015-0071-9
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发表时间：
2015-10-29
期刊：
影响因子：
3.3
通讯作者：
Kong J
中科院分区：
文献类型：
--
作者：
Chen X;Spaeth RB;Freeman SG;Scarborough DM;Hashmi JA;Wey HY;Egorova N;Vangel M;Mao J;Wasan AD;Edwards RR;Gollub RL;Kong J
脑成像的最新进展有助于我们理解与针灸治疗相关的神经活动。在这项研究中，我们调查了功能连接在纵向针灸治疗老年患者膝骨关节炎（OA）。在为期4周（6次治疗）的时间内，我们收集了30名患者在第一次、第三次和第六次治疗前后的静息状态功能性磁共振成像（fMRI）扫描。临床结果显示，与假针灸相比，真针灸的膝关节损伤和骨关节炎结局评分（KOOS）（表明改善）的疼痛分项评分显著更高。静息状态fMRI数据的独立成分分析（伊卡）显示，治疗后，与假手术组相比，verum组的右额顶网络（rFPN）和执行控制网络（ECN）与前扣带皮层/内侧前额叶皮层的功能连接（FC）增强，前扣带皮层/内侧前额叶皮层是下行疼痛调节系统的关键区域。我们还发现，rFPN与左丘脑的连接（1）与治疗后KOOS疼痛评分的变化显著相关，（2）与假治疗相比，真针治疗后显著增强。针灸针刺激扫描的分析显示，与假治疗相比，Verum针刺激活了左盖/小脑，这也与静息状态分析中观察到的结果重叠。我们的研究结果表明，针刺可能通过调节rFPN，ECN和下行疼痛调节通路之间的功能连接来实现对膝关节OA疼痛的治疗效果。临床试验编号：NCT 01079390本文的在线版本（doi：10.1186/s12990-015-0071-9）包含补充材料，可供授权用户使用。
Recent advances in brain imaging have contributed to our understanding of the neural activity associated with acupuncture treatment. In this study, we investigated functional connectivity across longitudinal acupuncture treatments in older patients with knee osteoarthritis (OA). Over a period of 4 weeks (six treatments), we collected resting state functional magnetic resonance imaging (fMRI) scans from 30 patients before and after their first, third and sixth treatments. Clinical outcome showed a significantly greater pain subscore on the Knee Injury and Osteoarthritis Outcome Score (KOOS) (indicative of improvement) with verum acupuncture than with sham acupuncture. Independent component analysis (ICA) of the resting state fMRI data showed that the right frontoparietal network (rFPN) and the executive control network (ECN) showed enhanced functional connectivity (FC) with the rostral anterior cingulate cortex/medial prefrontal cortex, a key region in the descending pain modulatory system, in the verum groups as compared to the sham group after treatments. We also found that the rFPN connectivity with the left insula is (1) significantly associated with changes in KOOS pain score after treatments, and (2) significantly enhanced after verum acupuncture treatments as compared to sham treatment. Analysis of the acupuncture needle stimulation scan showed that compared with sham treatment, verum acupuncture activated the left operculum/insula, which also overlaps with findings observed in resting state analysis. Our results suggest that acupuncture may achieve its therapeutic effect on knee OA pain by modulating functional connectivity between the rFPN, ECN and the descending pain modulatory pathway. Clinical trial number: NCT01079390 The online version of this article (doi:10.1186/s12990-015-0071-9) contains supplementary material, which is available to authorized users.