Acupuncture Evoked Response in Contralateral Somatosensory Cortex Reflects Peripheral Nerve Pathology of Carpal Tunnel Syndrome
Acupuncture Evoked Response in Contralateral Somatosensory Cortex Reflects Peripheral Nerve Pathology of Carpal Tunnel Syndrome
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DOI：
10.1089/acu.2013.0964
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发表时间：
2013-08-01
影响因子：
1.1
通讯作者：
Napadow, Vitaly
中科院分区：
文献类型：
--
作者：
Maeda, Yumi;Kettner, Norman;Napadow, Vitaly
背景：大多数探索大脑对不同穴位反应的神经影像学研究都是在健康成人中进行的。目的：本研究的目的是比较慢性疼痛腕管综合征（CTS）患者与健康对照组（HC）对局部和远端穴位针灸的脑反应，并将这些反应与正中神经功能联系起来。材料与方法：采用事件相关功能MRI （fMRI）评估CTS （n = 37）和HC （n = 30）患者对电针（EA; 2Hz）的脑反应。EA应用于CTS病变的局部（pc7至tw5）和远端（sp6至lv4）穴位。结果：两组和穴位的脑反应包括双侧次级体感皮层（S2）和脑岛的激活，以及对侧初级体感皮层（cS1）的激活。同侧初级体感觉皮层失活（S1）。HC在cS1的局部和远端穴位有显著差异，而CTS则无显著差异。此外，EA局部穴位激活cS1与HC正中神经峰值感觉潜伏期呈负相关，而与CTS正相关。两组远端穴位EA无相关性。结论：CTS和HC对EA的脑反应不同，局部穴位刺激与正中神经功能有关，反映了CTS的周围神经病理生理。
Background: Most neuroimaging studies exploring brain response to different acupoints have been performed in healthy adults.Objective: The aim of this study was to compare brain responses to acupuncture at local versus distal acupoints in patients with carpal tunnel syndrome (CTS), who have chronic pain, versus healthy controls (HC) and correlate these responses with median nerve function.Materials and Methods: Brain response to electroacupuncture (EA; 2Hz) was evaluated with event-related functional MRI (fMRI) in patients with CTS (n = 37) and age-matched HC (n = 30). EA was applied at acupoints local (PC 7 to TW 5) and distal (SP 6 to LV 4) to the CTS lesions.Results: Brain response in both groups and acupoints included activation of the bilateral secondary somatosensory cortex (S2) and insula, and the contralesional primary somatosensory cortex (cS1). Deactivation was noted in ipsilesional primary somatosensory cortex (S1). A significant difference between local and distal acupoints was found in cS1 for HC, but not CTS. Furthermore, cS1 activation by EA at local acupoints was negatively correlated with median nerve peak sensory latency in HC, but was positively correlated in CTS. No correlation was found for EA at distal acupoints for either group.Conclusions: Brain response to EA differs between CTS and HC and, for local acupoint stimulation, is associated with median nerve function, reflecting the peripheral nerve pathophysiology of CTS.