基于脑-肠轴的慢性偏头痛针刺疗效差异机制及适宜人群筛选的影像组学研究

本项目以慢性偏头痛为研究对象，结合课题组发现的偏头痛针刺治疗具有显著个体疗效差异，针刺可靶向调节患者异常的大脑功能及网络，假针刺产生的安慰剂效应具有突出的中枢影像特征等一系列研究基础，同时结合国际上关于肠道菌群对慢性偏头痛的发病和治疗具有显著影响的研究发现，以脑-肠轴为研究切入点，提出“慢性偏头痛患者的大脑功能与肠道微生物相互作用并影响针刺治疗的个体疗效，慢性偏头痛患者针刺的疗效差异与患者大脑结构、功能网络及特定菌群的结构和多样性的差异有关”的研究假说，通过分析针刺疗效不同的慢性偏头痛患者的临床行为学，大脑结构与功能网络个体化神经影像特征，肠道菌群结构和生物多样性等的区别，探讨针刺治疗慢性偏头痛的脑-肠-菌调控机制，并结合影像组学研究方法建立“临床行为学-中枢影像表征-肠道菌群表征”三位一体的可用于筛选针刺治疗适宜人群的生物标记，为促进针灸临床疗效提高及科研成果的转化应用具有重要意义。

This project focus on chronic migraine (CM) patients. Based on a series of research foundations such as acupuncture treatment of CM found by our research group has significant individual difference in efficacy, acupuncture can targetly regulate the abnormal brain function and functional network of migraineur, and the difference of clinical efficacy of sham acupuncture has prominent central image characteristics. Combined with international studies on gut microbiota in patients with CM, it is found that gut microbiota has a significant impact on the onset and treatment of CM. Taking the brain-intestinal axis as the breakthrough point, we propose the hypothesis that "the interaction between brain and gut microbiota affects the individual efficacy of acupuncture treatment. Acupuncture can affect the therapeutic efficacy by regulating the abnormal brain functional network and the structure and diversity of specific microflora in patients with CM". Based on the differences of clinical behavioral indexes, individualized neuroimaging features of brain structure and functional network, gut microbiota structure and biodiversity characteristics of CM patients with different acupuncture therapeutic effects are analyzed, and the brain-intestine- microflora regulatory mechanism of acupuncture in treating CM is discussed. Combined with the radiomics research methods, we excavate the deep quantitative characteristics which can predict curative effect and establish "clinical behavior, central imaging features and gut microbiota characteristics" which can screen biomarkers in migraineurs who are suitable for acupuncture. It is of great significance for promoting the clinical curative effect of acupuncture and the transformation the achievements of scientific research.