SⅠ-MⅠ通路介导的针刺治疗面神经损伤的初级运动皮层突触可塑性机制研究

周围神经损伤指神经轴索中断或神经断裂导致支配区域感觉运动功能丧失，严重影响患者生活质量，当前以促进神经再生为主的治疗策略难以令人满意。系列研究证实，脑可塑性对神经损伤后的功能恢复有重要作用，是治疗神经损伤的新策略。我们的前期研究表明，生理状况下针刺可以诱发感觉皮层SⅠ和运动皮层MⅠ的可塑性；病理状况下针刺可调节周围性面瘫和面肌痉挛患者MⅠ的功能重组，与临床疗效密切相关。在此基础上，我们提出项目的科学假说：针刺面口部穴位通过面口部躯体感觉传入作用于SⅠ，调节MⅠ可塑性，促进面神经损伤后的功能恢复。本研究以此为切入点，采用皮层内微刺激、在体LTP、离体膜片钳等在体/离体电生理技术，结合光遗传学、光纤钙成像、双光子显微成像等神经生物学前沿技术，从SⅠ－MⅠ介导的突触可塑性探讨针刺治疗面神经损伤的生物学机制，有别于既往以神经再生为主体的研究思路，对于面神经损伤的针灸治疗具有重要的临床应用价值。

Peripheral nerves can easily get damaged which may lead to the sensory and motor functions deficits and even lifelong disability. In spite of extensive research on this aspect, complete functional recovery still remains a challenge to be resolved. A series of studies have confirmed that brain plasticity plays an important role in functional recovery after nerve injury and is a new strategy for the treatment of peripheral nerve injury. Our previous studies have shown that acupuncture can induce the plasticity of sensory cortex SⅠ and motor cortex MⅠunder physiological conditions; under pathological conditions, acupuncture can regulate the functional reorganization of MⅠ in patients with peripheral facial paralysis and facial muscle spasm, which is closely related to clinical efficacy. On this basis, we hypothesize that acupuncture at face and mouth acupoint may convey sensory information to SⅠ and regulate MⅠplasticity, which promotes functional recovery after facial nerve injury. The project bases on our previous work, intends to use electrophysiology (including intracortical microstimulation, in vivo recording and patch-clamp), optogenetics, photometry and two-photon microscope to study on the mechanism of synaptic plasticity in the motor cortex of acupuncture in treating peripheral facial nerve injury through SⅠ- MⅠ connectivity. This study is different from the previous researches with nerve regeneration, and has important clinical application value for acupuncture of facial nerve injury.