CAJ | 학술논문

目的：研究在静息状态下周围性面瘫患者临床针刺治疗不同病程状态下的脑区局部一致性(regional homogeneity，ReHo)变化特点，探讨针刺治疗周围性面瘫的可能中枢整合机制。材料与方法采用静息态fMRI技术，采集32例健康志愿者及47例面瘫患者临床针刺治疗不同病程状态下(面瘫早期组、后期组及治愈组)的BOLD数据，采用ReHo的数据后处理方法进行分析，将面瘫早期组、后期组及治愈组分别与健康志愿者ReHo值比较，获取有统计学意义的差异脑区。结果(1)面瘫早期组ReHo增高的脑区有右侧额上回、额中回、额下回，左侧楔前叶、后扣带回和颞上回，ReHo值减低脑区有右侧颞下回、楔叶和楔前叶；(2)面瘫后期组ReHo增高的脑区有左侧SII、颞上回、额上回、中央旁小叶、楔叶、楔前叶和右侧额下回；(3)面瘫治愈组ReHo增高的脑区有左侧中央旁小叶、梭状回和颞上回。结论大脑皮层运动前区(PMA)、辅助运动区(SMA)是周围性面瘫患者脑功能重组及代偿的关键区域，也是针刺治疗周围性面瘫患者重要的调制和关键代偿区域。
목적：연구재정식상태하주위성면탄환자림상침자치료불동병정상태하적뇌구국부일치성(regional homogeneity，ReHo)변화특점，탐토침자치료주위성면탄적가능중추정합궤제。재료여방법채용정식태fMRI기술，채집32례건강지원자급47례면탄환자림상침자치료불동병정상태하(면탄조기조、후기조급치유조)적BOLD수거，채용ReHo적수거후처리방법진행분석，장면탄조기조、후기조급치유조분별여건강지원자ReHo치비교，획취유통계학의의적차이뇌구。결과(1)면탄조기조ReHo증고적뇌구유우측액상회、액중회、액하회，좌측설전협、후구대회화섭상회，ReHo치감저뇌구유우측섭하회、설협화설전협；(2)면탄후기조ReHo증고적뇌구유좌측SII、섭상회、액상회、중앙방소협、설협、설전협화우측액하회；(3)면탄치유조ReHo증고적뇌구유좌측중앙방소협、사상회화섭상회。결론대뇌피층운동전구(PMA)、보조운동구(SMA)시주위성면탄환자뇌공능중조급대상적관건구역，야시침자치료주위성면탄환자중요적조제화관건대상구역。
AbrtractObjective:To analyze the changes of regional homogeneity and explore the central mechanisms through the treatment of peripheral facial paralysis with acupuncture in the different pathological stages.Materials and Methods: 32 healthy adult volunteers and 47 patients with peripheral facial paralysis participated in the study. Resting-state fMRI were acquired for each volunteer and patient. The ReHo approach was used to compare the peripheral facial paralysis groups of different pathological stages to healthy group.Results:Compared to healthy group, (1) In the early group, the increased ReHo areas were showed in the right superior frontal gyrus, middle frontal gyrus, inferior frontal gyrus, and the left precuneus, posterior cingulated gyrus, superior temporal gyrus, while the decreased areas were showed in the right inferior temporal gyrus, cuneus and precuneus. (2) In the later group, the increased ReHo were found in the left SII, superior temporal gyrus, superior frontal gyrus, paracentral lobule, cuneus, precuneus, and the right inferior frontal gyrus. (3) In the recovered group, the increased ReHo were found in the left paracentral lobule, fusiform gyrus and superior temporal gyrus.Conclusions: The brain areas of the premotor cortex (PMA), supplementary motor area (SMA) were likely to be the key areas of compensatory and brain functional reorganization in patients with peripheral facial paralysis. These areas may be the key regions for integration and modulation in the patients suffering from peripheral facial paralysis treated by acupuncture.