Functional MRI study of embodied motor imagery training combined with acupuncture on improving upper limb motor function after ischemic stroke
Objective To explore the clinical efficacy of embodied motor imagery training(MIT)combined with acupuncture in improving upper limb motor function after ischemic stroke,and to understand the potential brain mechanism of the combined therapy through resting state functional MRI(fMRI).Methods A total of 36 patients with first cerebral infarction admitted to our hospital were randomly divided into control group and experimental group.The control group received routine rehabilitation+acupuncture treatment,and the experimental group received routine rehabilitation+embodied MIT combined with acupuncture treatment.Each training lasted for 60 min,once a day,5 days a week,for a total of 8 weeks.Before and after treatment,Fugl-Meyer assessment(FMA)and modified Barthel index(MBI)were used to evaluate the upper limb motor function and daily living ability of the patients,and fMRI data of the whole brain in resting state were collected to calculate the amplitude of low frequency fluctuation(fALFF)and z-score(zfALFF).Repeated measures analysis of variance was used to analyze the interaction effect of group x time,the main effect of group and the main effect of time.Results After treatment,the FMA score of the experimental group increased from(16.83±3.00)to(27.89±3.99),and the MBI score increased from(26.11±6.31)to(59.22±9.47).Compared with the control group,the differences were statistically significant(all P＜0.05).The fMRI data showed that the zfALFF of the lesion-side supplementary motor area,inferior parietal angular gyrus,triangular inferior frontal gyrus,supramarginal gyrus and middle temporal gyrus were significantly increased in the experimental group,while the zfALFF of the lesion-side supplementary motor area,postcentral gyrus,triangular inferior frontal gyrus,supramarginal gyrus and middle temporal gyrus were significantly decreased in the control group.The increased amplitude of zfALFF in the lesion-side supplementary motor area and supramarginal gyrus was significantly positively correlated with the increased amplitude of FMA(all P＜0.0 5).Conclusions Embodied MIT combined with acupuncture and routine rehabilitation can significantly improve the upper limb motor function and daily living ability of patients with cerebral infarction.The functional improvement is related to the neural activity and pathway activation in the lesion side auxiliary motor area,inferior parietal angular gyrus,triangular inferior frontal gyrus,supramarginal gyrus,middle temporal gyrus and bilateral postcentral gyrus.
ischemic strokeembodied motor imageryacupunctureupper-limb motor functionfunctional MRI
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