首页|基于神经影像学的常见神经系统疾病头针刺激靶点研究(上)

基于神经影像学的常见神经系统疾病头针刺激靶点研究(上)

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目的:基于神经影像学研究,总结现代脑科学的研究成果,探索常见神经系统疾病的头针刺激靶点.方法:基于Neurosynth数据库平台(http://neurosynth.org/)进行神经影像学研究的Meta分析,识别神经系统疾病的头针与脑刺激靶点并投射至头皮表面,进一步结合传统头部腧穴和脑电10-20系统做出定位建议,结合靶区形态做出操作建议.文献检索于2022年7月30日进行.结果:研究结果分上下两篇阐述,本文为上篇,包括帕金森病、慢性疼痛、失语症、失读症.帕金森病识别出了7个潜在头针靶点,对应的布罗德曼区(BA)主要为BA6等;慢性疼痛识别出了10个潜在头针靶点,对应脑区主要为BA40等;失语症识别出了7个潜在头针靶点,对应脑区主要为BA22等;失读症识别出了10个潜在头针靶点,对应脑区主要为BA40等.本文提供了以上各潜在靶点的基于神经影像的定位与操作建议.结论:本研究为头针的临床应用及研究提供了一种基于现代影像学证据的常见神经系统疾病的刺激靶点.这些靶点也可用于神经(脑)刺激治疗相关疾病的探索中.
Scalp acupuncture targets for neurological disorders:evidence from neuroimaging studies(part 1)
Objective Scalp acupuncture is a unique acupuncture method developed based on brain functional and pathophysiological knowledge.In past decades,there has been significant development in the understanding of the brain pathology of many neurological disorders through cutting-edge brain imaging techniques.Yet,these findings have not been incorporated into scalp acupuncture.In the present paper,we aimed to initiate an attempt to develop/identify scalp acupuncture targets based on neuroimaging findings.Methods Based on the meta-analysis of neuroimaging studies in the Neurosynth database platform(http://neurosynth.org/),the brain clusters related to neurological disorders were automatically identified according to the search terms"Parkinson's disease"(PD),"chronic pain"(CP),"aphasia"(APH),"dyslexia"(DYS),"mild cognitive impairment","Alzheimer's disease"and"dementia".Subsequently,the discovered brain region clusters projected onto the brain surface and scalp surface were listed,and the peak points of the clusters projected to the scalp surface were proposed as the potential stimulation targets for the corresponding diseases.Further,by combining the traditional scalp acupoints(including the scalp acupuncture lines)with 10-20 EEG system sites,we made localization suggestions for scalp stimulation targets and made acupuncture operation suggestions by combining with the shape of the brain region clusters.The literature search was conducted on July 30,2022.Results The localization and manipulation suggestions of neuroimage-based scalp acupuncture targets were introduced in two parts.This part(part 1)includes PD,CP,APH,and DYS.Here are 3 target examples of each of these 4 diseases simply introduced due to word limitation.1)PD.Based on the 175 articles retrieved from Neurosynth,we identified 7 potential scalp acupuncture targets for PD,the locations of the acupuncture stimulation and the recommended acupuncture needle operation(RANO)as well as the corresponding brain regions(CBRs)respectively are as below.PD1:about 0.5 cun(1 cun≈33.3 mm)superior-posterior to the left Xuanlu(GB5);puncturing subcutaneously and forward-upward;the left premotor area,subfrontal cortex of the island,inferior frontal gyrus and middle frontal gyrus.PD2:about 1 cun lateral-inferior to the left Chengling(GB18);puncturing subcutaneously and backward-upward;the inferior parietal lobule and postcentral gyrus.PD3:about 0.5 cun lateral-anterior to the left GB18;puncturing subcutaneously and inward-backward;left anterior central gyrus and posterior central gyrus.2)CP.Based on the retrieved 92 articles,we identified 8 potential scalp acupuncture targets,the location of the acupuncture stimulation and the RANO,and CBRs respectively are as below.CP1:about 1 cun anterior-inferior to the left Xuanli(GB8);puncturing subcutaneously and backward-inwards;the left inferior frontal gyrus orbitalis and pars triangularis.CP2:about 0.5 cun posterior-superior to the left GB5;puncturing subcutaneously and forward-upward;the left anterior central gyrus and premotor area.CP3:about 0.5 cun posterior-superior to the left GB8;puncturing subcutaneously and forward;left inferior central area/central sulci operculum(second somatosensory area).3)APH.Based on the retrieved 82 papers,we identified 7 potential scalp acupuncture targets for APH,their locations,RANO,and CBRs respectively are as below.APH1:close to the left GB5;puncturing subcutaneously and forward-downward;left subfrontal gyrus operculi/triangularis.APH2:about 0.5 cun posterior to the left Hanyan(GB4);puncturing subcutaneously and backward-upward;the left anterior central gyrus and posterior central gyrus.APH3:about 0.5 cun anterior-inferior to the left Qubin(GB7);puncturing subcutaneously and backward-downward;left medial/superior temporal gyrus.4)DYS.Based on the retrieved 76 researches,we identified 8 potential scalp acupuncture targets for DYS,their locations,RANO and CBRs respectively are as below.DYS1:about 1 cun anterior-inferior to the left GB5;puncturing subcutaneously and forward-upward;the pars triangularis of the left inferior frontal gyrus.DYS2:about 0.5 cun posterior-superior to the left GB5;puncturing subcutaneously and forward-downward;the left subfrontal gyrus operculum,pars triangularis and anterior central gyrus.DYS3:the midpoint between the left GB5 and GB18;puncturing subcutaneously and forward;the left anterior central gyrus and posterior central gyrus.Conclusion We identified scalp acupuncture targets for several common neurological disorders based on neuroimaging evidence for clinical application and research.The proposed targets may also be used for treating these disorders using brain stimulation methods.

Scalp acupunctureScalp acupuncture stimulation targetsNeuroimagingNeurological disordersBrain stimulation

张斌龙、刘娇、崔方圆、曹瑾、余思奕、孔乔、孔健

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中国中医科学院广安门医院,北京 100053

福建中医药大学福建省康复产业研究院,福州 350122

首都医科大学中医药学院,北京 100069

北京中医药大学东直门医院,北京 100700

北京中医药大学生命科学学院,北京 100029

成都中医药大学针灸推拿学院,成都 611137

哈佛医学院麻省总医院,波士顿02129,美国

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头针 头针刺激靶点 神经成像 神经系统疾病 脑刺激

国家自然科学基金国家自然科学基金中国科协青年人才托举工程项目中国中医科学院优秀青年科技人才培养专项中国中医科学院科技创新工程项目

82205299820043032022QNRC001ZZ14-YQ-017CI2021A03316

2024

针刺研究
中国中医研究院针灸研究所,中国针灸学会

针刺研究

CSTPCD北大核心
影响因子:1.656
ISSN:1000-0607
年,卷(期):2024.49(6)
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