杠杆定位手法调控前额叶缓解腰椎间盘突出症患者痛情绪的脑网络效应研究
Study on the brain network effect of lever positioning manipulation to regulate the prefrontal cortex to relieve pain emotion in patients with lumbar disc herniation
周星辰 1陈龙豪 1吴双 1王凯正 1魏子程 1吕智桢 2吕立江2
作者信息
- 1. 浙江中医药大学附属第三医院,杭州 310053;浙江中医药大学第三临床医学院,杭州 310053
- 2. 浙江中医药大学附属第三医院,杭州 310053;浙江中医药大学第三临床医学院,杭州 310053;浙江中医药大学推拿脊柱病研究所,杭州 310053
- 折叠
摘要
目的:本研究旨在进一步探究前额叶(PFC)在单次杠杆定位手法(LPM)干预腰椎间盘突出症(LDH)疗程结束时如何调控痛情绪的脑网络效应.方法:纳入28例LDH患者(LDH组)及28名健康者(对照组).LDH组采用LPM治疗30 min,隔日1次,共4周14次,对照组不干预.LDH组于治疗前后行静息态功能磁共振成像技术(rs-fMRI)扫描,对照组仅纳入时行rs-fMRI扫描.以前期研究结果的左侧PFC峰值坐标划定感兴趣区(ROI),分析LDH组疗程前后的功能连接(zFC)脑网络效应,并与情绪量表做相关性分析.结果:与健康组比较,LDH组治疗前在左侧中央前回和左侧内侧和旁扣带脑回的zFC值显著增强(P＜0.005).与治疗前比较,LDH组治疗后在左侧颞极:颞中回和左侧眶部额上回的zFC增强(P＜0.005).相关性分析显示LDH组经LPM治疗后颞极:颞中回的zFC值与治疗后SAS评分呈强正相关(r=0.8627,P＜0.001),与治疗后SDS评分呈强正相关(r=0.8261,P＜0.001).结论:LDH患者痛情绪的产生可能伴随左侧"PFC-S1-ECN"神经环路的显著激活.左侧"PFC-ECN-DMN"可能是LPM治疗LDH患者痛情绪调控的关键神经环路.左脑可能在LPM治疗LDH患者痛情绪调控上占据主导地位.
Abstract
Objective:To further explore how the prefrontal cortex(PFC)modulates the brain network effects on emotional pain regulation at the end of the lever positioning manipulation(LPM)in the treatment of lumbar disc herniation(LDH)course.Methods:We included 28 LDH patients(LDH group)and 28 healthy individuals(control group).The LDH group received LPM treatment for 30 minutes every other day for a total of 14 sessions over 4 weeks.Before and after the treatment,resting-state functional magnetic resonance imaging(rs-fMRI)scans were conducted.The control group underwent rs-fMRI scans only at the time of inclusion.Using the previously identified frontal lobe peak coordinates from earlier research,we delineated regions of interest(ROI)and analyzed differences in functional connectivity(zFC)brain networks in the LDH group before and after the treatment course.Results:Compared with the healthy group,the zFC values in the left precentral gyrus and left medial and paracingulate gyri of the LDH group before treatment were significantly enhanced(P＜0.005).Compared with before treatment,the zFC in the left temporal pole:middle temporal gyrus and left orbital superior frontal gyrus in the LDH group was enhanced after treatment(P＜0.005).Correlation analysis showed that in the LDH group after LPM treatment,the zFC value of the temporal pole:middle temporal gyrus had a strong positive correlation with the post-treatment SAS score(r=0.8627,P＜0.001),and with the post-treatment SDS score(r=0.8261,P＜0.001)shows a strong positive correlation.Conclusion:The generation of pain emotions in LDH patients may be accompanied by significant activation of the left'PFC-S1-ECN'neural circuit.The left'PFC-ECN-DMN'may be the key neural circuit for LPM to treat pain emotion regulation in LDH patients.The left brain may play a dominant role in the regulation of pain emotion in LDH patients treated with LPM.
关键词
推拿/杠杆定位手法/腰椎间盘突出症/痛情绪/功能磁共振/前额叶Key words
Tuina/Lever positioning manipulation(LPM)/Lumbar disc herniation(LDH)/Pain emotion/Functional magnetic resonance imaging(fMRI)/Prefrontal cortex(PFC)引用本文复制引用
基金项目
国家自然科学基金(82274672)
国家自然科学基金(81774442)
浙江省"尖兵""领雁"重大研发攻关项目(2022C03123)
全国名老中医药专家传承工作室建设项目吕立江传承工作室项目(GZS2021026)
浙江省教育厅一般科研项目(Y202351266)
出版年
2024
NETL
NSTL
万方数据