Effect of acupuncture on cerebral regional homogeneity in the Parkinson’s disease

다국어 초록 (Multilingual Abstract)

Regional homogeneity (ReHo), the processed data from resting-state functional magnetic resonance imaging, provides information about spontaneous brain activity in focal areas. Altered ReHo in brain regions has been reported in Parkinson’s disease (PD). GB34, an acupuncture point, has been frequently utilized in clinical studies in PD. In this study, acupuncture effect on ReHo in PD-related regions was investigated. The PD-related regions were explored in 22 patients with PD during their off-medication state and compared with 25 healthy controls. Elevated ReHo was observed in the left angular gyrus, the left inferior parietal lobule, the left supramarginal gyrus, the left middle occipital gyrus and the left parahippocampal gyrus. Conversely, ReHo was decreased in the right primary sensory cortex, the right primary motor cortex and the right middle frontal gyrus in the patients with PD. Acupuncture treatment on GB34 decreased the elevated ReHo in the left angular gyrus and the left inferior parietal lobule in patients with PD. ReHo of the two regions were resistant to spontaneous alteration by lapse of time, indicating temporal stability. The left angular gyrus was associated with motor function, which is impaired in PD. These results suggest that acupuncture modulates the PD-related regions with ReHo alteration.

국문 초록 (Abstract)

피험자가 안정된 상태에서 기능적 자기 공명 영상을 촬영하면 뇌의 자발적 신호를 측정할 수 있고, 이것을 이용하여 국소영역에서 뇌신호의 균질도를 계산할 수 있다. 양릉천은 침 치료에 사용되는 혈위 중의 하나이며 파킨슨병 환자의 임상연구에 많이 사용되어 왔다. 본 연구에서는 22명의 파킨슨병 환자와 25명의 정상인으로부터 뇌영상을 얻어 파킨슨병 환자의 뇌가 정상인의 뇌와 어떻게 다른지를 뇌신호의 균질도 측면에서 연구하였다. 파킨슨병 환자에서 뇌의 left angular gyrus, left inferior parietal lobule, left supramarginal gyrus, left middle occipital gyrus, left parahippocampal gyrus 에서 뇌신호의 균질도가 높아져 있었고, right primary sensory cortex, right primary motor cortex, right middle frontal gyrus 에서 균질도가 낮아져 있었다. 양릉천에 침을 놓자 파킨슨병 환자의 left angular gyrus 와 left inferior parietal lobule에서 높아졌던 뇌신호의 균질도가 낮아졌다. 이 두 영역은 시간의 경과에 따라 자연적으로 뇌신호가 낮아지는 것은 아니었다. 또한 left angular gyrus 는 파킨슨병에서 손상되기 쉬운 운동기능과 관련이 있었다. 이 결과들로부터 침 치료가 파킨슨병 환자의 뇌에서 뇌신호의 균질도가 변한 곳을 조절함을 제시하고자 한다.

목차 (Table of Contents)

• 1. Introduction 1
• 2. Materials and Methods 6
• 2.1. Participants 6
• 2.2. Groups 6
• 2.3. Motor task paradigm 7
• 2.4. Acupuncture paradigm 9
• 2.5. fMRI data acquisitions 12
• 2.6. fMRI data preprocessing for ReHo analysis 12
• 2.7. Discrimination of PD-related ReHo alteration 14
• 2.8. Statistics of clinical data 14
• 3. Results 15
• 3.1. Demographic details of participants 15
• 3.2. PD-related ReHo alteration on brain 18
• 3.3. Association between ReHo alteration and the clinical indices 23
• 3.4. ReHo of the de novo PD group in the PD-related regions 25
• 3.5. Temporal stability of ReHo 27
• 3.6. Effect of the motor task on ReHo in the PD-related regions 29
• 3.7. Effect of acupuncture on ReHo in the healthy participants 31
• 3.8. Effect of acupuncture on ReHo in the patients with PD 33
• 4. Discussion 35
• 4.1. Effect of acupuncture on the PD-related regions 35
• 4.2. Properties of the ReHo specific regions 38
• 5. Conclusion 42
• References 43
• Acknowledgment 50
• 국문초록 51