Exploring the regulatory effect of acupuncture for <italic style="font-style: italic">Ningshen Tongqiao</italic> on the functional connectivity between the anterior cingulate cortex and the whole brain in the patients with subjective tinnitus based on fMRI

ZHANG Yating; ZHA Bixiang; SHI Haiping; FAN Yinqiu; ZHENG Yunzi; RONG Zhihao; YANG Jun

doi:10.13703/j.0255-2930.20230628-0003

您当前的位置：

首页 >

文章列表页 >

Exploring the regulatory effect of acupuncture for Ningshen Tongqiao on the functional connectivity between the anterior cingulate cortex and the whole brain in the patients with subjective tinnitus based on fMRI

Imaging in clinical and basic research | 更新时间：2024-06-03

- Exploring the regulatory effect of acupuncture for Ningshen Tongqiao on the functional connectivity between the anterior cingulate cortex and the whole brain in the patients with subjective tinnitus based on fMRI
- Chinese Acupuncture & Moxibustion Vol. 44, Issue 1, Pages: 12-18(2024)
- 作者机构：
  
  1.安徽中医药大学第一临床医学院，合肥 230038
  2.安徽中医药大学第一附属医院
- 作者简介：
- 基金信息：
- DOI：10.13703/j.0255-2930.20230628-0003
  CLC：
- Received：28 June 2023，
  
  Online First：17 October 2023，
  
  Published：12 January 2024
- 稿件说明：
移动端阅览
张雅婷,查必祥,石海平等.基于fMRI初探宁神通窍法针刺对主观性耳鸣患者前扣带回与全脑功能连接的调控作用[J].中国针灸,2024,44(01):12-18.

ZHANG Yating,ZHA Bixiang,SHI Haiping,et al.Exploring the regulatory effect of acupuncture for Ningshen Tongqiao on the functional connectivity between the anterior cingulate cortex and the whole brain in the patients with subjective tinnitus based on fMRI[J].Chinese Acupuncture & Moxibustion,2024,44(01):12-18.
张雅婷,查必祥,石海平等.基于fMRI初探宁神通窍法针刺对主观性耳鸣患者前扣带回与全脑功能连接的调控作用[J].中国针灸,2024,44(01):12-18. DOI： 10.13703/j.0255-2930.20230628-0003.

ZHANG Yating,ZHA Bixiang,SHI Haiping,et al.Exploring the regulatory effect of acupuncture for Ningshen Tongqiao on the functional connectivity between the anterior cingulate cortex and the whole brain in the patients with subjective tinnitus based on fMRI[J].Chinese Acupuncture & Moxibustion,2024,44(01):12-18. DOI： 10.13703/j.0255-2930.20230628-0003.

摘要

目的

采用静息态功能磁共振成像（fMRI）探究宁神通窍法针刺对主观性耳鸣患者前扣带回（ACC）与全脑功能连接的影响。

方法

招募40例主观性耳鸣患者和40例健康受试者。主观性耳鸣患者予宁神通窍法针刺治疗，穴取哑门、百会及患侧听宫、头窍阴、率谷，听宫、头窍阴连接电针仪，使用疏密波，频率2 Hz/50 Hz。隔日针刺1次，每周针刺3次，共治疗10次。分别于治疗前后观察主观性耳鸣患者耳鸣评价量表（TEQ）、耳鸣残疾评估量表（THI）、耳鸣视觉模拟量表（VAS）评分，并评定临床疗效。主观性耳鸣患者分别在治疗前后2 d内进行1次fMRI扫描，健康受试者纳入后进行1次fMRI扫描。将双侧ACC作为感兴趣区域（ROI），采用matlab R2017b软件计算ACC和全脑之间的功能连接（FC）。

结果

治疗后，主观性耳鸣患者TEQ、THI、VAS评分均较治疗前降低（

0.01），总有效率为92.5%（37/40）。治疗前，与健康受试者比较，主观性耳鸣患者右侧ACC与左侧颞中回、左侧颞上回、左侧额上回FC降低。治疗后，与健康受试者比较，主观性耳鸣患者右侧ACC与左侧额中回、双侧角回FC降低；左侧ACC与左侧额中回、左侧丘脑、左侧角回、左侧颞中回FC降低。与治疗前比较，主观性耳鸣患者治疗后右侧ACC与左侧舌回、左侧丘脑FC降低；左侧ACC与右侧额中回、右侧额上回FC降低。

结论

针刺可有效改善主观性耳鸣患者临床症状，促进颞叶、额叶、丘脑等听觉及情绪相关脑区功能重组。

Abstract

Objective

To explore the effect of acupuncture for

Ningshen Tongqiao

(tranquilizing the spirit and unblocking the orifices) on the functional connectivity (FC) between the anterior cingulate cortex (ACC) and the whole brain in the patients with subjective tinnitus using the resting-state functional magnetic resonance imaging (fMRI).

Methods

Forty patients with subjective tinni

tus and 40 healthy subjects were recruited. The patients with subjective tinnitus were treated with acupuncture for

Ningshen Tongqiao

at Yamen (GV 15) and Baihui (GV 20)

as well as Tinggong (SI 19)， Touqiaoyin (GB 11) and Shuaigu (GB 8) on the affected side; and Tinggong (SI 19) and Touqiaoyin (GB 11) were attached to the electric acupuncture apparatus and stimulated with disperse-dense wave and 2 Hz/50 Hz in frequency. Acupuncture was operated once daily

3 times a week and 10 treatments were required. Before and after treatment

the scores of tinnitus evaluation questionnaire (TEQ)

tinnitus handicap inventory (THI) and tinnitus visual analogue scale (VAS) were evaluated; and the clinical therapeutic effect was assessed. Separately

the patients with subjective tinnitus received one time of fMRI within 2 days before and after treatment

and the healthy subjects underwent one time of fMRI after enrollment. The bilateral ACC was taken as the region of interest (ROI). Using matlab R2017b software

FC between ACC and the whole brain was calculated.

Results

After treatment

the scores of THI

TEQ and VAS were reduced in the subjective tinnitus patients compared with those before treatment (

0.01); and the total effective rate was 92.5% (37/40). Before treatment

compared with the healthy subjects

FC between the right ACC and the left middle temporal gyrus

the left superior temporal gyrus and the left superior frontal gyrus decreased in the subjective tinnitus patients. FC between the right ACC and the left middle frontal gyrus and the bilateral angular gyrus was dropped

while that between the left ACC and the left middle frontal gyrus

the left thalamus

the left angular gyrus and the left middle temporal gyrus was decreased in the subjective tinnitus patients when compared with the healthy subjects after treatment. Compared with those before treatment

FC between the right ACC and the left lingual gyrus and the left thalamus were declined

and

that between the left ACC and the right middle frontal gyrus and the right superior frontal gyrus was decreased in the subjective tinnitus patients after treatment.

Conclusion

Acupuncture can effectively relieve the clinical symptoms of subjective tinnitus patients

and promote the functional re-construction of the auditory regions (temporal lobe

frontal lobe and thalamus) and the emotion-related brain regions.

关键词

Keywords

references

卢兢哲 , 钟萍 , 郑芸 . 欧洲多学科耳鸣指南:诊断、评估和治疗 [J ] . 听力学及言语疾病杂志 , 2020 , 28 ( 1 ): 110 - 114 .

Cima RFF , Mazurek B , Haider H , et al . A multidisciplinary European guideline for tinnitus: diagnostics, assessment, and treatment [J ] . HNO , 2019 , 67 ( Suppl 1 ): 10 - 42 .

Loprinzi PD , Lee H , Gilham B , et al . Association between accelerometer-assessed physical activity and tinnitus, NHANES 2005-2006 [J ] . Res Q Exerc Sport , 2013 , 84 ( 2 ): 177 - 185 .

Távora-Vieira D , Wedekind A . Single-sided deafness: emotional and social handicap, impact on health status and quality of life, functional hearing, and the effects of cochlear implantation [J ] . Otol Neurotol , 2022 , 43 ( 10 ): 1116 - 1124 .

Trifunovic M , Zivic L , Ignjatovic-Ristic D , et al . Which affective temperaments are most expressed in patients with chronic sub-jective tinnitus? [J ] . Hippokratia , 2020 , 24 ( 2 ): 77 - 83 .

Cheng YF , Xirasagar S , Kuo NW , et al . Tinnitus and risk of attempted suicide: a one year follow-up study [J ] . J Affect Disord , 2023 , 322 : 141 - 145 .

Cai W , Chen AW , Ding L , et al . Thermal effects of acupuncture by the infrared thermography test in patients with tinnitus [J ] . J Acupunct Meridian Stud , 2019 , 12 ( 4 ): 131 - 135 .

Li Y , Sang D , Wu ZT , et al . Systematic evaluation of the efficacy of acupuncture associated with physical and mental intervention when treating idiopathic tinnitus and the improvement of tinnitus symptoms [J ] . Comput Math Methods Med , 2022 , 2022 : 6764909 .

Li QQ , Shi GX , Fu XX , et al . Effects of deqi on autonomic balance in adult tinnitus patients: study design of a randomized controlled trial [J ] . Evid Based Complement Alternat Med , 2013 , 2013 : 756012 .

刘翔维 , 袁爱红 , 杨骏 . 杨骏治疗神经性耳鸣经验撷要 [J ] . 中医药临床杂志 , 2018 , 30 ( 10 ): 1796 - 1799 .

张雅婷 , 杨骏 , 袁爱红 , 等 . 杨骏教授针灸治疗慢性耳鸣经验撷要 [J ] . 浙江中医药大学学报 , 2022 , 46 ( 6 ): 665 - 668, 676 .

张万林 , 杨骏 , 张庆萍 , 等 . 针灸联合冰片外用治疗主观性耳鸣31例 [J ] . 中国针灸 , 2021 , 41 ( 9 ): 1021 - 1022 .

You YB , Bai LJ , Dai RW , et al . Altered hub configurations within default mode network following acupuncture at ST36: a multimodal investigation combining fMRI and MEG [J ] . PLoS One , 2013 , 8 ( 5 ): e64509 .

黄辛钊 , 武敬沂 , 彭华 . 主观性耳鸣的中枢发病机制研究进展 [J/OL ] . 听力学及言语疾病杂志 [ 2023-03-13 ] . http://kns.cnki.net/kcms/detail/42.1391.R.20230310.1111.010.html http://kns.cnki.net/kcms/detail/42.1391.R.20230310.1111.010.html .

Zenke JK , Rahman S , Guo Q , et al . Central processing in tinnitus: fMRI study outlining patterns of activation using an auditory discrimination task in normal versus tinnitus patients [J ] . Otol Neurotol , 2021 , 42 ( 8 ): e1170 - e1180 .

Han Q , Zhang Y , Liu DH , et al . Disrupted local neural activity and functional connectivity in subjective tinnitus patients: evidence from resting-state fMRI study [J ] . Neuroradiology , 2018 , 60 ( 11 ): 1193 - 1201 .

Adamchic I , Hauptmann C , Tass PA . Changes of oscillatory activity in pitch processing network and related tinnitus relief induced by acoustic CR neuromodulation [J ] . Front Syst Neurosci , 2012 , 6 : 18 .

Fan X , Song Y , Du YL , et al . Participation of the anterior cingulate cortex in sodium salicylate-induced tinnitus [J ] . Otol Neurotol , 2021 , 42 ( 8 ): e1134 - e1142 .

Boly M , Balteau E , Schnakers C , et al . Baseline brain activity fluctuations predict somatosensory perception in humans [J ] . Proc Natl Acad Sci U S A , 2007 , 104 ( 29 ): 12187 - 12192 .

朱继民 , 闫国立 . 医学统计分析方法 [M ] . 2版 . 合肥 : 中国科学技术大学出版社 , 2020 : 30 .

黄选兆 , 汪吉宝 , 孔维佳 . 实用耳鼻咽喉头颈外科学 [M ] . 2版 . 北京 : 人民卫生出版社 , 2008 .

国家质量监督检验检疫总局 , 中国国家标准化管理委员会 . 腧穴名称与定位 : GB/T 12346-2006 [S ] . 北京 : 中国标准出版社 , 2006 .

Kuk FK , Tyler RS , Russell D , et al . The psychometric properties of a tinnitus handicap questionnaire [J ] . Ear Hear , 1990 , 11 ( 6 ): 434 - 445 .

Newman CW , Jacobson GP , Spitzer JB . Development of the tinnitus handicap inventory [J ] . Arch Otolaryngol Head Neck Surg , 1996 , 122 ( 2 ): 143 - 148 .

Newman CW , Sandridge SA , Jacobson GP . Assessing outcomes of tinnitus intervention [J ] . J Am Acad Audiol , 2014 , 25 ( 1 ): 76 - 105 .

Yan CG , Wang XD , Zuo XN , et al . DPABI: data processing & analysis for (resting-state) brain imaging [J ] . Neuroinformatics , 2016 , 14 ( 3 ): 339 - 351 .

查必祥 , 袁爱红 , 黄春裕 , 等 . 杨骏教授针灸临床“形神并调”经验撷要 [J ] . 上海针灸杂志 , 2022 , 41 ( 6 ): 634 - 636 .

Devinsky O , Morrell MJ , Vogt BA . Contributions of anterior cingulate cortex to behaviour [J ] . Brain , 1995 , 118 ( Pt 1 ): 279 - 306 .

Song JJ , Vanneste S , Schlee W , et al . Erratum to: onset-related differences in neural substrates of tinnitus-related distress: the anterior cingulate cortex in late-onset tinnitus, and the frontal cortex in early-onset tinnitus [J ] . Brain Struct Funct , 2015 , 220 ( 1 ): 585 .

Shore SE , Wu C . Mechanisms of noise-induced tinnitus: insights from cellular studies [J ] . Neuron , 2019 , 103 ( 1 ): 8 - 20 .

Adjamian P , Sereda M , Hall DA . The mechanisms of tinnitus: perspectives from human functional neuroimaging [J ] . Hear Res , 2009 , 253 ( 1/2 ): 15 - 31 .

Henry JA , Roberts LE , Caspary DM , et al . Underlying mechanisms of tinnitus: review and clinical implications [J ] . J Am Acad Audiol , 2014 , 25 ( 1 ): 5 - 22 ;quiz126.

刘蓬 , 阮紫娟 , 龚慧涵 , 等 . 262例耳鸣患者听力损失情况的临床调查 [J ] . 中华耳科学杂志 , 2009 , 7 ( 3 ): 194 - 199 .

郭焕萍 , 杨海弟 , 郑亿庆 , 等 . 2171例耳鸣患者的临床特征分析 [J ] . 听力学及言语疾病杂志 , 2017 , 25 ( 4 ): 378 - 381 .

Konishi S , Chikazoe J , Jimura K , et al . Neural mechanism in anterior prefrontal cortex for inhibition of prolonged set interference [J ] . Proc Natl Acad Sci USA , 2005 , 102 ( 35 ): 12584 - 12588 .

韩祺 , 冯亚瑾 , 刘代洪 , 等 . 慢性主观性耳鸣患者大脑局部一致性和灰质结构的MRI分析 [J ] . 中国医学影像技术 , 2018 , 34 ( 1 ): 30 - 34 .

Aron AR , Robbins TW , Poldrack RA . Inhibition and the right inferior frontal cortex: one decade on [J ] . Trends Cogn Sci , 2014 , 18 ( 4 ): 177 - 185 .

Chen YC , Wang F , Wang J , et al . Resting-state brain abnormalities in chronic subjective tinnitus: a meta-analysis [J ] . Front Hum Neurosci , 2017 , 11 : 22 .

de Ridder D , Vanneste S , Plazier M , et al . Dorsolateral prefrontal cortex transcranial magnetic stimulation and electrode implant for intractable tinnitus [J ] . World Neurosurg , 2012 , 77 ( 5/6 ): 778 - 784 .

Lee CC , Sherman SM . Glutamatergic inhibition in sensory neocortex [J ] . Cereb Cortex , 2009 , 19 ( 10 ): 2281 - 2289 .

朱美婵 , 李恒 , 李振华 , 等 . 丘脑-听觉皮层投射的研究进展 [J ] . 听力学及言语疾病杂志 , 2016 , 24 ( 2 ): 191 - 197 .

Almasabi F , Janssen MLF , Devos J , et al . The role of the medial geniculate body of the thalamus in the pathophysiology of tinnitus and implications for treatment [J ] . Brain Res , 2022 , 1779 : 147797 .

Benson RR , Gattu R , Cacace AT . Left hemisphere fractional anisotropy increase in noise-induced tinnitus: a diffusion tensor imaging (DTI) study of white matter tracts in the brain [J ] . Hear Res , 2014 , 309 : 8 - 16 .

Leaver AM , Turesky TK , Seydell-Greenwald A , et al . Intrinsic network activity in tinnitus investigated using functional MRI [J ] . Hum Brain Mapp , 2016 , 37 ( 8 ): 2717 - 2735 .

Hullfish J , Abenes I , Yoo HB , et al . Frontostriatal network dysfunction as a domain-general mechanism underlying phantom perception [J ] . Hum Brain Mapp , 2019 , 40 ( 7 ): 2241 - 2251 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Professor SUN Hua's clinical experience of acupuncture for subjective tinnitus

Tongdu Tiaoshen acupuncture for subjective tinnitus:a randomized controlled trial

Introduction to the Meta-analysis method of functional magnetic resonance imaging research and the exploration of its application in the field of acupuncture

Experimental studies on acupuncture-moxibustion for irritable bowel syndrome in the past five years: a literature analysis

Biomechanical effect of acupotomy on cartilage degeneration in rabbits with knee osteoarthritis

Related Author

XU Hong

SUN Hua

LI Chenglong

MAO Wei

ZHANG Lida

ZHANG Xin

WU Haiyang

ZHANG Guoqing

Related Institution

Chinese Academy of Medical Sciences, Peking Union Medical College, Department of TCM, Peking Union Medical College Hospital

First Clinical Medical College, Anhui University of CM

Department of TCM, Affiliated Brain Hospital of Guangzhou Medical University

Department of Acupuncture and Moxibustion, Nanjing Gaochun District Hospital of TCM

Department of Encephalopathy, Second Affiliated Hospital of Anhui University of CM

⁰

Exploring the regulatory effect of acupuncture for Ningshen Tongqiao on the functional connectivity between the anterior cingulate cortex and the whole brain in the patients with subjective tinnitus based on fMRI

DOI：10.13703/j.0255-2930.20230628-0003

摘要

Abstract

关键词

Keywords

references