不同间隔时间电针对初级运动皮层皮质脊髓兴奋性的后效应研究

谢萌萌; 陈梓臻; 程伟丽; 黄键澎; 许能贵; 刘健华

doi:10.13703/j.0255-2930.20230420-k0003

您当前的位置：

首页 >

文章列表页 >

不同间隔时间电针对初级运动皮层皮质脊髓兴奋性的后效应研究

临床研究2 | 更新时间：2024-06-03

- 不同间隔时间电针对初级运动皮层皮质脊髓兴奋性的后效应研究
- Study on after-effect of electroacupuncture with different time intervals on corticospinal excitability in primary motor cortex
- 中国针灸 2023年43卷第11期页码：1239-1245
- 作者机构：
  
  1.广州中医药大学针灸康复临床医学院，广东广州510405
  2.广州中医药大学第二临床医学院，广东广州510120
- 作者简介：
  
  值值
  刘健华，研究员。E-mail：jianhualiu@gzucm.edu.cn
- 基金信息：
  
  国家自然科学基金资助项目(81873381);国家中医药管理局中医药创新团队及人才支持计划项目(ZYYCXTD-C-202004);广东省岭南中医药重点研发项目(2020B1111100008)
- DOI：10.13703/j.0255-2930.20230420-k0003
  中图分类号： R 245.9⁺7
- 收稿：2023-04-20，
  
  网络首发：2023-09-01，
  
  纸质出版：2023-11-12
- 稿件说明：
移动端阅览
谢萌萌,陈梓臻,程伟丽等.不同间隔时间电针对初级运动皮层皮质脊髓兴奋性的后效应研究[J].中国针灸,2023,43(11):1239-1245.

XIE Meng-meng,CHEN Zi-zhen,CHENG Wei-li,et al.Study on after-effect of electroacupuncture with different time intervals on corticospinal excitability in primary motor cortex[J].Chinese Acupuncture & Moxibustion,2023,43(11):1239-1245.
谢萌萌,陈梓臻,程伟丽等.不同间隔时间电针对初级运动皮层皮质脊髓兴奋性的后效应研究[J].中国针灸,2023,43(11):1239-1245. DOI： 10.13703/j.0255-2930.20230420-k0003.

XIE Meng-meng,CHEN Zi-zhen,CHENG Wei-li,et al.Study on after-effect of electroacupuncture with different time intervals on corticospinal excitability in primary motor cortex[J].Chinese Acupuncture & Moxibustion,2023,43(11):1239-1245. DOI： 10.13703/j.0255-2930.20230420-k0003.

摘要

目的

比较不同间隔时间电针对健康受试者初级运动皮层（M1）皮质脊髓兴奋性及上肢运动功能的影响，观察针刺后效应规律。

方法

采用同体自身前后对照设计，纳入15名健康受试者，所有健康受试者共接受3个阶段的试验观察，分别为EA

组（单独接受电针1次）、EA

组（1 d内接受2次电针刺激，2次干预间隔6 h）和EA

48h

组（3 d内接受2次电针刺激，2次干预间隔48 h），各阶段之间洗脱期为1周。各组均直刺左侧合谷23 mm，并且在合谷穴向左旁开0.5 cm处再直刺1针，连接HANS-200A韩氏电针仪，予连续波，频率2 Hz，给予运动阈值以上的刺激强度（肉眼可见局部肌肉明显跳动，且健康受试者耐受为度，1~2 mA），留针30 min。运用经颅磁刺激（TMS）技术的单脉冲模式，检测首次电针前（T0）和末次电针结束后即刻（T1）、2 h（T2）、24 h（T3）健康受试者左侧第一背侧骨间肌的运动诱发电位（MEPs）波幅、潜伏期（LAT）、静息运动阈值（rMT）以及凹槽钉板试验（GPT）完成时间。EA

组在末次电针前（T0*）运用TMS检测M1的兴奋性（MEPs波幅、LAT和rMT）。

结果

组T1、T2时点，EA

组T0*时点以及EA

48h

组T1、T2、T3时点MEPs波幅均较T0时升高（

0.001）。MEPs波幅在T1时点，EA

组、EA

48h

组较EA

组升高（

0.001，

0.01）；在T2时点，EA

组较EA

组升高（

0.01）；在T3时点，EA

组、EA

组较EA

48h

组降低（

0.001）。3组T1时点LAT较T0时缩短（

0.05），其余时点较T0时差异无统计学意义（

0.05）。EA

组、EA

48h

组健康受试者T1、T2、T3时点GPT完成时间较T0时缩短（

0.001），EA

组T3时点较T0时缩短（

0.05）；在T2时点，EA

48h

组较EA

组缩短（

0.05）。3组rMT组间、组内比较差异均无统计学意义（

0.05）。

结论

生理状态下，电针对皮质脊髓兴奋性及上肢运动功能具有明显的后效应；短时间间隔（6 h）电针一定程度阻断了电针后效应，长时间间隔（48 h）电针可以延长电针后效应。

Abstract

Objective

To compare the effects of electroacupuncture (EA) with different time intervals on corticospinal excitability of the primary motor cortex (M1) and the upper limb motor function in healthy subjects and observe the after-effect rule of acupuncture.

Methods

Self-comparison before and after intervention design was adopted. Fifteen healthy subjects were included and all of them received three stages of trial observation

namely EA

group (received one session of EA)

group (received two sessions of EA within 1 day

with an interval of 6 h) and EA

48h

group (received two sessions of EA within 3 days

with an interval of 48 h). The washout period among stages was 1 week. In each group

the needles were inserted perpendicularly at Hegu (LI 4) on the left side

23 mm in depth and at a non-acupoint

0.5 cm nearby to the left side of Hegu (LI 4)

separately.

Han

's acupoint nerve stimulator (HANS-200A) was attached to these two needles

with continuous wave and the frequency of 2 Hz. The stimulation intensity was exerted higher than the exercise threshold (local muscle twitching was visible

and pain was tolerable by healthy subjects

1-2 mA ). The needles were retained for 30 min. Using the single pulse mode of transcranial magnetic stimulation (TMS) technique

before the first session of EA (T0) and at the moment (T1)

in 2 h (T2) and 24 h (T3) after the end of the last session of EA

on the left first dorsal interosseous muscle

the amplitude

latency (LAT)

resting motor threshold (rMT) of motor evoked potentials (MEPs) and the completion time of grooved pegboard test (GPT) were detected. Besides

in the EA

group

TMS was adopted to detect the excitability of M1 (amplitude

LAT and rMT of MEPs) before the last session of EA (T0*)

Results

The amplitude of MEPs at T1 and T2 in the EA

group

at T0* in the EA

group and at T1

T2 and T3 in the EA

48h

group was higher when compared with the value at T0 in each group separately (

0.001). At T1

the amplitude of MEPs in the EA

group and the EA

48h

group was higher than that in the EA

group (

0.001

0.01); at T2

it was higher in the EA

group when compared with that in the EA

group (

0.01); at T3

the amplitude in the EA

group and the EA

group was lower than that of the EA

48h

group (

0.001). The LAT at T1 was shorter than that at T0 in the three groups (

0.05)

and the changes were not obvious at the rest time points compared with that at T0 (

0.05). The GPT completion time of healthy subjects in the EA

group and the EA

48h

group at T1

T2 and T3 was reduced in comparison with that at T0 (

0.001). The completion time at T3 was shorter than that at T0 in the EA

group (

0.05); at T2

it was reduced in the EA

48h

group when compared with that of the EA

group (

0.05). There were no significant differences in rMT among the three groups and within each group (

0.05).

Conclusion

Under physiological conditions

EA has obvious after-effect on corticospinal excitability and upper limb motor function. The short-term interval protocol (6 h) blocks the after-effect of EA to a certain extent

while the long-term interval protocol (48 h) prolongs the after-effect of EA.

关键词

Keywords

references

林娜 , 颜国富 , 李淑君 . 两种针刺间隔时间治疗糖尿病胃轻瘫的疗效比较 [J ] . 光明中医 , 2013 , 28 ( 10 ): 2109 - 2111 .

杨帆 , 程彪 , 谭奇纹 . 不同时间间隔针刺治疗对神经根型颈椎病疗效观察 [J ] . 中医学报 , 2010 , 25 ( 5 ): 1002 - 1003 .

程立红 , 缑燕华 , 谢建平 , 等 . 针灸间隔时间与面神经麻痹疗效相关性研究 [J ] . 江西中医学院学报 , 2009 , 21 ( 4 ): 24 - 26 .

林璐璐 , 王丽琼 , 杨静雯 , 等 . 针刺时效关系研究进展 [J ] . 中国针灸 , 2019 , 39 ( 5 ): 565 - 570 .

陈姣 , 杨洁 , 唐宏智 , 等 . 关于针刺疗效持续效应的探讨 [J ] . 中国针灸 , 2013 , 33 ( 10 ): 957 - 960 .

陈少宗 . 针刺作用时效关系研究的临床意义 [J ] . 针灸临床杂志 , 2008 , 24 ( 6 ): 1 - 3 .

Müller-Dahlhaus F , Ziemann U . Metaplasticity in human cortex [J ] . Neuroscientist , 2015 , 21 ( 2 ): 185 - 202 .

刘玉龙 , 赵士弟 , 葛荣靖 . 表观遗传修饰调控突触可塑性在学习记忆中的作用研究进展 [J ] . 包头医学院学报 , 2017 , 33 ( 6 ): 127 - 129, 135 .

钟嘉明 , 黄键澎 , 蒋丽 , 等 . 电针合谷穴所产生的运动皮层手面区之间的可塑性 [J ] . 针刺研究 , 2020 , 45 ( 10 ): 829 - 834 .

Zeng D , Yang YL , Pinto CB , et al . Proceedings #53: effects of electrical stimulation on maladaptive plasticity in hemifacial spasm [J ] . Brain Stimul , 2019 , 12 ( 2 ): e126 - e127 .

Huang JP , Liang ZM , Zou QW , et al . Electroacupuncture on hemifacial spasm and temporomandibular joint pain co-morbidity: a case report [J ] . Front Neurol , 2022 , 13 : 931412 .

李洁枚 , 黄键澎 , 刘健华 . 电针结合运动训练对运动学习及运动皮层兴奋性的作用研究 [J ] . 中国针灸 , 2021 , 41 ( 12 ): 1365 - 1369 .

Yu FY , Tang XW , Hu RP , et al . The after-effect of accelerated intermittent Theta burst stimulation at different session intervals [J ] . Front Neurosci , 2020 , 14 : 576 .

Petrigna L , Pajaujiene S , Iacona GM , et al . The execution of the grooved pegboard test in a dual-task situation: a pilot study [J ] . Heliyon , 2020 , 6 ( 8 ): e04678 .

McDonnell MN , Ridding MC . Afferent stimulation facilitates performance on a novel motor task [J ] . Exp Brain Res , 2006 , 170 ( 1 ): 109 - 115 .

Weinstein AA , Ngo D , de Avila L , et al . Association of physical activity and fine motor performance in individuals with type 2 diabetes mellitus and/or non-alcoholic fatty liver disease [J ] . Ann Med , 2023 , 55 ( 1 ): 1345 - 1353 .

钱晓平 , 徐芳 , 宋佳霖 , 等 . 不同针刺频次对脑梗死恢复期患者疗效的影响 [J ] . 中国针灸 , 2009 , 29 ( 1 ): 7 - 9 .

薛晓静 , 刘智斌 , 王莹莹 , 等 . 针灸间隔时间与疗效相关性的研究述评 [J ] . 针灸临床杂志 , 2018 , 34 ( 1 ): 1 - 4 .

钟润芬 , 尹旭辉 , 曹玉华 , 等 . 不同时间间隔针刺治疗腰椎间盘突出症的疗效对比 [J ] . 中国针灸 , 2019 , 39 ( 5 ): 457 - 461 .

Agboada D , Mosayebi-Samani M , Kuo MF , et al . Induction of long-term potentiation-like plasticity in the primary motor cortex with repeated anodal transcranial direct current stimulation - better effects with intensified protocols? [J ] . Brain Stimul , 2020 , 13 ( 4 ): 987 - 997 .

Peinemann A , Reimer B , Löer C , et al . Long-lasting increase in corticospinal excitability after 1800 pulses of subthreshold 5 Hz repetitive TMS to the primary motor cortex [J ] . Clin Neurophysiol , 2004 , 115 ( 7 ): 1519 - 1526 .

Mosayebi Samani M , Agboada D , Kuo MF , et al . Probing the relevance of repeated cathodal transcranial direct current stimulation over the primary motor cortex for prolongation of after-effects [J ] . J Physiol , 2020 , 598 ( 4 ): 805 - 816 .

Chae Y , Lee H , Kim H , et al . Parsing brain activity associated with acupuncture treatment in Parkinson's diseases [J ] . Mov Disord , 2009 , 24 ( 12 ): 1794 - 1802 .

Lo YL , Cui SL , Fook-Chong S . The effect of acupuncture on motor cortex excitability and plasticity [J ] . Neurosci Lett , 2005 , 384 ( 1/2 ): 145 - 149 .

Maioli C , Falciati L , Marangon M , et al . Short- and long-term modulation of upper limb motor-evoked potentials induced by acupuncture [J ] . Eur J Neurosci , 2006 , 23 ( 7 ): 1931 - 1938 .

McCambridge AB , Zaslawski C , Bradnam LV . Investigating the mechanisms of acupuncture on neural excitability in healthy adults [J ] . Neuroreport , 2019 , 30 ( 2 ): 71 - 76 .

王贺春 , 万有 , 姚磊 , 等 . 不同频度电针治疗大鼠慢性神经源性痛的疗效比较 [J ] . 针刺研究 , 2002 , 27 ( 2 ): 112 - 118 .

Keck T , Hübener M , Bonhoeffer T . Interactions between synaptic homeostatic mechanisms: an attempt to reconcile BCM theory, synaptic scaling, and changing excitation/inhibition balance [J ] . Curr Opin Neurobiol , 2017 , 43 : 87 - 93 .

Wankerl K , Weise D , Gentner R , et al . L-type voltage-gated Ca 2+ channels: a single molecular switch for long-term potentiation/long-term depression-like plasticity and activity-dependent metaplasticity in humans [J ] . J Neurosci , 2010 , 30 ( 18 ): 6197 - 6204 .

Hamada M , Terao , Hanajima R , et al . Bidirectional long-term motor cortical plasticity and metaplasticity induced by quadripulse transcranial magnetic stimulation [J ] . J Physiol , 2008 , 586 ( 16 ): 3927 - 3947 .

Hamada M , Hanajima R , Terao , et al . Quadro-pulse stimulation is more effective than paired-pulse stimulation for plasticity induction of the human motor cortex [J ] . Clin Neurophysiol , 2007 , 118 ( 12 ): 2672 - 2682 .

Fricke K , Seeber AA , Thirugnanasambandam N , et al . Time course of the induction of homeostatic plasticity generated by repeated transcranial direct current stimulation of the human motor cortex [J ] . J Neurophysiol , 2011 , 105 ( 3 ): 1141 - 1149 .

Murakami T , Müller-Dahlhaus F , Lu MK , et al . Homeostatic metaplasticity of corticospinal excitatory and intracortical inhibitory neural circuits in human motor cortex [J ] . J Physiol , 2012 , 590 ( 22 ): 5765 - 5781 .

Monte-Silva K , Kuo MF , Liebetanz D , et al . Shaping the optimal repetition interval for cathodal transcranial direct current stimulation (tDCS) [J ] . J Neurophysiol , 2010 , 103 ( 4 ): 1735 - 1740 .

Monte-Silva K , Kuo MF , Hessenthaler S , et al . Induction of late LTP-like plasticity in the human motor cortex by repeated non-invasive brain stimulation [J ] . Brain Stimul , 2013 , 6 ( 3 ): 424 - 432 .

Abraham WC , Mason-Parker SE , Bear MF , et al . Heterosynaptic metaplasticity in the hippocampus in vivo: a BCM-like modifiable threshold for LTP [J ] . Proc Natl Acad Sci U S A , 2001 , 98 ( 19 ): 10924 - 10929 .

Buschler A , Manahan-Vaughan D . Brief environmental enrichment elicits metaplasticity of hippocampal synaptic potentiation in vivo [J ] . Front Behav Neurosci , 2012 , 6 : 85 .

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

MEP定位下头针联合经颅磁刺激对缺血性脑卒中偏瘫患者肢体运动能力的影响

舒适化细芒针针具进针可行性探索

针刺干预认知功能障碍的脑电特征研究现状与展望

从生物力学角度探讨针刀干预膝关节骨关节炎兔膝关节软骨退化的作用机制

基于红外热成像评估解剖点等分定位后斜刺法对急性期骶髂关节损伤的影响