机构：[1]Department of Neurology, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China,[2]Department ofNeurology, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China,广东省中医院[3]Department ofRadiology, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China,广东省中医院[4]Department ofRadiology, The People’s Hospital of Gaozhou, Gaozhou, China,[5]Department of Laboratory, The Second Affiliated Hospital,Guangzhou Medical University, Guangzhou, China,[6]Department of Business Development, Zhujiang Hospital, SouthernMedical University, Guangzhou, China,[7]Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University,Guangzhou, China,中山大学附属第一医院[8]Department of Neurology, Guangzhou Hospital of Integrated Traditional and West Medicine,Guangzhou, China,[9]Department of Neurology, Yuebei People’s Hospital, Shaoguan, China
Objective: To investigate the effect of acupuncture on Parkinson's disease (PD) patients with tremor and its potential neuromechanism by functional magnetic resonance imaging (fMRI). Methods: Forty-one PD patients with tremor were randomly assigned to true acupuncture group (TAG, n = 14), sham acupuncture group (SAG, n = 14) and waiting group (WG, n = 13). All patients received levodopa for 12 weeks. Patients in TAG were acupunctured on DU20, GB20, and the Chorea-Tremor Controlled Zone, and patients in SAG accepted sham acupuncture, while patients in WG received no acupuncture treatment until 12 weeks after the course was ended. The UPDRS II and III subscales, and fMRI scans of the patients' brains were obtained before and after the treatment course. UPDRS II and III scores were analyzed by SPSS, while the degree centrality (DC), regional homogeneity (ReHo) and amplitude low-frequency fluctuation (ALFF) were determined by REST. Results: Acupuncture improved the UPDRS II and III scores in PD patients with tremor without placebo effect, only in tremor score. Acupuncture had specific effects on the cerebrocerebellar pathways as shown by the decreased DC and ReHo and increased ALFF values, and nonspecific effects on the spinocerebellar pathways as shown by the increased ReHo and ALFF values (P < 0.05, AlphaSimcorrected). Increased ReHo values were observed within the thalamus and motor cortex of the PD patients (P < 0.05, AlphaSim corrected). In addition, the default mode network (DMN), visual areas and insula were activated by the acupuncture with increased DC, ReHo and/or ALFF, while the prefrontal cortex (PFC) presented a significant decrease in ReHo and ALFF values after acupuncture (P < 0.05, AlphaSim corrected). Conclusions: The cerebellum, thalamus and motor cortex, which are connected to the cerebello-thalamo-cortical (CTC) circuit, were modulated by the acupuncture stimulation to alleviate the PD tremor. The regulation of neural activity within the cognitive brain regions (the DMN, visual areas, insula and PFC) together with CTC circuitmay contributes to enhancing movement and improving patients' daily life activities.
基金：
Guangzhou Postdoctoral International Training Program Funding Project; National Key Research and Development Projects of China [2016YFC1306600, 2017YFC1310300]; National Natural Science Foundation of ChinaNational Natural Science Foundation of China [81471292, U1603281, U1503222, 81430021, 81603681]; Science and Technology Project of Guangdong Province [2015A030311021, 2016A020215201]; Science and Technology Planning Project of Guangzhou [201504281820463, 2018-1202-SF-0019]; international project of science and technology for Guangdong [2016A050502025]
第一作者机构：[1]Department of Neurology, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China,[2]Department ofNeurology, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China,
共同第一作者：
通讯作者：
推荐引用方式(GB/T 7714)：
Li Zhe,Chen Jun,Cheng Jianbo,et al.Acupuncture Modulates the Cerebello-Thalamo-Cortical Circuit and Cognitive Brain Regions in Patients of Parkinson's Disease With Tremor[J].FRONTIERS IN AGING NEUROSCIENCE.2018,10:doi:10.3389/fnagi.2018.00206.
APA：
Li, Zhe,Chen, Jun,Cheng, Jianbo,Huang, Sicong,Hu, Yingyu...&Xu, Pingyi.(2018).Acupuncture Modulates the Cerebello-Thalamo-Cortical Circuit and Cognitive Brain Regions in Patients of Parkinson's Disease With Tremor.FRONTIERS IN AGING NEUROSCIENCE,10,
MLA：
Li, Zhe,et al."Acupuncture Modulates the Cerebello-Thalamo-Cortical Circuit and Cognitive Brain Regions in Patients of Parkinson's Disease With Tremor".FRONTIERS IN AGING NEUROSCIENCE 10.(2018)
