基于EEG-fMRI的电针四神聪调节睡眠结构、改善认知功能的中枢机制研究

EX-HN 1 is the key point treating insomnia and forgetfulness. In the previous study, we found that the quality of sleep for stroke patients has been improved by electroacupuncture on EX-HN 1, meanwhile, their neurocognitive function has been improved. However, the mechanism of the effect “tranquilize the mind and promote the intelligence, reinforce the brain and regulate the mind” is not clear. The latest study shows that sleep contributes to the consolidation of memory. Accordingly, we hypothesized that electroacupuncture may improve the sleep-dependent short-term memory by adjusting the sleep architecture, improving sleep efficiency, reducing daytime sleepiness. The cumulative effect of electroacupuncture can influence the brain's default network connection, promoting the reconstruction of brain function to achieve a comprehensive increase in neurocognitive level. In this study, we will investigate the relationship between sleep architecture, daytime sleepiness and neurocognitive level in stroke patients using polysomnography and quantitative electroencephalography. Then, we will conduct the study of the immediate effect of electroacupuncture in improving short-term memory, exploring the effects of different stimulation parameters on EEG and memory. Then, based on rs-fMRI technology, the method of seed area was used to analyze the brain default network function of stroke patients. Furthermore, we will explore the mechanism of electroacupuncture in improving sleep architecture and neurocognitive function of stroke patients using the EEG-fMRI fusion technique. The implementation of this project will provide a novel approach to elucidate the effect of acupuncture in “regulating the mind and promoting the intelligence”.

四神聪是治疗失眠、健忘的要穴。我们前期研究发现电针四神聪在改善脑卒中患者睡眠质量的同时，其认知功能也有明显的提升。但其如何发挥“安神益智、健脑调神”的功效，机制尚不明确。最新研究表明睡眠有助于记忆的巩固。据此我们设想：电针可能通过调节睡眠结构、提高睡眠效率、减少日间嗜睡从而改善睡眠依赖短时记忆；并通过针灸的累积效应，影响脑的默认网络连接，促进脑功能重建而达到全面提高认知水平。本课题拟通过多导睡眠监测(PSG)、定量脑电图技术对脑卒中患者的睡眠结构、日间嗜睡和认知水平进行相关性分析；再进行电针四神聪改善睡眠结构与提高短时记忆的即刻效应研究，并探索不同刺激参数对脑电及记忆的影响；基于静息态功能磁共振技术，采用种子区的方法分析脑默认网络功能连接；应用EEG-fMRI融合技术，探讨电针改善脑卒中患者睡眠结构和认知功能的神经生物学机制。本项目的实施，将为针灸“调神益智”治疗效应的科学阐述提供新的思路

四神聪是治疗失眠、健忘的要穴。但其如何发挥“安神益智、健脑调神”的功效，机制尚不明确。最新研究表明睡眠有助于记忆的巩固。据此我们设想：电针可能通过调节睡眠结构、提高睡眠效率、减少日间嗜睡从而改善睡眠依赖短时记忆；并通过针灸的累积效应，影响脑的默认网络连接，促进脑功能重建而达到全面提高认知水平。本课题拟通过多导睡眠监测对脑卒中患者的睡眠结构、日间嗜睡和认知水平进行相关性分析；再进行电针四神聪改善睡眠结构与提高短时记忆的即刻效应研究，并探索不同刺激参数对脑电及记忆的影响；基于静息态功能磁共振技术，格兰杰因果分析观察脑网络之间的功能连接变化；基于图论进行脑网络全局效率及连边分析，探讨电针改善脑卒中患者睡眠结构和认知功能的神经生物学机制。.本项目研究结果显示：.1.电针四神聪能调整脑梗死相关失眠患者的睡眠结构，缩短入睡潜伏期，增加REM期及N3期睡眠时间，增加睡眠总时间，提高睡眠效率，从而改善睡眠质量。.2. 电针四神聪能改善脑梗死相关失眠患者的警觉性注意力、短时记忆等认知功能。电针四神聪在改善警觉性注意力上，即刻效应不明显，存在累积效应，脑电快波活动增加。电针四神聪在改善短时记忆力上，存在一定的即刻效应和累积效应，脑电快波活动增加，慢波活动减弱。.3.电针四神聪能促进脑电活化程度的增强，相应脑区的快波活动及慢波活动随之协同改变，存在一定的同步性，这可能是电针四神聪改善脑梗死相关失眠患者认知功能的脑效应机制之一。.4.电针四神聪可调节大脑的兴奋平衡性，使优势半球中与高级认知相关脑区的功能连接增强、非优势半球中与负性情绪和认知代偿相关脑区减弱；电针四神聪通过调节多个与认知相关脑区，使默认网和认知控制网的功能连接增强，恢复了它们对认知的控制作用，从而改善认知功能，其通过多靶点调整关键节点脑区而调整脑网络的运行。