针刺治疗慢性疲劳综合征睡眠感知障碍的神经机制研究

The breakthrough of progress made on studies of CFS lied in screening effective treatment methods and elaborating its scientific connotations. The early study showed that sleep state misperception (SSM) was the key pathological characteristic of CFS, while disordered regulation of sleep-awake homeostasis system and hyperarousal might be the pathological mechanism of SSM. Acupuncture had specific effects in treating SSM. In this project, with the hypothesis that promoted adenosine secretion and inhibited hyperarousal caused by acupuncture might be the neural mechanism in treating SSM, the integration of neuroimaging and neural electrophysiology, and the combination of Functional magnetic resonance imaging (fMRI), Event-Related Brain Potential(ERP), and Encephalofluctuograph Technology(ET), neural pathological basis of SSM due to possibly existed abnormalities of central nerve anatomy or neural biology was detected. Meanwhile, the neural mechanism of acupuncture in treating SSM through promoting adenosine secretion and inhibiting hyperarousal was studied with the application of molecular biology.

慢性疲劳综合征（CFS）研究近期取得进展的突破点在于有效治疗手段的筛选及其科学内涵的阐释。课题组前期研究发现：睡眠感知障碍（SSM）是CFS的关键病理特征，睡眠-觉醒内稳态调节紊乱，过度觉醒可能是CFS患者SSM的病理机制，针灸具有特异性治疗SSM的作用。本研究拟紧密围绕"针刺通过促进腺苷分泌，抑制过度觉醒是治疗SSM 神经机制"的工作假说，整合运用神经影像和神经电生理技术，将功能磁共振（fMRI）、事件相关电位（ERP）和脑电超慢涨落分析技术（ET）相结合，探明CFS是否存在中枢神经解剖或神经生化异常的SSM神经病理基础，并通过分子生物学研究探讨针刺通过促进腺苷分泌，抑制过度觉醒，治疗SSM的神经机制，以丰富针刺治疗CFS的科学内涵。

本项目在前期发现慢性疲劳综合征（CFS）患者存在睡眠感知障碍的基础上，继续以60例CFS患者与20例健康受试者为研究对象，采用ERP检测、MRS检测和fMRI检测观察CFS患者可能存在的神经病理异常和生化异常以及针刺干预对其神经病理和生化异常的调整效应，同时以60只CFS模型大鼠为研究载体，采用免疫组化和放射免疫方法检测下丘脑前区和基底前脑AD及其受体含量和活性以及针刺干预对其的影响。结果发现：CFS患者在执行PVSAT认知任务时，正确率明显降低，距状沟裂上皮质及内皮质、舌回、枕极、楔叶等行动感知网络脑区激活程度明显降低，且右侧额叶GPC+PCh含量明显降低；过度警觉导致额中央区早期信息加工速度增快，但信息加工深度不足，且行动感知网络脑区激活降低，因此决策加工需要调动更多的资源以及信息提取再加工时间延长，最终导致执行输出错误增加，可能是CFS感知障碍的病理机制；与安慰针刺相比较，针刺可以改善CFS模型大鼠下丘脑前区和腹侧纹状体区紊乱的AD的分泌及其A1和A2a受体活性，改变异常的过度觉醒，从而达到对其感知障碍的改善。本研究结果初步揭示了CFS患者存在的感知障碍病理机制，同时为阐明针刺治疗CFS的生物学机制提供了科学依据。