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Objective:To observe the effect of electroacupuncture at Baihui (DU20) and Shenting (DU24) acupoints on white matter fiber and learning-memory function in rats with vascular dementia (VD). Methods:Sprague-Dawley rats were randomly divided into operation group and sham group (n = 8). The operation group accepted two-vessel occlusion, while the sham group only separated the bilateral common carotid arteries without ligation. The rats modeled successfully were randomly divided into model group (n = 8), non-acupoint group (n = 8) and electroacupuncture group (n = 8). The electroacupuncture group accepted electroacupuncture at Baihui and Shenting, and the non-acupoint group accepted electroacupuncture at axillary non-acupoint, once a day for 28 days. All the rats were tested with object recognition test before and after intervention, while the white matter fibers were observed with Diffusion Tensor Imaging. Results:Compared with the sham group, the preference coefficients of the model group, the non-acupoint group and the electroacupuncture group decreased before intervention (P< 0.05), and there was no significant difference among the later three groups (P> 0.05). The preference coefficients increased in the electroacupuncture group compared with the model group after intervention (P< 0.05). The fractional anisotropy (FA) of corpus callosum, cingulate gyrus and hippocampus decreased in the model group, the non-acupoint group and the electroacupuncture group compared with the sham group before intervention. FA of hippocampus, cingulate gyrus, corpus callosum and external capsule increased in the electroacupuncture group compared with the model group after intervention. Conclusion:Electroacupuncture at Baihui and Shenting can improve learning-memory function of VD rats, which may be related with repairment of white matter fibers in prefrontal cortex, hippocampus and others.
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Objective To investigate the diagnostic value of MR diffusion tensor imaging (DTI) and diffusion tensor fiber bundle imaging (DTT) in white matter injury of cerebral infarction in different periods, and to observe the damage of white matter fiber bundles. Methods Four adult male rhesus monkeys, aging 8. 0 ± 1. 5 years old and weighted 9. 6 ± 1. 2 kg were experimented. Middle cerebral artery (Ml segment) embolization-reperfusion model was prepared by rhesus monkey autologous thrombosis and recanalization with recombinant tissue plasminogen activator 2. 5 h after embolization. Routine magnetic resonance imaging (MRI), diffusion weighted imaging (DWI) and DTI were performed at 4 h, 7 d and 30 d after surgery, respectively. The anisotropic coefficient (FA) values and changes of the white matter fiber bundles in corresponding parts of cerebral white matter between the infarcted side and the healthy side were compared. Results FA and the number of fiber bundles in the infarct side showed a trend of decrease on day 7 and increase on day 30 after ischemia, and the difference was statistically significant (At 4 h, 7 d and 30 d after cerebral ischemia, FA was 0. 301 ± 0. 045, 0. 200 ± 0. 050 and 0. 305 ± 0. 026, respectively: The number of fiber bundles was 43. 0 ± 1. 6, 22. 8 ±11.0 and 31.3 ± 6. 4, respectively. F values were 8. 223 and 7. 861, respectively; all P 0. 05). Conclusion DTI and DTT can better evaluate the degree of white matter fiber bundle injury in cerebral infarction at different stages, which is of great value in guiding clinical diagnosis and predicting prognosis.
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OBJECTIVE@#To explore the effectiveness and safety of the combined treatment with acupuncture and venlafaxine hydrochloride on depression in terms of the microstructure change of white matter fiber tracts of brain based on diffusion tensor imaging technology (DTI).@*METHODS@#The prospective study design was adopted. All of 60 patients with depression were randomized into an acupuncture-medication group and a medication group, 30 cases in each one. In the medication group, venlafaxine hydrochloride was used, 75 mg per day in the 1st week, 150 mg per day in the 2nd week and 225 mg per day from the 3rd to 6th week. In the acupuncture-medication group, on the base of the treatment in the medication group, acupuncture was combined. Baihui (GV 20) and Yintang (GV 29) were the main acupoints. The supplementary acupoints were selected according to the clinical symptoms of individuals. The needles were retained for 30 min. Acupuncture was provided once every 2 days, 3 times a week. The consecutive 12 weeks of treatment were required in the two groups. Additionally, a normal group was prepared with 30 healthy volunteers. Separately, before treatment, in 2, 8 and 12 weeks of treatment, Hamilton's depression scale (HAMD-17), Beck depression inventory scale (BDI) and the antidepressant side effect scale (SERS) were adopted to evaluate the effectiveness and safety of the two groups. Moreover, before and after 12 weeks of treatment, DTI was adopted to detect the fractional anisotropy score (FA) of each brain region in the patients.@*RESULTS@#After treatment, the scores of HAMD-17 and BDI were all reduced in the two groups (0.05). Compared with the healthy volunteers, FA scores in 6 brain regions changed obviously in the patients with depression, including the white matter of bilateral frontal lobes, splenium of corpus callosum, left cingulated gyrus, white matter of bilateral inferior temporal gyrus, white matter of bilateral inferior parietal lobe and white matter of bilateral deep temporal occipital region separately. Before treatment, the differences in FA scores of these 6 brain regions were not significant statistically between the two groups (>0.05). After treatment, FA scores in the white matter of bilateral frontal lobes, white matter of bilateral inferior temporal gyrus and white matter of bilateral deep temporal occipital region in the acupuncture-medication group were all higher than those in the medication group (<0.05).@*CONCLUSION@#Acupuncture repairs the brain white matter fiber tracts in some brain regions to certain extent and the therapeutic effects are enhanced with the adjuvant medication of venlafaxine hydrochloride.
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Humans , Acupuncture Therapy , Brain , Depression , Therapeutics , Diffusion Tensor Imaging , Prospective Studies , Venlafaxine HydrochlorideABSTRACT
Objective To explore abnormal microstmctural changes of white matter in patients with white matter lesions using diffusion tensor imaging(DTI),and to determine the association of such abnormalities of DTI parameters with cognitive function.Methods The objects who have already confirmed with WML were collected from March 2012 to February 2018 through magnetic resonance imaging (MRI) scan from the neurology department of Beijing Tiantan Hospital.Use The hamilton depression scale(HAMD) and the hamilton anxiety scale (HAMA) to eliminate anxiety and depression,and divided into WML-CN group,WML-VCIND group and WML-VAD group with Mini-mental state examination (MMSE),Montreal Cognitive Assessment (MOCA)and clinical dementia rating(CDR).In addition,select the healthy elderly people without WML by MRI scan as the normal control group.All of the subjects were detected with the superconduct magnetic resonance imaging system (German SIEMENS 3.0T) for the DTI scanning.Original images were processed with VBA.Then explore the changes of FA and MD of DTI in whole brain and regions of interest in NC group,WML-CN group,WML-VCIND group and WWML-VAD group,and its correlation with the severity of cognitive impairment in patients with WML.Results The damage degree of the fiber microstructure of brain white matter was significantly correlated with the total grade point of MoCA (P＜0.01).In figure FA,the variance analysis of F test results showed that the significant brain areas were the splenium of the corpus callosum,the genu of corpus callosum,bilateral posterior internal capsule,retrolenticular part of internal capsule,anterior thalamic radiation,partial inferior longitudinal fasciculus and inferior fronto-occipital fasciculus,cingulate,external capsule,upper and posterior part of the radiation crowns,partial superior longitudinal fasciculus,etc.(P＜0.05 after FWE correction based on TFCE method).In Figure MD,the variance analysis of F test results showed that the statistically significant brain areas mainly included the left external capsule and hook,partial genu and splenium of corpus callosum,Bilateral,bilateral inferior fronto-occipital fasciculus,inferior longitudinal fasciculus,anterior thalamic radiation,retrolenticular part of internal capsule,cingulate,etc (P＜ 0.05 after FWE conection based on TFCE).Conclusion No matter whether cognitive impairment exists in patient with WML or not,all DTI parameters are different from those of normal people.The integrity of white matter fiber has been damaged with different degrees.The more severe the cognitive impairment in the external manifestations of patients with WML,the greater the damage to the intrinsic white matter microstructure.
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Objective To discuss the prognostic evaluation of magnetic resonance diffusion tensor imaging (DTI) in term neonates with mild and severe asphyxia.Methods Eleven neonates with mild asphyxia,14 neonates with severe asphyxia and 10 control neonates were studied.All the neonates were examined by conventional magnetic resonance imaging(MRI) and DTI.Fraction anisotropy (FA) values,apparent diffusion coefficient (ADC) values,voxel numbers and fiber numbers were calculated in seven regions of interest(ROI) and compared among the 3 groups.The correlation between FA values and neonatal behavioral neurological assessment (NBNA) scores were analyzed.Results (1) FA values in the left and the right thalamus were 0.54 ± 0.08 and 0.56 ± 0.15 in control group,0.45 ±0.03 and 0.44 ± 0.10 in mild group,and 0.21 ± 0.11 and 0.25 ± 0.13,respectively in severe group.FA values in posterior limbs of internal capsule were 0.49 ± 0.09 and 0.48 ± 0.08 in control group,0.37 ± 0.08 and 0.38 ± 0.03 in mild group,and 0.20 ± 0.04,0.19 ± 0.13 in severe group;FA values in thalamus and posterior limbs of internal capsule had statistical differences among the 3 groups (F =9.12,9.11,8.18,8.55,all P ＜ 0.05).Voxel numbers in the left and the right superior longitudinal fasciculus were 1 094 ± 112 and 1 123 ± 113 in control group,986 ± 111 and 1 009 ± 144 in mild group,450 ± 116 and 671 ± 126 in severe group.Voxel numbers in anterior limbs of internal capsule were 947 ± 104 and 1 237 ± 184 in control group,854 ± 118 and 799 ± 114 in mild group,324 ± 110 and 311 ± 126 in severe group.Voxel numbers in posterior limbs of internal capsule were 2 047 ± 129 and 2 137 ± 238 in control group,1 843 ± 233 and 1 753 ± 247 in mild group,867 ± 118 and 999 ± 167 in severe group.Voxel numbers in superior longitudinal fasciculus,anterior and posterior limbs of internal capsule had statistical differences among the 3 groups (F =10.11,9.45,7.33,8.45,12.65,11.23,all P ＜ 0.05);Fiber numbers in the left and the right cingulate gyrus were 245 ±72 and 405 ±94 in control group,225 ±52 and 365 ± 114 in mild group,145 ±62 and 185 ±84 in severe group.Fiber numbers in inferior front-occipital fasciculus were 56 ± 19 and 212 ± 33 in control group,49 ±22 and 197 ± 33 in mild group,33 ± 12 and 156 ± 39 in severe group.Fiber numbers in posterior limbs of internal capsule were 284 ± 112 and 988 ± 233 in control group,234 ± 67 and 678 ± 234 in mild group,114 ± 67 and 188 ± 84 in severe group.Fiber numbers in cingulate gyrus,inferior front-occipital fasciculus and posterior limbs of internal capsule had statistical differences among the 3 groups (F =3.11,3.45,9.88,9.12,7.45,8.88,all P ＜ 0.05).(2) The correlation between FA value and NBNA scores was analyzed:the correlation coefficient in posterior limbs of internal capsule was 0.666 which was higher than those of the other areas.The area under the ROC curve of FA values in anterior limbs of internal capsule was 0.816 (P =0.005),used NBNA scores ≥ 35 as a good outcome.FA values (≥ 0.375) in the posterior limbs of the internal capsules predicted a good outcome and the corresponding sensitivity and specificity was 73.1％ and 77.8％,respectively.Conclusion In some ROIs,FA values,voxel numbers,and fiber numbers can quantitatively reflect the degree of white matter injury in neonates with asphyxia.Furthermore,the FA values in the posterior limbs of the internal capsules are closely correlated with NBNA scores,so it has more important clinical significance,and can accurately and objectively assess the prognosis in neonates with asphyxia.
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Objective To discuss the prognostic evaluation of magnetic resonance diffusion tensor imaging (DTI) in term neonates with mild and severe asphyxia.Methods Eleven neonates with mild asphyxia,14 neonates with severe asphyxia and 10 control neonates were studied.All the neonates were examined by conventional magnetic resonance imaging(MRI) and DTI.Fraction anisotropy (FA) values,apparent diffusion coefficient (ADC) values,voxel numbers and fiber numbers were calculated in seven regions of interest(ROI) and compared among the 3 groups.The correlation between FA values and neonatal behavioral neurological assessment (NBNA) scores were analyzed.Results (1) FA values in the left and the right thalamus were 0.54 ± 0.08 and 0.56 ± 0.15 in control group,0.45 ±0.03 and 0.44 ± 0.10 in mild group,and 0.21 ± 0.11 and 0.25 ± 0.13,respectively in severe group.FA values in posterior limbs of internal capsule were 0.49 ± 0.09 and 0.48 ± 0.08 in control group,0.37 ± 0.08 and 0.38 ± 0.03 in mild group,and 0.20 ± 0.04,0.19 ± 0.13 in severe group;FA values in thalamus and posterior limbs of internal capsule had statistical differences among the 3 groups (F =9.12,9.11,8.18,8.55,all P ＜ 0.05).Voxel numbers in the left and the right superior longitudinal fasciculus were 1 094 ± 112 and 1 123 ± 113 in control group,986 ± 111 and 1 009 ± 144 in mild group,450 ± 116 and 671 ± 126 in severe group.Voxel numbers in anterior limbs of internal capsule were 947 ± 104 and 1 237 ± 184 in control group,854 ± 118 and 799 ± 114 in mild group,324 ± 110 and 311 ± 126 in severe group.Voxel numbers in posterior limbs of internal capsule were 2 047 ± 129 and 2 137 ± 238 in control group,1 843 ± 233 and 1 753 ± 247 in mild group,867 ± 118 and 999 ± 167 in severe group.Voxel numbers in superior longitudinal fasciculus,anterior and posterior limbs of internal capsule had statistical differences among the 3 groups (F =10.11,9.45,7.33,8.45,12.65,11.23,all P ＜ 0.05);Fiber numbers in the left and the right cingulate gyrus were 245 ±72 and 405 ±94 in control group,225 ±52 and 365 ± 114 in mild group,145 ±62 and 185 ±84 in severe group.Fiber numbers in inferior front-occipital fasciculus were 56 ± 19 and 212 ± 33 in control group,49 ±22 and 197 ± 33 in mild group,33 ± 12 and 156 ± 39 in severe group.Fiber numbers in posterior limbs of internal capsule were 284 ± 112 and 988 ± 233 in control group,234 ± 67 and 678 ± 234 in mild group,114 ± 67 and 188 ± 84 in severe group.Fiber numbers in cingulate gyrus,inferior front-occipital fasciculus and posterior limbs of internal capsule had statistical differences among the 3 groups (F =3.11,3.45,9.88,9.12,7.45,8.88,all P ＜ 0.05).(2) The correlation between FA value and NBNA scores was analyzed:the correlation coefficient in posterior limbs of internal capsule was 0.666 which was higher than those of the other areas.The area under the ROC curve of FA values in anterior limbs of internal capsule was 0.816 (P =0.005),used NBNA scores ≥ 35 as a good outcome.FA values (≥ 0.375) in the posterior limbs of the internal capsules predicted a good outcome and the corresponding sensitivity and specificity was 73.1％ and 77.8％,respectively.Conclusion In some ROIs,FA values,voxel numbers,and fiber numbers can quantitatively reflect the degree of white matter injury in neonates with asphyxia.Furthermore,the FA values in the posterior limbs of the internal capsules are closely correlated with NBNA scores,so it has more important clinical significance,and can accurately and objectively assess the prognosis in neonates with asphyxia.
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@# Diffusion tensor imaging (DTI) could not only reconstruct of the brain white matter neural connectivity, but also show clearly the brain white matter fiber morphology of lesions, either directly or indirectly, which imaged on white matter fiber tracts in the three-dimensional geometric structure by special software for image on the anisotropic thermal motion of water molecules. This paper reviewed the researches on DTI in the assessment of white matter fiber tracts injury and prognosis in patients with stroke.