基于fMRI对经皮耳穴迷走神经刺激减重的中枢机制研究

打开文本图片集

[Abstract]ObjectiveToinvestigatetheefectsandmechanismsoftranscutaneousauricularpointvagusnervestimulation（tapVNS） onweightlossMethods：Atotalof49overweightandobesepatientswererecruitedandrandomlyasignedtoeitherthe taVNSgroup（24cases）orthecontrolgroup（25cases）．Thetwogroupswereinstructedtofolowanenergy-restricteddiet andexerciseregularly，whilethetapVNSgroupreceivedtapVNStreatmentaditionallWeight，BM，bodycompositionanalysis andresting-statefMRIdatawerecollctedbeforeandafterintervention.Results：Atotalof38participantscompletedthe study，with19casesinachgroup.Afterintervention，thebodyweight，BM，bodyfat，bodyfatrateandvisceralfatidein thetapVNSgroupwerelowerthanthosebeforeintervention，meanwhilethechangesinbodyweight，BMI，bodyfatbeforeand afterinterventionweregreaterthanthoseinthecontrol group，andthediferenceswerestatisticallysignificant（ll P<0.05 ） Comparedwithbeforeintervention，theALFFvaluesoftherightmidlefrontalgyrus，leftsupramarginalgyrusandleftangular gyrus weredecreased，andtheALFFvalueoftheleftmiddletemporalgyrus wasincreasedinthetapVNSgroup.However，in thecontrolgroup，theALFFvaluesincreasedintheleftsupramargonalgyrusandangulargyrus，anddecreasedintheright middle frontal gyrus，left middle temporal gyrusand right superior frontal gyrus（all P<0.05 ）.Using the left middle temporal gyrusastheseedpoint，thefunctionalconectivityofthemedialsuperiorfrontalgyruswasdecreasedinthetapVNS group after intervention （cluster P<0.05，GRF corrected）.Correlation analysis showed that the change of ALFF value in the leftmiddletemporalgyrusbeforeandafterinterventionwasnegativelycorrelatedwiththechangeofvisceralfatindexinthe tapVNS group （ r=. T 0.54，P =0.016）.Conclusions：The adjuvant therapy of tapVNS demonstrates enhanced eficacy in promoting weightloss，withthemidletemporalgyrusidentifiedasapotentialcentraltargetmediatingitstherapeuticefects.The underlying mechanisms may beattributed to its involvement in emotion regulation and stress relief.

[Keywords] Auricular Point;Vagus nerve stimulation;Obesity;Magnetic resonance imaging

在过去40年中，超重和肥胖人群数量迅速增加，由其可能引发的糖尿病、代谢综合征、心血管疾病等多种疾病，已成为全球的一个重大公共卫生问题[1]。（剩余12146字）