Effect of the Integrated Chinese and Western Medicine on the Default Mode Network in the Acute Ischemic Stroke Based on fMRI

OBJECTIVE  To observe the clinical efficacy of Shuxuetong injection combined with conventional treatment on acute ischemic stroke using resting-state functional magnetic resonance imaging (fMRI), and to investigate the changes of functional connectivity within the default mode network (DMN) to reveal the potential mechanism of efficacy.METHODS  A total of 20 patients with acute ischemic stroke were included to undergo fMRI before and after the integrated Chinese and Western medicine treatment, while 20 healthy subjects were selected as controls to compare the differences within the DMN between patients and healthy subjects. In addition, the differences in clinical scale scores and functional connectivity within the DMN between patients before and after treatment were also compared to further analyze the correlation between the differential encephalic region and clinical scale scores.RESULTS  ① After treatment, patients' NIHSS and mRS scores reduced significantly, BI scores increased significantly (P < 0.01), and diagnosis scores of Chinese medicine disease category improved significantly (P < 0.01). ②Compared with healthy subjects, the functional connectivity of the right superior temporal gyrus and right precuneus in DMN of patients before treatment reduced significantly (P < 0.05), and there was no significant difference in DMN of patients after treatment (P>0.05). The functional connectivity of the right posterior cingulate gyrus and the right precuneus in the DMN enhanced significantly after treatment compared with that before treatment (P < 0.05). ③The change in the functional connectivity of the right precuneus was significantly correlated with the NIHSS and BI scores (P < 0.01).CONCLUSION  Integrated treatment of ischemic stroke with Chinese and Western medicine may reduce neurologic impairment and improve the living quality by modulating the functional connectivity of the right precuneus in the DMN.