Research hotspots and frontiers of functional magnetic resonance imaging in treatment of ischemic stroke by traditional Chinese medicine

doi:10.12307/2024.227

Abstract

Abstract: BACKGROUND: This review explores the current research status and frontier hot spots of functional magnetic resonance imaging (fMRI) in the field of traditional Chinese medicine (TCM) for the treatment of ischemic stroke, and attempts to grasp future research trends, with a view to providing a reference for subsequent research in this field.
OBJECTIVE: To visualize and analyze the hotspots and frontiers in the TCM treatment of ischemic stroke based on fMRI using CiteSpace knowledge mapping combined with binary logistic regression equations, in order to grasp the future research trends and further explore the distribution of brain regions with abnormal neural activity related to the types of post-stroke dysfunction.
METHODS: CNKI, WanFang, VIP, Chinese Biomedical Literature Database and Web of Science core set database were searched. CiteSpace was used to plot keyword co-occurrence, keyword clustering timeline, burst term detection, co-cited literature mapping to analyze hotpots and frontiers in this field. Binary logistic regression analysis fitted the distribution of brain regions with abnormal neural activity associated with different dysfunction after ischemic stroke.

RESULTS AND CONCLUSION: A total of 354 articles were included for CiteSpace knowledge mapping analysis. The number of annual publications showed that the research popularity has been raised from 2000 to 2022 with a good development prospect, but the core strength is mainly concentrated in China. Keywords co-occurrence and clustering time line analysis showed that aphasia, hemiplegia and cognitive impairment are the hot poststroke dysfunction types. Electroacupuncture, acupuncture and head acupuncture are hotspot intervention measures. Functional connectivity is a hotspot analysis method, and resting fMRI is a hotspot scanning technology. The time span of each research hotspot is long, indicating that it has a certain research value and the relevant research is gradually deepening, promoting the research progress in this field. However, acupuncture is the main intervention measure, and there is a lack of research on traditional Chinese medicine, Chinese patent medicine, acupuncture and medicine combination and other TCM therapy. Burst term detection results showed that functional connectivity, graph theory, degree centrality, default mode network, randomized controlled trials have great influence and strong explosive power. They are the current and future frontier hot spots in this field, suggesting that future research should focus on the brain network information integration and strengthen the scientific and rigorous clinical trial design. The results of co-cited literature analysis showed that the epidemiological investigation of ischemic stroke, the safety and effectiveness of acupuncture in the treatment of stroke, the brain activation patterns under different tasks, and the neuropathological mechanism of brain network dysfunction after stroke are the theoretical basis of this field. Future research direction in this field is to explore TCM-targeted brain regions and neural networks to reveal the brain effect mechanism of TCM promoting neural remodeling after stroke. A total of 255 articles were included for binary Logistic regression analysis. The results showed that sensorimotor cortex and premotor area dysfunction are positively correlated with the incidence of motor dysfunction after stroke; hippocampus, cerebellum posterior lobe, precuneus, inferior temporal gyrus and anterior cingulate nerve dysfunction are positively correlated with the incidence of cognitive impairment after stroke; cuneus, angular gyrus and prefrontal lobe neural dysfunction were positively correlated with the incidence of affective disorder after stroke; anterior cingulate, cerebellum posterior lobe neural dysfunction are positively correlated with the incidence of swallowing disorder after stroke. The above brain regions are the core brain regions of the sensorimotor network, default mode network and reward loop, suggesting that functional abnormalities within or between brain networks related to dysfunction may be potential target areas for TCM intervention, but the specific changes in neural activity activation or inhibition still need to be refined.

Key words: ischemic stroke, traditional Chinese medicine, functional magnetic resonance imaging, neural remodeling, visualized analysis, CiteSpace, binary Logistic regression, functional connectivity, brain network

CLC Number:

Xu Kangli, An Lanhua, Zhang Jinsheng, Du Xiaoyan, Yin Lele, Zhang Xixian. Research hotspots and frontiers of functional magnetic resonance imaging in treatment of ischemic stroke by traditional Chinese medicine[J]. Chinese Journal of Tissue Engineering Research, 2024, 28(11): 1789-1796.

Figures/Tables 16

每个聚类的研究热度随时间而变化，结果显示#0 neural regeneration(神经再生)、#2 cortex(大脑皮质)、#4 activation(激活)均属于脑效应机制研究，#0 neural regeneration(神经再生)主题的研究热点自2006年持续至2022年，研究热度集中在2010-2017年，Electroacupuncture(电针)为该主题下影响力最大的干预措施，脑卒中后运动功能障碍为主要研究对象[24]。#2 cortex(大脑皮质)主题的研究自2006年持续至2022年，研究热度集中在2013-2018年，该主题的研究内容以探究与脑卒中后功能恢复相关的皮质激活、脑功能或结构的完整性等中枢神经机制为主[25-26]。#4 activation(激活)主题的研究自2008年持续至2021年，研究热度集中于2010-2021年，研究内容以对比acupuncture(针刺)和sham acupuncture(假针刺)刺激对脑功能的影响进而探究穴位特异性为主[27]。#1 connectivity(连通性)、#5 network connectivity(网络连接)聚类属于分析技术层面的研究主题。#1 connectivity(连通性)研究自2007年持续至2022年，研究热度集中在2012-2014年；#5 network connectivity(网络连接)研究自2007年持续至2019年，研究热度集中在2007-2015年。#1 connectivity(连通性)、#5 network connectivity(网络连接)主题以揭示脑卒中后失语、运动功能障碍的中枢机制为主，其中以探究default mode network(默认网络)内的功能连接的改变为主[28-29]。 2.3.3 关键词突显图谱对关键词进行突显性检测有助于探索某一时间段内影响力较大的研究热点，通过突显词的变化可以识别该领域前沿热点[11]。中文关键词突显图谱显示，2003-2019年突显词的动态演变与共现分析、聚类分析结果基本一致。2019-2022年“图论”“功能连接”“度中心性”成为该领域中影响力较大的研究热点，且爆发力较强，为当前研究前沿热点，见图6A。英文关键词突显图谱显示，2019-2022年，“rehabilitation(康复)”“default mode network(默认网络)”“functional connectivity(功能连接)”“ischemic stroke(缺血性脑卒中)”“randomized controlled trial(随机对照试验)”在该领域中影响力大、爆发力强，为当前研究前沿热点，见图6B。"

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