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.