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• Clinical Article •
Evaluation of the therapeutic efficacy of acupuncture in children with autism using DTI
LI Yuxin  DANG Weili  MA Bingxiang  XING Wei  ZHOU Rongyi  KONG Yamin  JING Zhenhao 

Cite this article as: LI Y X, DANG W L, MA B X, et al. Evaluation of the therapeutic efficacy of acupuncture in children with autism using DTI[J]. Chin J Magn Reson Imaging, 2024, 15(1): 61-69. DOI:10.12015/issn.1674-8034.2024.01.010.


[Abstract] Objective Using diffusion tensor imaging (DTI) to observe the changes in the microstructure of white matter in children with autism spectrum disorder (ASD) before and after acupuncture treatment, in order to explore the value of acupuncture in treating ASD and the role of DTI in evaluating the effectiveness of acupuncture.Materials and Methods Prospective inclusion of children diagnosed with ASD in our hospital from November 2021 to October 2022, randomized using a random number table into an acupuncture group or a sham acupuncture group, for 12 weeks of intervention. Before treatment (week 0) and after treatment (week 12), the Child Autism Rating Scale (CARS), Autism Behavior Checklist (ABC), Autism Treatment Evaluation Checklist (ATEC) and DTI examination were performed. The changes in scores of various scales between the two groups were compared, and the tract-based spatial statistics (TBSS) was used to analyze the differences in fractional anisotropy (FA) of white matter between the two groups. Then compare the differences in mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) of brain regions with varying fractional anisotropy (FA), and explore the correlations between scale ratings and DTI parameters.Results Compared to the sham acupuncture group, the acupuncture group showed a significant decrease in various scale scores after treatment, and the difference was statistically significant (P<0.05). There was a statistically significant difference in FA values between the two groups after treatment (P<0.05), but no significant difference in RD values (P>0.05). In terms of AD values, there was a statistically significant difference between the two groups in the left inferior longitudinal fasciculus (P<0.05). The correlation analysis revealed in children with ASD, the ATEC scores were negatively correlated with the FA values of the right uncinate fasciculus, positively correlated with the RD values of the right infero-frontal-occipital fasciculus, right inferior longitudinal fasciculus, and right uncinate fasciculus, and positively correlated with the AD values of the right uncinate fasciculus. The CARS scores were positively correlated with the AD values of the right uncinate fasciculus (P<0.05). The FA values of the right inferior longitudinal fasciculus were negatively correlated with language problems and sensory abnormalities in children with ASD, while the RD values were positively correlated with social impairments and sensory abnormalities. The FA values of the right uncinate fasciculus were negatively correlated with language problems, social impairments, and sensory abnormalities, while the RD values were positively correlated with these clinical symptoms. The AD values of the right uncinate fasciculus were positively correlated with social impairments and health issues. In addition, the FA values of bilateral infero-frontal-occipital fasciculus were negatively correlated with sensory abnormalities, and the RD values of the right infero-frontal-occipital fasciculus were positively correlated with social impairments and sensory abnormalities. The RD values of the right superior longitudinal fasciculus were positively correlated with sensory abnormalities. The AD values of the left anterior thalamic radiation were positively correlated with sensory abnormalities (P<0.05).Conclusions Acupuncture may improve clinical symptoms in children with ASD, particularly in areas such as speech, social interaction, perception, and health problems, possibly by promoting the integrity of brain white matter fiber bundles. This further indicates the important value of DTI in evaluating the therapeutic effect of acupuncture.
[Keywords] autism spectrum disorder；acupuncture；magnetic resonance imaging；diffusion tensor imaging；tract-based spatial statistics；neural fiber bundle

LI Yuxin1   DANG Weili1, 2   MA Bingxiang1, 2*   XING Wei3   ZHOU Rongyi1, 2   KONG Yamin1, 2   JING Zhenhao1  

1 School of Pediatric Medicine, Henan University of Chinese Medicine, Zhengzhou 450000, China

2 Pediatric Neurology Diagnosis and Rehabilitation Center, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450000, China

3 Department of Magnetic Resonance, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450000, China

Corresponding author: MA B X, E-mail: mbx1963@126.com

Conflicts of interest   None.

Received  2023-07-08
Accepted  2024-01-02
DOI: 10.12015/issn.1674-8034.2024.01.010
Cite this article as: LI Y X, DANG W L, MA B X, et al. Evaluation of the therapeutic efficacy of acupuncture in children with autism using DTI[J]. Chin J Magn Reson Imaging, 2024, 15(1): 61-69. DOI:10.12015/issn.1674-8034.2024.01.010.

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