Share this content in WeChat
Research progress on the brain network mechanism of Chinese medicine rehabilitation therapy intervention in knee osteoarthritis
LIU Jun  LI Xingjie  WAN Yiwen  CHEN Shangjie  XIE Hongliang 

Cite this article as: Liu J, Li XJ, Wan YW, et al. Research progress on the brain network mechanism of Chinese medicine rehabilitation therapy intervention in knee osteoarthritis[J]. Chin J Magn Reson Imaging, 2022, 13(11): 161-164. DOI:10.12015/issn.1674-8034.2022.11.033.

[Abstract] Knee osteoarthritis (KOA) is an osteoarthritic disease that occurs in the elderly. Traditional exercise, acupuncture, and Tui-na rehabilitation therapies are clinical approaches to alleviate KOA. MRI shows that KOA is associated with changes in brain structure and functional networks such as cortical thinning and abnormal functional connectivity of brain regions. Chinese medicine rehabilitation therapy works by restoring abnormal changes in brain function and structure in KOA patients. Therefore, this review is based on MRI technology to review and summarize it: (1) KOA pain causes cortical thinning, gray matter volume, density reduction, and other abnormal changes in the structural network of the brain; (2) KOA shows changes in functional network such as abnormal activation of specific brain regions and abnormal changes in functional connectivity of different brain regions; (3) standardized exercise training can modulate brain networks; (4) acupuncture, moxibustion, and massage can improve the functional structure of multiple brain regions. To provide new ideas for promoting the combination of traditional Chinese medicine rehabilitation and imaging technology, and to relieve the symptoms of KOA and relieve the pain of patients with traditional Chinese medicine rehabilitation.
[Keywords] knee osteoarthritis;Chinese medicine rehabilitation therapy;acupuncture;kinesitherapy;cerebral network;magnetic resonance imaging;review

LIU Jun1   LI Xingjie1   WAN Yiwen2   CHEN Shangjie1, 2   XIE Hongliang2*  

1 Graduate School of Anhui University of Chinese Medicine, Hefei 230038, China

2 Department of Rehabilitation Medicine, Shenzhen Baoan Hospital Affiliated to Southern Medical University, Shenzhen 518101, China

Xie HL, E-mail:

Conflicts of interest   None.

Received  2022-01-18
Accepted  2022-11-04
DOI: 10.12015/issn.1674-8034.2022.11.033
Cite this article as: Liu J, Li XJ, Wan YW, et al. Research progress on the brain network mechanism of Chinese medicine rehabilitation therapy intervention in knee osteoarthritis[J]. Chin J Magn Reson Imaging, 2022, 13(11): 161-164.DOI:10.12015/issn.1674-8034.2022.11.033

Hunter DJ, Bierma-Zeinstra S. Osteoarthritis[J]. Lancet, 2019, 393(10182): 1745-1759. DOI: 10.1016/S0140-6736(19)30417-9.
GBD Neurological Disorders Collaborator Group. Global, regional, and national burden of neurological disorders during 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015[J]. Lancet Neurol, 2017, 16(11): 877-897. DOI: 10.1016/S1474-4422(17)30299-5.
Chen HB, Wu JH, Wang ZJ, et al. Trends and patterns of knee osteoarthritis in China: a longitudinal study of 17.7 million adults from 2008 to 2017[J/OL]. Int J Environ Res Public Health, 2021, 18(16): 8864 [2022-01-17]. DOI: 10.3390/ijerph18168864.
Georgiev T, Angelov AK. Modifiable risk factors in knee osteoarthritis: treatment implications[J]. Rheumatol Int, 2019, 39(7): 1145-1157. DOI: 10.1007/s00296-019-04290-z.
Gress K, Charipova K, An D, et al. Treatment recommendations for chronic knee osteoarthritis[J]. Best Pract Res Clin Anaesthesiol, 2020, 34(3): 369-382. DOI: 10.1016/j.bpa.2020.06.006.
Xu J, Xu H, Liang QQ, et al. Research progress of acupuncture treatment on knee osteoarthritis in recent 5 years[J]. China J Tradit Chin Med Pharm, 2020, 35(7): 3557-3559.
Sun N, Li YT, Lin LL, et al. Comparison and analysis of therapeutic effects of different types of acupuncture and moxibustion interventions on knee osteoarthritis[J]. China J Tradit Chin Med Pharm, 2017, 32(7): 3253-3255.
Chong CD, Dodick DW, Schlaggar BL, et al. Atypical age-related cortical thinning in episodic migraine[J]. Cephalalgia, 2014, 34(14): 1115-1124. DOI: 10.1177/0333102414531157.
Alshuft HM, Condon LA, Dineen RA, et al. Cerebral cortical thickness in chronic pain due to knee osteoarthritis: the effect of pain duration and pain sensitization[J/OL]. PLoS One, 2016, 11(9): e0161687 [2022-01-17]. DOI: 10.1371/journal.pone.0161687.
Liao X, Mao CP, Wang Y, et al. Brain gray matter alterations in Chinese patients with chronic knee osteoarthritis pain based on voxel-based morphometry[J/OL]. Medicine (Baltimore), 2018, 97(12): e0145 [2022-01-17]. DOI: 10.1097/MD.0000000000010145.
Barroso J, Vigotsky AD, Branco P, et al. Brain gray matter abnormalities in osteoarthritis pain: a cross-sectional evaluation[J]. Pain, 2020, 161(9): 2167-2178. DOI: 10.1097/j.pain.0000000000001904.
Wang X, Wang K, Bao ZY, et al. The correlation between altered brain fMRI and pain perception before and after operation in patients with knee osteoarthritis[J]. Int J Med Radiol, 2019, 42(3): 255-259, 284. DOI: 10.19300/j.2019.L6400.
Cottam WJ, Iwabuchi SJ, Drabek MM, et al. Altered connectivity of the right anterior insula drives the pain connectome changes in chronic knee osteoarthritis[J]. Pain, 2018, 159(5): 929-938. DOI: 10.1097/j.pain.0000000000001209.
Lan F, Lin GW, Cao GL, et al. Altered intrinsic brain activity and functional connectivity before and after knee arthroplasty in the elderly: a resting-state fMRI study[J/OL]. Front Neurol, 2020, 11: 556028 [2022-01-17]. DOI: 10.3389/fneur.2020.556028.
Reckziegel D, Raschke F, Cottam WJ, et al. Cingulate GABA levels inversely correlate with the intensity of ongoing chronic knee osteoarthritis pain[J/OL]. Mol Pain, 2016 [2022-01-17]. DOI: 10.1177/1744806916650690.
Barroso J, Wakaizumi K, Reis AM, et al. Reorganization of functional brain network architecture in chronic osteoarthritis pain[J]. Hum Brain Mapp, 2021, 42(4): 1206-1222. DOI: 10.1002/hbm.25287.
Hiramatsu T, Nakanishi K, Yoshimura S, et al. The dorsolateral prefrontal network is involved in pain perception in knee osteoarthritis patients[J]. Neurosci Lett, 2014, 581: 109-114. DOI: 10.1016/j.neulet.2014.08.027.
Shanahan CJ, Hodges PW, Wrigley TV, et al. Organisation of the motor cortex differs between people with and without knee osteoarthritis[J]. Arthritis Res Ther, 2015, 17: 164 [2022-01-17]. DOI: 10.1186/s13075-015-0676-4.
Liu J, Chen LD, Chen XL, et al. Modulatory effects of different exercise modalities on the functional connectivity of the periaqueductal grey and ventral tegmental area in patients with knee osteoarthritis: a randomised multimodal magnetic resonance imaging study[J]. Br J Anaesth, 2019, 123(4): 506-518. DOI: 10.1016/j.bja.2019.06.017.
Liu J, Chen LD, Tu YH, et al. Different exercise modalities relieve pain syndrome in patients with knee osteoarthritis and modulate the dorsolateral prefrontal cortex: a multiple mode MRI study[J]. Brain Behav Immun, 2019, 82: 253-263. DOI: 10.1016/j.bbi.2019.08.193.
Wang ZP. Explore the neural mechanism of exercise rehabilitation of knee osteoarthritis[D]. Fuzhou: Fujian University of Traditional Chinese Medicine, 2017.
Tu YX. The white matter fiber changes under different exercises in patients with knee osteoarthritis: a DTI-TBSS study[D]. Fuzhou: Fujian University of Traditional Chinese Medicine, 2017.
Fransen M, McConnell S, Harmer AR, et al. Exercise for osteoarthritis of the knee: a Cochrane systematic review[J]. Br J Sports Med, 2015, 49(24): 1554-1557. DOI: 10.1136/bjsports-2015-095424.
Egorova N, Gollub RL, Kong J. Repeated verum but not placebo acupuncture normalizes connectivity in brain regions dysregulated in chronic pain[J]. Neuroimage Clin, 2015, 9: 430-435. DOI: 10.1016/j.nicl.2015.09.012.
Sun N, Sun RR, Zhou YF, et al. A narrative review of fMRI researches on acupuncture treatment of chronic pain[J]. Mod Tradit Chin Med Mater Med World Sci Technol, 2021, 23(1): 225-231. DOI: 10.11842/wst.20200407005.
Chen XY, Spaeth RB, Freeman SG, et al. The modulation effect of longitudinal acupuncture on resting state functional connectivity in knee osteoarthritis patients[J/OL]. Mol Pain, 2015, 11: 67 [2022-01-17]. DOI: 10.1186/s12990-015-0071-9.
Cheng SR. A study of the regulation effect of acupuncture on the resting-state functional connectivity of Insula in knee osteoarthritis patients[D]. Chengdu: Chengdu University of TCM, 2020.
Tang CJ. Mechanism of acupuncture influence on default mode network in knee osteoarthritis patients: a resting-state functional magnetic resonance imaging study[D]. Chengdu: Chengdu University of TCM, 2019.
Qu B, Wang H, Zhao CY, et al. Clinical efficacy evaluation and central mechanism study of acupuncture in treating chronic knee osteoarthritis[J]. J Xinjiang Med Univ, 2021, 44(5): 600-604. DOI: 10.3639/j.issn.1009-5551.2021.05.016.
Chen XY, Spaeth RB, Retzepi K, et al. Acupuncture modulates cortical thickness and functional connectivity in knee osteoarthritis patients[J]. Sci Rep, 2014, 4: 6482 [2022-01-17]. DOI: 10.1038/srep06482.
Bao QN, Zhao L, Zhou YM, et al. Research progress of moxibustion in treating knee osteoarthritis at home and abroad[J]. J Clin Acupunct Moxibustion, 2017, 33(1): 76-78. DOI: 10.3969/j.issn.1005-0779.2017.01.024.
Chen Y, Jia YJ, Lü JH, et al. Comparision of therapertic effect of different acupuncture methods for knee osteoarthritis[J]. Acupunct Res, 2020, 45(7): 569-573. DOI: 10.13702/j.1000-0607.191015.
Xie HW, Xu FM, Chen RX, et al. Image formation of brain function in patients suffering from knee osteoarthritis treated with moxibustion[J]. J Tradit Chin Med, 2013, 33(2): 181-186. DOI: 10.1016/S0254-6272(13)60122-3.
Luo Q, Xie HW, Xu FM, et al. Study on resting-state functional magnetic resonance imaging in patients with knee osteoarthritis treated with heat-sensitive moxibustion on Dubi acupoint[J]. J Beijing Univ Tradit Chin Med, 2013, 36(6): 429-432, 435. DOI: 10.3969/j.issn.1006-2157.2013.06.016.
Qing LX. Study on fMRI and contrast-enhanced ultrasonography of rectus femoris in the treatment of chronic knee osteoarthritis pain by massage[D]. Beijing: Beijing University of Chinese Medicine, 2019.
Chen SJ, Xu QY, Peng XM, et al. FMRI study on activating different brain functional areas with acupuncture and massage at Taixi point[J]. J Clin Acupunct Moxibustion, 2013, 29(6): 55-56. DOI: 10.3969/j.issn.1005-0779.2013.06.022.
Mortimer JA, Ding D, Borenstein AR, et al. Changes in brain volume and cognition in a randomized trial of exercise and social interaction in a community-based sample of non-demented Chinese Elders[J]. J Alzheimers Dis, 2012, 30(4): 757-766. DOI: 10.3233/JAD-2012-120079.
Tao J, Chen XL, Egorova N, et al. Tai Chi Chuan and Baduanjin practice modulates functional connectivity of the cognitive control network in older adults[J/OL]. Sci Rep, 2017, 7: 41581 [2022-01-17]. DOI: 10.1038/srep41581.
Zheng ZW, Zhu XY, Yin SF, et al. Combined cognitive-psychological-physical intervention induces reorganization of intrinsic functional brain architecture in older adults[J/OL]. Neural Plast, 2015, 2015: 713104 [2022-01-17]. DOI: 10.1155/2015/713104.
Yin SF, Zhu XY, Li R, et al. Intervention-induced enhancement in intrinsic brain activity in healthy older adults[J/OL]. Sci Rep, 2014, 4: 7309 [2022-01-17]. DOI: 10.1038/srep07309.
Yu AP, Tam BT, Lai CW, et al. Revealing the neural mechanisms underlying the beneficial effects of Tai Chi: a neuroimaging perspective[J]. Am J Chin Med, 2018, 46(2): 231-259. DOI: 10.1142/S0192415X18500131.
Li XL, Cai LN, Jiang XX, et al. Resting-state fMRI in studies of acupuncture[J/OL]. Evid Based Complement Alternat Med, 2021, 2021: 6616060 [2022-01-17]. DOI: 10.1155/2021/6616060.
Okada K, Yamaguchi S, Sato Y, et al. Comparison of meniscal extrusion and osteophyte formation at the intercondylar Notch as a predictive biomarker for incidence of knee osteoarthritis-Data from the Osteoarthritis Initiative[J]. J Orthop Sci, 2019, 24(1): 121-127. DOI: 10.1016/j.jos.2018.08.003.

PREV Research progress on precise diagnosis and treatment of bladder cancer based on multiparameter MRI radiomics
NEXT Research progress of deep learning in chemical exchange saturation transfer magnetic resonance imaging

Tel & Fax: +8610-67113815    E-mail: