Effects of the Prolong Life With Nine Turn Method (Yan Nian Jiu Zhuan) Qigong on Brain Functional Changes in Patients With Chronic Fatigue Syndrome in Terms of Fatigue and Quality of Life

Fangfang Xie, Chong Guan, Yuanjia Gu, Yanli You, Fei Yao, Fangfang Xie, Chong Guan, Yuanjia Gu, Yanli You, Fei Yao

Abstract

Background: Chronic fatigue syndrome (CFS) is characterized by persistent fatigue, which often leads to physical and psychological damage. The Prolong Life with Nine Turn method (PLWNT) Qigong is considered as one of the complementary treatments for improving symptoms in patients with CFS. In this study, we used functional magnetic resonance imaging (fMRI) to explore the effects of PLWNT intervention on the subjects with CFS.

Methods: Thirty four CFS patients were randomly divided into PLWNT group and cognitive behavioral therapy (CBT) group. Both groups were taught by a highly qualified professor at the Shanghai University of Traditional Chinese Medicine once a week and were supervised online during the remaining 6 days at home, over 12 consecutive weeks. We calculated the regional rs-fMRI index amplitude of low-frequency fluctuations (ALFF) for all subjects. To study the changes of the brain network, we used the brain regions with significant differences in ALFF as the regions of interest for whole-brain functional connectivity (FC) analysis. The Multi-dimensional Fatigue Inventory 20 (MFI-20) and Short Form 36-item Health Survey (SF-36) were used for clinical symptom assessment to explore the possible correlation between the rs-fMRI indicators and clinical variations.

Results: The ALFF values of the right superior frontal gyrus (SFG), and left median cingulate gyrus (DCG) were increased, whereas those of the left middle occipital gyrus (OG), right middle OG and left middle temporal gyrus (MTG) were decreased in PLWNT group. The FC values between the DCG and middle temporal gyrus (MTG), and those between the left OG and the right OG were enhanced. In addition, the SF-36 were positively with the left OG (r = 0.524), SFG (r = 0.517), and DCG (r = 0.533), MFI-20 were negatively with the SFG (r = -0.542) and DCG (r = -0.578). These results were all corrected by FWE (voxel level p < 0.001, cluster level p < 0.05).

Conclusion: CFS patients have abnormal regional spontaneous neuronal activity and abnormal functional connections between regions after PLWNT intervention. PLWNT can relieve the fatigue symptoms of CFS patients and improve their quality of life. The study was registered in the American Clinical Trial Registry (12/04/2018). Registration Number is NCT03496961.

Keywords: ALFF; FC; chronic fatigue syndrome; fMRI; fatigue; prolong life with nine turn method Qigong; quality of life.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflictof interest.

Copyright © 2022 Xie, Guan, Gu, You and Yao.

Figures

Figure 1
Figure 1
The postures of PLWNT. (A) Press and knead acupoint in Danzhong. (B) Rubbing from Danzhong Acupoint to Pubic Symphysis. (C) Rubbing from Pubic Symphysis to Danzhong Acupoint. (D) Pushing from Danzhong Acupoint to Pubic Symphysis. (E) The right hand massages the abdomen by the left circle. (F) The left hand massages the abdomen by the right circle. (G) Pushing with the right hand from the left breast to the groin. (H) Pushing with the left hand from the right breast to the groin. (K) Turn left and right. Every movements will be carried out 21 times. PLWNT, prolong life with nine turn method.
Figure 2
Figure 2
Flow diagram of the study design.
Figure 3
Figure 3
Compared with the education group, the ALFF brain area changes in the PLWNT group. Red shows enhanced area, green shows reduced area, based on FWE correction, with voxel level p < 0.001 and cluster level p < 0.05.
Figure 4
Figure 4
(A) Functional connection enhancement area of DCG and MTG. (B) Functional connection enhancement area of the left OG and the right middle occipital gyrus.
Figure 5
Figure 5
(A–E) The relationship between the changes of neuronal activity (ALFF) in OG, SFG, and DCG brain regions and the scores of patients on the MFI-20 and SF-36 scales.

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