Shan Yi, Wang Jing-Juan, Wang Zhi-Qun, Zhao Zhi-Lian, Zhang Mo, Xu Jian-Yang, Han Ying, Li Kun-Cheng, Lu Jie
Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China.
Evid Based Complement Alternat Med. 2018 Jul 17;2018:7619197. doi: 10.1155/2018/7619197. eCollection 2018.
Although acupuncture is considered to be effective and safe for Alzheimer's disease (AD) and mild cognitive impairment (MCI), the mechanism underlying its therapeutic effect is still unknown. Most studies clarifying the neuronal pathway produced by acupuncture were still applied to healthy subjects with limited single acupuncture point stimulation, which was inconsistency with clinical practice. Thus, in our present study, we investigate the differences between brain activity changes in AD and MCI patients caused by multi-acupuncture point Siguan (four gates), in order to provide visualized evidence for neuronal specificity of clinical acupuncture. Forty-nine subjects were recruited, including 21 AD patients, 14 MCI patients, and 14 healthy controls (HC). AD and MCI patients were randomly divided into two groups, respectively: real acupuncture point group (14 AD and 8 MCI) and sham acupuncture point group (7 AD and 6 MCI). We adopted a 16-minute, single-block, experimental design for acquiring functional MRI images. We found, in AD and MCI patients, Siguan (four gates) elicited extensive activations and deactivations in cognitive-related areas, visual-related areas, the sensorimotor-related area, basal ganglia, and cerebellum. Compared with HC, AD and MCI patients showed similar activations in cognitive-related brain areas (inferior frontal gyrus, supramarginal gyrus, and rolandic operculum) as well as deactivations in cognitive-related areas, visual-related areas, basal ganglia, and cerebellum, which were not found in HC. Compared with sham acupuncture points, real acupuncture points produced more specific brain changes with both activated and deactivated brain activities in AD and MCI. The preliminary results in our study verified the objective evidence for neuronal specificity of acupuncture in AD and MCI patients.
尽管针刺被认为对阿尔茨海默病（AD）和轻度认知障碍（MCI）有效且安全，但其治疗效果的潜在机制仍不清楚。大多数阐明针刺产生的神经通路的研究仍应用于健康受试者，且针刺点刺激单一有限，这与临床实践不一致。因此，在我们目前的研究中，我们调查了多穴位四关针刺引起的AD和MCI患者脑活动变化的差异，以便为临床针刺的神经特异性提供可视化证据。招募了49名受试者，包括21名AD患者、14名MCI患者和14名健康对照（HC）。AD和MCI患者分别随机分为两组：真穴组（14名AD和8名MCI）和假穴组（7名AD和6名MCI）。我们采用16分钟的单组实验设计来获取功能磁共振成像图像。我们发现，在AD和MCI患者中，四关穴在认知相关区域、视觉相关区域、感觉运动相关区域、基底神经节和小脑中引起广泛的激活和去激活。与HC相比，AD和MCI患者在认知相关脑区（额下回、缘上回和中央前回盖）表现出相似的激活，以及在认知相关区域、视觉相关区域、基底神经节和小脑中的去激活，而HC中未发现这些情况。与假穴相比，真穴在AD和MCI中产生了更具特异性的脑变化，包括脑活动的激活和去激活。我们研究的初步结果验证了针刺在AD和MCI患者中神经特异性的客观证据。
