College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, 430061, China.
Department of Rehabilitation, Wuhan Central Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China.
Chin J Integr Med. 2019 Aug;25(8):631-640. doi: 10.1007/s11655-018-2993-3.
As the worldwide population ages, the prevalence of Alzheimer's disease (AD) increases. However, the results of promising medications have been unsatisfactory. Chinese acupuncture has a long history of treating dementia, but lack of evidence from well-designed randomized controlled trials that validate its efficacy and safety, as well as its lack of clear underlying mechanisms, contribute to its limited application in clinical practice. In recent years, brain imaging technologies, such as functional magnetic resonance imaging and positron emission tomography, have been used to assess brain responses to acupuncture in a dynamic, visual, and objective way. These techniques are frequently used to explore neurological mechanisms of responses to acupuncture in AD and provide neuroimaging evidence as well as starting points to elucidate the possible mechanisms. This review summarizes the existing brain imaging evidence that explains the effects of acupuncture for AD and analyzes brain responses to acupuncture at cognitive-related acupoints [Baihui (GV 20), Shenmen (HT 7), Zusanli (ST 36), Neiguan (PC 6), and Taixi (KI 3)] from perspectives of acupoint specificity and acupoint combinations. Key issues and directions to consider in future studies are also put forward. This review should deepen our understanding of how brain imaging studies can be used to explore the underlying mechanisms of acupuncture in AD.
随着全球人口老龄化,阿尔茨海默病(AD)的患病率增加。然而,有前景的药物治疗的结果并不令人满意。中国针灸治疗痴呆症已有悠久的历史,但缺乏精心设计的随机对照试验的证据来验证其疗效和安全性,以及其缺乏明确的潜在机制,导致其在临床实践中的应用有限。近年来,脑成像技术,如功能磁共振成像和正电子发射断层扫描,已被用于以动态、直观和客观的方式评估针刺对大脑的反应。这些技术常用于探索针刺治疗 AD 的神经机制,并提供神经影像学证据,以及阐明可能机制的起点。这篇综述总结了现有的脑成像证据,解释了针刺对 AD 的作用,并从穴位特异性和穴位组合的角度分析了针刺认知相关穴位(百会穴(GV20)、神门穴(HT7)、足三里穴(ST36)、内关穴(PC6)和太溪穴(KI3))对大脑的反应。还提出了未来研究中需要考虑的关键问题和方向。这篇综述应该加深我们对脑成像研究如何用于探索针刺治疗 AD 的潜在机制的理解。