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针刺治疗调节遗忘型轻度认知障碍患者背外侧前额叶皮质的局部一致性。

Acupuncture Treatment Modulate Regional Homogeneity of Dorsal Lateral Prefrontal Cortex in Patients with Amnesic Mild Cognitive Impairment.

机构信息

The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China.

Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.

出版信息

J Alzheimers Dis. 2022;90(1):173-184. doi: 10.3233/JAD-220592.

Abstract

BACKGROUND

Although acupuncture is widely used to improve cognitive and memory in the amnesic mild cognitive impairment (aMCI) patients with impressive effectiveness, its neural mechanism remains largely unclear.

OBJECTIVE

We aimed to explore functional magnetic resonance imaging (fMRI) mechanism of acupuncture for aMCI.

METHODS

A randomized, controlled, single-blind research was performed. A total of 46 aMCI patients were randomly assigned into verum and sham acupuncture group, who received a total of 24 times treatments (3 times/week, 8 weeks). Clinical evaluation and fMRI scanning were performed at baseline and after treatment for all aMCI patients. The interaction effects and inter-group effects of regional homogeneity (ReHo) were performed using mixed effect models, and the correlations between clinical improvement and neuroimaging changes before and after verum acupuncture treatment were analyzed using Pearson correlations.

RESULTS

As a result, interaction effects showed increased ReHo value in left dorsal lateral prefrontal cortex (DLPFC), increased functional connectivity between left DLPFC and left precuneus, and decreased functional connectivity between left DLPFC and left inferior temporal gyrus after verum acupuncture but inversely after sham acupuncture in the aMCI. Condition effects showed increased ReHo in right lingual gyrus, and bilateral post-central gyrus after verum and sham acupuncture in the aMCI. In addition, the changed Montreal Cognitive Assessment scores in verum acupuncture group were significantly correlated with changed ReHo values in left DLPFC.

CONCLUSION

Together, our findings further confirmed that acupuncture could be used as a promising complementary therapy for aMCI by modulating function of left DLPFC to improve cognitive symptoms.

摘要

背景

虽然针刺在改善健忘型轻度认知障碍(aMCI)患者的认知和记忆方面被广泛应用,且效果显著,但针刺的神经机制仍很大程度上不清楚。

目的

我们旨在探索针刺治疗 aMCI 的功能磁共振成像(fMRI)机制。

方法

采用随机、对照、单盲研究。共 46 例 aMCI 患者随机分为真针刺和假针刺组,分别接受总共 24 次治疗(每周 3 次,共 8 周)。所有 aMCI 患者在基线和治疗后均进行临床评估和 fMRI 扫描。采用混合效应模型进行局部一致性(ReHo)的交互效应和组间效应分析,并采用 Pearson 相关性分析真针刺治疗前后临床改善与神经影像学变化之间的相关性。

结果

结果显示,与假针刺相比,真针刺后 aMCI 患者左侧背外侧前额叶(DLPFC)的 ReHo 值增加,左侧 DLPFC 与左侧楔前叶之间的功能连接增加,左侧 DLPFC 与左侧颞下回之间的功能连接减少;而假针刺后则相反。条件效应显示,真针刺和假针刺后 aMCI 患者右侧舌回和双侧中央后回的 ReHo 值增加。此外,真针刺组蒙特利尔认知评估量表评分的变化与左侧 DLPFC 的 ReHo 值变化显著相关。

结论

我们的研究结果进一步证实,针刺通过调节左侧 DLPFC 的功能来改善认知症状,可作为治疗 aMCI 的一种有前途的补充疗法。

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