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基于脑-肠轴理论探索针刺疗法治疗轻度认知障碍

Exploration of acupuncture therapy in the treatment of mild cognitive impairment based on the brain-gut axis theory.

作者信息

Jin Yuanyuan, Hu Fen, Zhu Jianfang

机构信息

Department of Acupuncture and Moxibustion, Zhejiang Hospital, Hangzhou, China.

Department of Acupuncture and Moxibustion, Zhejiang Chinese Medical University, Hangzhou, China.

出版信息

Front Hum Neurosci. 2022 Sep 20;16:891411. doi: 10.3389/fnhum.2022.891411. eCollection 2022.

Abstract

BACKGROUND

Mild cognitive impairment (MCI) is an intermediary state between normal aging and dementia. Early intervention for MCI may be a key opportunity in managing dementia. Recent studies have demonstrated the alterations in the gut microbial communities associated with MCI. This study aims to evaluate if acupuncture can improve cognitive function in subjects with MCI and explore the possible mechanism of acupuncture by better defining the interactions of gut microbiota.

METHODS

A randomized assessor-blind controlled study is proposed. A total of 62 subjects will be recruited and randomly allocated into two groups in a 1:1 ratio: the treatment and control groups. Participants in the treatment group will receive active acupuncture and exercise/cognitive training (conventional treatment). The control group will receive sham acupuncture and exercise/cognitive training. Each participant will receive active or sham acupuncture for 12 weeks. The primary outcome will be the Montreal Cognitive Assessment (MoCA) score and intestinal flora. Secondary outcomes will include mini-mental state examination (MMSE) and activity of daily living (ADL) scores. Various scales will be collected at baseline, during the treatment (weeks 4 and 8), week 12, and months 4 and 6 after the intervention. Feces will be collected before and after the treatment based on 16S rRNA gene sequencing technology for each participant to characterize the intestinal flora. Adverse events will be recorded by monthly follow-up.

RESULTS

The trial is expected to show that cognitive function can be improved by acupuncture and produce reliable clinical outcomes in MCI patients. It will also provide preliminary data on the possible mechanism based on the changes in the intestinal flora. Collected data will be used to support future large-scale fundamental studies.

CONCLUSION

Acupuncture is an effective method to improve cognitive function for MCI. This study will provide data on the relationship between gut microbiota and the effectiveness of acupuncture in patients with MCI from a new angle.

CLINICAL TRIAL REGISTRATION

[www.ClinicalTrials.gov], identifier [MR-33-22-002376].

摘要

背景

轻度认知障碍(MCI)是正常衰老与痴呆之间的中间状态。对MCI进行早期干预可能是管理痴呆的关键时机。近期研究已证实与MCI相关的肠道微生物群落改变。本研究旨在评估针刺是否能改善MCI受试者的认知功能,并通过更好地明确肠道微生物群的相互作用来探索针刺的可能机制。

方法

拟进行一项随机、评估者盲法对照研究。共招募62名受试者,按1:1比例随机分为两组:治疗组和对照组。治疗组参与者将接受真针刺以及运动/认知训练(传统治疗)。对照组将接受假针刺以及运动/认知训练。每位参与者将接受12周的真针刺或假针刺治疗。主要结局指标将是蒙特利尔认知评估(MoCA)评分和肠道菌群。次要结局指标将包括简易精神状态检查表(MMSE)和日常生活活动能力(ADL)评分。在基线、治疗期间(第4周和第8周)、第12周以及干预后的第4个月和第6个月收集各种量表。基于16S rRNA基因测序技术,在治疗前后收集每位参与者的粪便,以表征肠道菌群。通过每月随访记录不良事件。

结果

该试验预计将表明针刺可改善认知功能,并在MCI患者中产生可靠的临床结局。它还将基于肠道菌群的变化提供关于可能机制的初步数据。收集的数据将用于支持未来的大规模基础研究。

结论

针刺是改善MCI认知功能的有效方法。本研究将从新的角度提供关于肠道微生物群与针刺对MCI患者有效性之间关系的数据。

临床试验注册

[www.ClinicalTrials.gov],标识符[MR-33-22-002376]

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21f4/9531719/1c145954a672/fnhum-16-891411-g001.jpg

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