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针刺对轻度认知障碍患者脑功能网络的影响:激活似然估计荟萃分析。

Effect of acupuncture on brain functional networks in patients with mild cognitive impairment: an activation likelihood estimation meta-analysis.

机构信息

Shenzhen Bao'an Clinical Medical School, Guangdong Medical University, Shenzhen, China.

Guangdong Medical University, Dongguan, China.

出版信息

Acupunct Med. 2023 Oct;41(5):259-267. doi: 10.1177/09645284221146199. Epub 2023 Feb 15.

Abstract

BACKGROUND

Prior research has shown that acupuncture, a traditional Chinese medical therapy, may have a certain therapeutic effect in patients with mild cognitive impairment (MCI). Furthermore, some studies have explored the effects of acupuncture on the brain functional networks of MCI patients to investigate the mechanism of action. Different studies have analysed the brain regions involved in acupuncture-induced changes, but (to our knowledge) these have not been summarized by a systematic review.

METHODS

We searched PubMed, EMBASE, Cochrane Library, SinoMed, CNKI and other databases in Chinese and English to identify neuroimaging studies of acupuncture interventions in MCI patients. After two stages of literature screening, bias risk assessment and data extraction, brain regions with significant differences were input into GingerALE software. Based on the activation likelihood estimation algorithm, coordinate-based meta-analyses were conducted.

RESULTS

The changes in functional activation of 95 different areas in 8 trials, including 212 MCI patients, were analysed. The three most commonly used traditional acupuncture point locations in acupuncture interventions for MCI were KI3 (), LR3 () and LI4 (). The results of the ALE data analysis showed that, after acupuncture intervention, the degree of activation in the anterior cingulate, inferior frontal gyrus, medial frontal gyrus and cerebellar tonsil of MCI patients increased significantly.

CONCLUSIONS

Acupuncture intervention for MCI appears to change the plasticity of brain function and improve the cognitive function of patients. Due to the small number and low quality of the included studies, the conclusion of this meta-analysis should be treated with caution.

REGISTRATION

PROSPERO reference CRD42022301056 (http://www.crd.york.ac.uk/PROSPERO).

摘要

背景

先前的研究表明,作为一种传统的中医疗法,针灸可能对轻度认知障碍(MCI)患者具有一定的治疗效果。此外,一些研究已经探索了针灸对 MCI 患者大脑功能网络的影响,以研究其作用机制。不同的研究分析了涉及针灸引起变化的大脑区域,但(据我们所知)这些区域尚未通过系统评价进行总结。

方法

我们在中英文的 PubMed、EMBASE、Cochrane 图书馆、SinoMed、CNKI 和其他数据库中进行了搜索,以确定针对 MCI 患者的针灸干预的神经影像学研究。经过两个阶段的文献筛选、偏倚风险评估和数据提取,将具有显著差异的大脑区域输入 GingerALE 软件。基于激活似然估计算法,进行了基于坐标的荟萃分析。

结果

对 8 项试验中的 95 个不同区域的功能激活变化进行了分析,其中包括 212 名 MCI 患者。在针对 MCI 的针灸干预中,最常使用的三个传统针灸穴位是 KI3()、LR3()和 LI4()。ALE 数据分析的结果表明,针灸干预后,MCI 患者的前扣带、下额叶、内侧额叶和小脑扁桃体的激活程度显著增加。

结论

针灸干预 MCI 似乎改变了大脑功能的可塑性,改善了患者的认知功能。由于纳入研究的数量少且质量低,因此应谨慎对待本荟萃分析的结论。

注册

PROSPERO 参考 CRD42022301056(http://www.crd.york.ac.uk/PROSPERO)。

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