Tang Endy-Chun-Hung, Lau Alexander-Yuk-Lun, Au David, Ju Yanli, Lam Bonnie-Yin-Ka, Wong Adrian, Au Lisa, Mok Vincent-Chung-Tong
Lau Tat-chuen Research Centre of Brain Degenerative Diseases in Chinese, Margaret K.L. Cheung Research Centre for Management of Parkinsonism, Therese Pei Fong Chow Research Centre for Prevention of Dementia, Gerald Choa Neuroscience Institute, Lui Che Woo Institute of Innovative Medicine, Li Ka Shing Institute of Health Sciences, Division of Neurology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China.
The Hong Kong Institute of Integrative Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Flat 4L, 4/F, Day Treatment Block, Shatin, Hong Kong SAR, China.
Cereb Circ Cogn Behav. 2023 May 18;4:100168. doi: 10.1016/j.cccb.2023.100168. eCollection 2023.
Recent preclinical studies and meta-analysis of clinical trials suggested that acupuncture may improve cognition in cerebral small vessel disease (CSVD). We investigated the cerebral hemodynamics of acupuncture in subjects with CSVD and compared its impact upon the cerebral hemodynamics in normal elderly subjects.
10 subjects with CSVD (CSVD group) and 10 aged-matched control subjects who had no or insignificant CSVD (control group) were recruited. A single session of acupuncture was applied for 30 min in both groups. We assessed the effect of our acupuncture intervention on cerebral hemodynamics by transcranial Doppler ultrasound (TCD). Peak systolic velocity (PSV) and pulsatility index (PI) of the middle cerebral artery (MCA) were assessed.
We observed that PSV increased by a maximum of 39% at 20 min (<0.05), while there was no significant change in PI in the CSVD group during the acupuncture session. In the control group, although we observed no significant change in PSV during the acupuncture session, there was a significant decrease in PI by a maximum of 22% at 20 min (<0.05). No adverse events were reported during or after the procedure.
This study suggested that our acupuncture prescription was associated with an increase in cerebral blood flow in subjects with established moderate to severe CSVD yet without apparent impact on distal vascular resistance. While, in subjects with no or insignificant CSVD, it may reduce cerebral small vessel distal vascular resistance. A larger study is needed to confirm our findings.
近期的临床前研究及临床试验的荟萃分析表明，针灸可能改善脑小血管病（CSVD）患者的认知功能。我们研究了CSVD患者针刺治疗时的脑血流动力学情况，并与正常老年人的脑血流动力学影响进行比较。
招募10例CSVD患者（CSVD组）和10例年龄匹配的无或轻度CSVD的对照受试者（对照组）。两组均接受单次30分钟的针刺治疗。我们通过经颅多普勒超声（TCD）评估针刺干预对脑血流动力学的影响。评估大脑中动脉（MCA）的收缩期峰值流速（PSV）和搏动指数（PI）。
我们观察到，CSVD组在针刺20分钟时PSV最大增加了39%（<0.05），而PI在针刺过程中无显著变化。在对照组中，虽然针刺过程中PSV无显著变化，但在20分钟时PI最大显著降低了22%（<0.05）。治疗期间及治疗后均未报告不良事件。
本研究表明，我们的针刺处方与中度至重度CSVD患者脑血流量增加有关，但对远端血管阻力无明显影响。而在无或轻度CSVD的受试者中，针刺可能降低脑小血管远端血管阻力。需要更大规模的研究来证实我们的发现。
