Yin Zihan, Li Yaqin, Zhang Xinyue, Liu Yiwei, Wang Ziqi, Ye Fang, He Xia, Bao Qiongnan, Xia Manze, Chen Zhenghong, Zhong Wanqi, Wu Kexin, Yao Jin, Chen Ziwen, Wang Ziwen, Sun Mingsheng, Chen Jiao, Hong Xiaojuan, Zhao Ling, Liang Fanrong
School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China.
J Evid Based Med. 2025 Jun;18(2):e70047. doi: 10.1111/jebm.70047.
Due to the limited evidence, the effects and neuroimaging mechanisms of acupuncture for amnestic mild cognitive impairment (aMCI) are still needed to investigate. Our objectives were to assess the effects and investigate its therapy-driven modification in functional neural response.
Right-handed aMCI patients were enrolled and randomly assigned to an acupuncture group (AG) or a waitlist control group (WG) in the randomized clinical trial using computer-generated randomization sequence method. Twenty normal cognition individuals were included in the normal control (NC) group. The primary outcomes were the changes in the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog) subscale score from baseline to the 12th and 24th week. Acupuncture's neural responses were investigated by detecting changes in regional homogeneity (ReHo), seed-based functional connectivity (FC), and effective connectivity (EC) from baseline to the 12th week. Generalized estimating equations and correlational analyses were employed.
Overall, 343 participants were screened, and 72 aMCI patients were included. The ADAS-Cog score changes at Weeks 12 and 24 of AG were significantly higher than that of WG. In neural response, aMCI patients had higher ReHo in the left dorsolateral prefrontal cortex (DLPFC.L) compared to NCs. Acupuncture significantly reduced ReHo in the DLPFC.L and its FC with the left anterior cingulate cortex (ACC.L) compared to the WG. The causal evidence for decreased EC from the DLPFC.L to the ACC.L after acupuncture, which correlated with change in ADAS-Cog score.
Acupuncture was effective in overall cognitive function in aMCI patients, and the effect was associated with the DLPFC.L-ACC.L circuit.
由于证据有限，针刺治疗遗忘型轻度认知障碍（aMCI）的效果及神经影像学机制仍有待研究。我们的目的是评估其效果，并研究其对功能性神经反应的治疗驱动性改变。
在这项随机临床试验中，使用计算机生成的随机序列方法，招募右利手aMCI患者，并将其随机分配到针刺组（AG）或等待列表对照组（WG）。正常对照组（NC）纳入20名正常认知个体。主要结局指标是从基线到第12周和第24周阿尔茨海默病评估量表认知部分（ADAS-Cog）子量表评分的变化。通过检测从基线到第12周局部一致性（ReHo）、基于种子点的功能连接（FC）和有效连接（EC）的变化，研究针刺的神经反应。采用广义估计方程和相关性分析。
总体而言，共筛查343名参与者，纳入72例aMCI患者。AG组在第12周和第24周时ADAS-Cog评分变化显著高于WG组。在神经反应方面，与NC组相比，aMCI患者左侧背外侧前额叶皮质（DLPFC.L）的ReHo更高。与WG组相比，针刺显著降低了DLPFC.L的ReHo及其与左侧前扣带回皮质（ACC.L）的FC。针刺后从DLPFC.L到ACC.L的EC降低的因果证据，这与ADAS-Cog评分的变化相关。
针刺对aMCI患者的整体认知功能有效，且该效果与DLPFC.L-ACC.L回路有关。
