Cheng Wangxinjun, Wang Moyu, Li Moyi
Department of Rehabilitation Medicine, First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
Queen Mary College, Nanchang University, Nanchang, China.
JMIR Res Protoc. 2025 Sep 12;14:e74981. doi: 10.2196/74981.
Poststroke cognitive impairment (PSCI) is a prevalent and disabling complication following stroke, affecting critical functions such as memory, attention, language, and executive abilities. Despite the growing clinical burden, standardized and effective treatment strategies for PSCI remain limited. Acupuncture, a key modality in traditional Chinese medicine, has shown promise in improving cognitive outcomes among survivors of stroke. However, the neural mechanisms underlying its efficacy are not well understood. The default mode network (DMN), a brain network implicated in cognition and memory, has been shown to exhibit altered functional and structural connectivity in patients with PSCI. Investigating whether acupuncture modulates DMN activity may provide critical insights into its therapeutic potential.
This study aims to evaluate the efficacy of acupuncture in improving cognitive function in patients with PSCI and explore its potential neurobiological mechanisms, particularly those involving changes in the DMN, using multimodal neuroimaging techniques.
We will conduct a single-blind, randomized controlled trial involving 54 eligible patients with PSCI who will be randomly assigned to either an acupuncture group or a sham acupuncture control group. Both groups will receive conventional rehabilitation therapies. The intervention group will undergo standardized scalp acupuncture targeting Baihui (GV20), Shenting (GV24), and Sishencong (EX-HN1) for 8 weeks. The control group will receive sham acupuncture at nonacupoint locations using placebo needles. Cognitive function will be assessed at baseline and 4 and 8 weeks using the Montreal Cognitive Assessment and Mini-Mental State Examination. Secondary outcomes include activities of daily living, quality of life, and neuroimaging data acquired through resting-state functional magnetic resonance imaging and diffusion tensor imaging.
This study is currently in the recruitment phase. All results, including clinical and imaging data, will be reported upon trial completion and publication.
This protocol is designed to investigate the efficacy of acupuncture and its underlying mechanisms in treating PSCI, with a particular focus on functional brain networks. By integrating clinical cognitive assessments and neuroimaging analysis of DMN connectivity, this study seeks to establish objective correlates of cognitive improvement. Findings from this research may advance the understanding of how acupuncture modulates large-scale brain networks and contribute to the development of imaging-based biomarkers for treatment evaluation. If successful, this approach could support the inclusion of acupuncture as a personalized nonpharmacological strategy in the neurorehabilitation of cognitive deficits following stroke.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/74981.
中风后认知障碍（PSCI）是中风后一种常见且致残的并发症，会影响记忆、注意力、语言和执行能力等关键功能。尽管临床负担日益加重，但针对PSCI的标准化有效治疗策略仍然有限。针灸作为中医的一种关键疗法，在改善中风幸存者的认知结果方面已显示出前景。然而，其疗效背后的神经机制尚不清楚。默认模式网络（DMN）是一个与认知和记忆相关的脑网络，已被证明在PSCI患者中表现出功能和结构连接的改变。研究针灸是否能调节DMN活动可能为其治疗潜力提供关键见解。
本研究旨在使用多模态神经成像技术评估针灸改善PSCI患者认知功能的疗效，并探索其潜在的神经生物学机制，特别是那些涉及DMN变化的机制。
我们将进行一项单盲、随机对照试验，纳入54名符合条件的PSCI患者，他们将被随机分配到针灸组或假针灸对照组。两组都将接受常规康复治疗。干预组将针对百会（GV20）、神庭（GV24）和四神聪（EX-HN1）进行标准化头皮针灸，为期8周。对照组将使用安慰剂针在非穴位位置进行假针灸。在基线、4周和8周时使用蒙特利尔认知评估和简易精神状态检查评估认知功能。次要结果包括日常生活活动、生活质量以及通过静息态功能磁共振成像和扩散张量成像获得的神经成像数据。
本研究目前处于招募阶段。所有结果，包括临床和影像数据，将在试验完成并发表后报告。
本方案旨在研究针灸治疗PSCI的疗效及其潜在机制，特别关注功能性脑网络。通过整合临床认知评估和DMN连接的神经成像分析，本研究旨在建立认知改善的客观关联。本研究结果可能会推进对针灸如何调节大规模脑网络的理解，并有助于开发基于成像的生物标志物用于治疗评估。如果成功，这种方法可能支持将针灸作为中风后认知缺陷神经康复中的一种个性化非药物策略。
国际注册报告识别码（IRRID）：PRR1-10.2196/74981。
