Effect of acupuncture at the acupoints for <italic style="font-style: italic">Yizhi Tiaoshen</italic> on the functional connectivity between the hippocampus and the brain in the patients with Alzheimer's disease

WEI Yu-ting; SU Ming-li; ZHU Tian-tian; REN De-lin; YAN Xing-ke

doi:10.13703/j.0255-2930.20230405-0002

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Effect of acupuncture at the acupoints for Yizhi Tiaoshen on the functional connectivity between the hippocampus and the brain in the patients with Alzheimer's disease

Imaging in clinical and basic research | 更新时间：2024-06-03

- Effect of acupuncture at the acupoints for Yizhi Tiaoshen on the functional connectivity between the hippocampus and the brain in the patients with Alzheimer's disease
- Chinese Acupuncture & Moxibustion Vol. 43, Issue 12, Pages: 1351-1357(2023)
- 作者机构：
  
  甘肃中医药大学针灸推拿学院，兰州730000
- 作者简介：
- 基金信息：
- DOI：10.13703/j.0255-2930.20230405-0002
  CLC： R 246.6
- Received：05 April 2023，
  
  Online First：17 October 2023，
  
  Published：12 December 2023
- 稿件说明：
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魏玉婷,苏明莉,朱田田等.针刺“益智调神”穴方对阿尔茨海默病患者海马与全脑功能连接的影响[J].中国针灸,2023,43(12):1351-1357.

WEI Yu-ting,SU Ming-li,ZHU Tian-tian,et al.Effect of acupuncture at the acupoints for Yizhi Tiaoshen on the functional connectivity between the hippocampus and the brain in the patients with Alzheimer's disease[J].Chinese Acupuncture & Moxibustion,2023,43(12):1351-1357.
魏玉婷,苏明莉,朱田田等.针刺“益智调神”穴方对阿尔茨海默病患者海马与全脑功能连接的影响[J].中国针灸,2023,43(12):1351-1357. DOI： 10.13703/j.0255-2930.20230405-0002.

WEI Yu-ting,SU Ming-li,ZHU Tian-tian,et al.Effect of acupuncture at the acupoints for Yizhi Tiaoshen on the functional connectivity between the hippocampus and the brain in the patients with Alzheimer's disease[J].Chinese Acupuncture & Moxibustion,2023,43(12):1351-1357. DOI： 10.13703/j.0255-2930.20230405-0002.

摘要

目的

采用静息态功能磁共振成像技术（rs-fMRI）分析针刺“益智调神”穴方对阿尔茨海默病（AD）患者海马与全脑功能连接的影响，揭示针刺治疗AD的脑功能机制。

方法

将60例轻中度AD患者随机分为针药组（30例，脱落3例）和西药组（30例，脱落2例）。西药组口服盐酸多奈哌齐片治疗，每次2.5~5 mg，每日1次，治疗4周后每次加量至10 mg；针药组在西药组基础上针刺“益智调神”穴方（百会、四神聪及双侧神门、内关、足三里、三阴交、悬钟）治疗，留针30 min，每日1次，每周6次。两组均治疗6周。采用简易精神状态检查量表（MMSE）、阿尔茨海默病评定量表认知部分（ADAS-Cog）评估两组患者治疗前后整体认知功能；采用rs-fMRI分析两组患者（针药组11例、西药组12例）治疗前后左侧海马与全脑功能连接（FC）变化。

结果

治疗后，两组患者MMSE评分均较治疗前升高、ADAS-Cog评分较治疗前降低（

0.05），且针药组MMSE评分高于西药组、ADAS-Cog评分低于西药组（

≤0.05）。治疗后，西药组患者左侧海马与左侧梭状回、左侧三角部额下回、双侧颞上回、右侧顶上回之间FC较治疗前增强（

0.05），与左侧颞下回、左侧额中回、右背外侧额上回之间FC较治疗前减弱（

0.05）；针药组患者左侧海马与右侧回直肌、左侧枕下回、右侧颞上回、左侧枕中回之间FC较治疗前增强（

0.05），与左侧丘脑之间FC较治疗前减弱（

0.05）。治疗后，针药组患者左侧海马与双侧颞下回、双侧颞中回、右侧回直肌、双侧枕上回、左侧豆状壳核、左侧距状裂周围皮层、左侧岛盖部额下回、左内侧额上回、右侧中央后回之间FC较西药组增强（

0.05）。

结论

针刺“益智调神”穴方可改善AD患者的认知功能，主要脑功能机制为加强左侧海马与默认网络（颞下回、颞中回、额上回、回直肌）及左侧海马与感觉（中央后回）、视觉（距状裂周围皮层、枕上回）支配脑区之间的功能连接。

Abstract

Objective

To analyze the effect of acupuncture at the acupoints for

Yizhi Tiaoshen

(benefiting the intelligence and regulating the spirit) on the functional connectivity between the hippocampus and the whole brain in the patients with Alzheimer's disease (AD)

and reveal the brain function mechanism of acupuncture in treatment of AD using resting state functional magnetic resonance imaging (rs-fMRI).

Methods

Sixty patients with mild to moderate AD were randomly divided into an acupuncture + medication group (30 cases

3 cases dropped out) and a western medication group (30 cases

2 cases dropped out). In the western medication group

the donepezil hydrochloride tablets were administered orally

2.5 mg to 5 mg each time

once daily; and adjusted to be 10 mg each time after 4 weeks of medication. Besides the therapy as the western medication group

in the acupuncture + medicati

on group

acupuncture was supplemented at the acupoints for

Yizhi Tiaoshen

i.e. Baihui (GV 20)

Sishencong (EX-HN 1)

and bilateral Shenmen (HT 7)

Neiguan (PC 6)

Zusanli (ST 36)

Sanyinjiao (SP 6) and Xuanzhong (GB 39). The needles were retained for 30 min in one treatment

once daily; and 6 treatments were required weekly. The duration of treatment was 6 weeks in each group. The general cognitive function was assessed by the mini-mental state examination (MMSE) and Alzheimer's disease assessment scale-cognitive part (ADAS-Cog) before and after treatment in the two groups. Using the rs-fMRI

the changes in the functional connectivity (FC) of the left hippocampus and the whole brain before and after treatment were analyzed in the patients of the two groups (11 cases in the acupuncture + medication group and 12 cases in the western medication group).

Results

After treatment

compared with those before treatment

MMSE scores increased and ADAS-Cog scores decreased in the two groups (

0.05); MMSE score was higher

while the ADAS-Cog score was lower in the acupuncture + medication group when compared with those in the western medication group (

≤0.05). After treatment

in the western medication group

FC of the left hippocampus was enhanced with the left fusiform gyrus

the inferior frontal gyrus of the left triangular region

the bilateral superior temporal gyrus and the right superior parietal gyrus (

0.05)

while FC was weakened with the left inferior temporal gyrus

the left middle frontal gyrus and the right dorsolateral superior frontal gyrus when compared with that before treatment (

0.05). After treatment

in the acupuncture + medication group

FC of the left hippocampus was increased with the right gyrus rectus

the left inferior occipital gyrus

the right superior temporal gyrus and the left middle occipital gyrus (

0.05)

and it was declined with the left th

alamus (

0.05) when compared with those before treatment. After treatment

in the acupuncture + medication group

FC of the left hippocampus was strengthened with the bilateral inferior temporal gyrus

the bilateral middle temporal gyrus

the right gyrus rectus

the bilateral superior occipital gyrus

the left lenticular nucleus putamen

the left calcarine fissure and surrounding cortex

the inferior frontal gyrus of the left insulae operculum

the left medial superior frontal gyrus and the right posterior central gyrus (

0.05) compared with that of the western medication group.

Conclusion

Acupuncture at the acupoints for

Yizhi Tiaoshen

improves the cognitive function of AD patients

and its main brain functional mechanism is related to intensifying the functional connectivity of the left hippocampus with the default network (inferior temporal gyrus

middle temporal gyrus and superior frontal gyrus

gyrus rectus)

as well as with the sensory (posterior central gyrus) and visual (calcarine fissure and surrounding cortex and superior occipital gyrus) brain regions.

关键词

Keywords

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⁰

Effect of acupuncture at the acupoints for Yizhi Tiaoshen on the functional connectivity between the hippocampus and the brain in the patients with Alzheimer's disease

DOI：10.13703/j.0255-2930.20230405-0002

摘要

Abstract

关键词

Keywords

references