中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2017, Vol. 12 ›› Issue (2): 250-258.doi: 10.4103/1673-5374.200808

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

针灸干预调控轻度认知障碍患者相关脑区的网络连接网络

  

  • 收稿日期:2017-01-18 出版日期:2017-02-15 发布日期:2017-02-15
  • 基金资助:

    中国国家自然科学基金项目（81173354），广东省科技计划项目（2013B021800099），深圳市科技计划项目（JCYJ20150402152005642）

Modulatory effects of acupuncture on brain networks in mild cognitive impairment patients

Ting-ting Tan1, Dan Wang1, Ju-ke Huang2, Xiao-mei Zhou1, Xu Yuan1, Jiu-ping Liang3, Liang Yin3, Hong-liang Xie1, Xin-yan Jia1, Jiao Shi1, Fang Wang4, Hao-bo Yang5, Shang-jie Chen1   

  1. 1 Department of Rehabilitation Medicine, Shenzhen Baoan Hospital, Southern Medical University, Shenzhen, Guangdong Province, China; 
    2 Shenzhen Baoan Hospital, Southern Medical University, Shenzhen, Guangdong Province, China; 
    3 Department of Radiology, Shenzhen Baoan Hospital, Southern Medical University, Shenzhen, Guangdong Province, China; 
    4 Department of Neurology, Shenzhen Baoan Hospital, Southern Medical University, Shenzhen, Guangdong Province, China; 
    5 Tianjin Medical University, Tianjin, China
  • Received:2017-01-18 Online:2017-02-15 Published:2017-02-15
  • Contact: Shang-jie Chen, Ph.D., csjme@163.com.
  • Supported by:

    This study was supported by the National Natural Science Foundation of China, No. 81173354; a grant from the Science and Technology Plan Project of Guangdong Province of China, No. 2013B021800099; a grant from the Science and Technology Plan Project of Shenzhen City of China, No. JCYJ20150402152005642.

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摘要：

 

目前功能磁共振已经应用于针灸对大脑机制的研究中，但多数研究仅关注针灸引起的脑区急性变化，而这些变化是否持续至针刺后尚不得而知。为此，试验将32例轻度认知障碍患者随机分为调神益智针灸组和假穴组，分别针刺调神益智相关穴位（四神聪、印堂穴、内关、太溪、丰隆及太冲）及附近假穴，进针15mm，以60°捻转120次/min，1min/次/穴位，每周5次，连续4周。对比针刺前及针刺4周后静息态功能磁共振检测结果，发现刺激调神益智穴位后脑岛、背外侧前额叶皮质、海马、丘脑、顶下小叶和前扣带皮质等认知相关脑区连接增加，其中脑岛、背外侧前额叶皮质和海马成为网络的中心；同时治疗后患者认知功能明显改善。而刺激假穴后脑区连接分散，认知功能无明显变化。表明针灸调神益智穴位可以通过增加认知相关脑区间大脑网络之间的连接，改善轻度认知障碍患者的认知功能。

ORCID:0000-0001-8414-7074(Shang-jie Chen)

关键词: 神经再生, 轻度认知障碍, 阿尔茨海默病, 神经影像学, 静息态功能磁共振, 大脑网络, 针灸, 调神益智法

Abstract:

Functional magnetic resonance imaging has been widely used to investigate the effects of acupuncture on neural activity. However, most functional magnetic resonance imaging studies have focused on acute changes in brain activation induced by acupuncture. Thus, the time course of the therapeutic effects of acupuncture remains unclear. In this study, 32 patients with amnestic mild cognitive impairment were randomly divided into two groups, where they received either Tiaoshen Yizhi acupuncture or sham acupoint acupuncture. The needles were either twirled at Tiaoshen Yizhi acupoints, including Sishencong (EX-HN1), Yintang (EX-HN3), Neiguan (PC6), Taixi (KI3), Fenglong (ST40), and Taichong (LR3), or at related sham acupoints at a depth of approximately 15 mm, an angle of ± 60°, and a rate of approximately 120 times per minute. Acupuncture was conducted for 4 consecutive weeks, five times per week, on weekdays. Resting-state functional magnetic resonance imaging indicated that connections between cognition-related regions such as the insula, dorsolateral prefrontal cortex, hippocampus, thalamus, inferior parietal lobule, and anterior cingulate cortex increased after acupuncture at Tiaoshen Yizhi acupoints. The insula, dorsolateral prefrontal cortex, and hippocampus acted as central brain hubs. Patients in the Tiaoshen Yizhi group exhibited improved cognitive performance after acupuncture. In the sham acupoint acupuncture group, connections between brain regions were dispersed,and we found no differences in cognitive function following the treatment. These results indicate that acupuncture at Tiaoshen Yizhi acupoints can regulate brain networks by increasing connectivity between cognition-related regions, thereby improving cognitive function in patients with mild cognitive impairment.

Key words: nerve regeneration, mild cognitive impairment, Alzheimer’s disease, neuroimaging, resting-state functional magnetic resonance imaging, brain network, acupuncture, Tiaoshen Yizhi, neural regeneration