Effects Of Acupuncture Combined With Cognitive Training On The Expression Of Synapse Related MiRNAs In Patients With Post-Stroke Cognitive Impairment

Objective:To investigate the clinical efficacy of acupuncture combined with cognitive training in Post-stroke Cognitive Impairment(PSCI)and the influence of synapse related miR-124,miR-132,miR-134 and miR-138 expression levels in peripheral blood mononuclear cells,to explore the possible mechanism of acupuncture combined with cognitive rehabilitation training.Methods:A randomized controlled trial had been conducted in the Shiyan Taihe Hospital of Hubei province and Rehabilitation Hospital affiliated to Fujian University of Traditional Chinese Medicine.62 eligible patients were randomly allocated into the control group(n=31)or the treatment group(n=31).The control group received conventional treatment and cognitive rehabilitation training.The treatment group received conventional treatment,acupunctured at Baihui(DU20)and Shenting(DU24)combined with cognitive rehabilitation training.Both two groups had been intervented 12 weeks(30 minutes/day,5 days/week).Into the group and at the end of the intervention Mini-mental State Examination(MMSE)was used to assess cognitive function,and collected the blood samples for separating to PBMCs,RNA was extracted using Trizol method,four miRNAs(miR-124,miR-132,miR-134,miR-138)related to PSCI were detected using Real-time quantitative polymerase chain reaction(RT-qPCR)method.Results:1.Two groups of PSCI patients demographic data(age,gender,level of education),the characteristics of stroke(duration,type,location),past medical history(hypertension,diabetes,hyperlipoidemia,heart disease),and stroke damage degree(NIHSS score)had no significant statistical differences(P>0.05).2.Compared with before treatment,the scores of MMSE scale and the dimensions(Orientation,Immediate memory,Attention and calculation,Recall and Language)were significant difference within the group(P<0.05);the comparison between the two groups showed that the total score of MMSE,Orientation,Attention and calculation in the treatment group were significantly higher than those in the control group(P<0.05),while the Immediate memory,Recall and Language were also higher than the control group,but no significant difference(P>0.05).3.Compared with before treatment,the relative expression levels of miRNAs(miR-124,miR-132,miR-134,miR-138)in PBMCs were significant different within the group(P<0.001);which miR-124,miR-134,miR-138 were down-regulated,miR-132 was up-regulated.4.Compared with control group,the relative expression of miR-132 and miR-134 have statistical differences(P<0.05),there is no significant difference in the expression of miR-124 and miR-138(P>0.05).5.Correlation the analysis of the changes of the expression levels of miR-124,miR-132,miR-134,miR-138 and differences in MMSE score,before ’and after the intervention.The expression levels of miR-132 and MMSE was positively correlated r=0.400(P<0.05);The expression levels of miR-134 and MMSE was negatively correlated r=-0.321(P<0.05).Conclusions:1.Only cognitive rehabilitation training and acupuncture combined with cognitive rehabilitation training both could improve cognitive function in patients with PSCI,and acupuncture combined with cognitive rehabilitation training to improve the cognitive function of patients with PSCI is more significant.2.The expression levels of miR-132、miR-134 may play an important role in cognitive function,and acupuncture combined with cognitive rehabilitation training may improve cognitive function through the regulation of miR-132,miR-134 expression level,but which still needs further research.