| Objective.To observe the clinical efficacy of acupuncture in the treatment of vascular mild cognitive impairment(VaMCI)using resting-state functional magnetic resonance imaging(RS-f MRI),to explore the effects of acupuncture on local coherence(Re Ho)and degree centrality(DC)in different frequency bands and the modulation of brain function in relevant brain regions in VaMCI patients,to elucidate the mechanism of the central effect of acupuncture in improving VaMCI,and to preliminarily reveal the imaging characteristics of VaMCI,and provide evidence to support the early diagnosis of VaMCI and clinical intervention.Methods.A total of 14 patients with VaMCI were recruited in the acupuncture clinic and ward of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine and divided into acupuncture group and non-acupuncture area shallow acupuncture group(hereafter referred to as non-acupuncture group),which were divided into 7 cases in the acupuncture group and 7 cases in the non-acupuncture group in a 1:1 ratio using the randomized grouping method of sealed envelope.Both groups were treated according to conventional treatment methods to control blood pressure,blood glucose,antiplatelet,and lipid lowering.On this basis,the acupuncture group was given acupuncture treatment and the non-acupuncture group was given non-acupuncture superficial acupuncture treatment;both groups were treated 3 times a week for 3 months.Before and after treatment,patients’ cognitive functions were evaluated using a set of neuropsychological evaluation scales,including the Montreal Cognitive Assessment Scale(Mo CA),the MMSE,the Hopkins Verbal Learning Test(HVLT),the Instrumental Activities of Daily Living Scale(ADL),the Boston Naming Test(BNT-2),the Connectedness Test(TMT),and the Clock Drawing Test(CDT);and resting-state functional magnetic resonance(rs-f MRI)imaging techniques were used to analyze the changes in Re Ho values and DC values in different brain regions in different frequency bands before and after the patients’ treatment.The data were analyzed using SPSS20.0 statistical software.The t-test was used for the measurement data: paired t-test for intra-group comparison and independent sample t-test for inter-group comparison;χ2 test was used for the count data,and P < 0.05 was considered statistically significant.The RESTplus v1.25 analysis software under Matlab R2017 b platform was applied to preprocess the RS-f MRI data,and then the preprocessed data were subjected to paired t-tests from both Re Ho and DC algorithms for the index values before and after the intervention in both groups,and finally the results were subjected to multiple regression correction to observe the differences in activated brain regions in different frequency bands between the two groups,and combined with the cognitive functional scale assessment results for a comprehensive comparative analysis.Results.1.neuropsychological evaluation scale assessment results.The HVLT,BNT-2,CDT4 score,TMT(s)-A,TMT(s)-B,MMSE,and IADL scale scores of the acupuncture and non-acupuncture groups did not differ significantly between the groups before treatment(all P>0.05).The HVIT,BNT-2,CDT4 scale,TMT(s)-B,and IADL scores of both groups did not differ significantly between groups after treatment(all P>0.05),and the TMT(s)-A and MMSE scores of both groups were highly significant after treatment(P=0.000);the Mo CA scores of both groups for visuospatial and executive,naming,attention,language,abstraction,delayed recall,and orientation scores were not significantly different before treatment(all P>0.05),language,abstraction ability,delayed recall,and orientation scores were not significantly different between the two groups after treatment(all P>0.05),and visuospatial and executive power and attention scores were highly significant between the two groups after treatment(P=0.000).2.Resting-state functional NMR results.(1)Brain regions with differences in Re Ho before and after treatment in the acupuncture group: in the conventional band,Re Ho values were significantly higher in the left superior cerebellar and right superior frontal gyri,and significantly lower in the left anterior cingulate and paracingulate gyri,and in the right perirhinal cortex of the talar fissure;in the slow4 band,Re Ho values were significantly lower in the left postcentral gyrus;in the slow5 band,Re Ho values in the right intraorbital superior frontal gyrus significantly decreased,and the Re Ho values of the right orbital frontal middle gyrus,left precuneus,left superior parietal gyrus,right triangular inferior frontal gyrus,and left inferior parietal marginal angular gyrus were significantly increased.(2)Brain regions with differences in Re Ho before and after treatment in the non-cave group: in the conventional band,Re Ho values were significantly higher in the right precuneus and left middle frontal gyrus,and significantly lower in the left middle occipital gyrus and left perisylvian cortex;in the slow4 band,Re Ho values were significantly lower in the right middle temporal gyrus and left lingual gyrus;in the slow5 band,Re Ho values were significantly lower in the right cingulate gyrus,left inferior temporal gyrus,left cingulate The Re Ho values of the right precuneus,right perisylvian cortex and left cuneus were significantly increased.(3)Brain regions with differences in DC before and after treatment in the acupuncture group: in the traditional band,DC values in the left superior cerebellar gyrus and left pallidum were significantly increased,and DC values in the right supplementary motor area were significantly decreased;in the slow4 band,DC values in the left precentral gyrus,right supplementary motor area,and right superior parietal gyrus were significantly decreased;in the slow5 band,DC values in the right middle temporal gyrus,right anterior cingulate and paracingulate gyrus,left anterior cingulate and paracingulate gyrus,and left anterior cingulate and paracingulate gyrus were significantly decreased.The DC values of the right middle temporal gyrus,right anterior and paracordate gyrus,left anterior and paracordate gyrus,left medial and paracordate gyrus,and right angular gyrus were significantly reduced,and the DC values of the left superior orbital gyrus and right syrinx were significantly increased.(4)Brain regions with differences in DC before and after treatment in the non-cave group: in the conventional band,DC values of the right supramarginal gyrus and right postcentral gyrus were significantly increased,and DC values of the right orbital superior frontal gyrus were significantly decreased;in the slow4 band,DC values of the left inferior parietal marginal angular gyrus were significantly increased;in the slow5 band,DC values of the left inferior temporal gyrus were significantly decreased,and DC values of the right lingual gyrus,the left perirhinal cortex of the talar fissure,the right The DC values of the right lingual gyrus,left perirhinal cortex,right perirhinal cortex and right superior occipital gyrus were significantly increased.(5)Brain regions with differences in Re Ho compared with the two groups after treatment: in the conventional frequency band,the Re Ho values of the right inferior cerebellar gyrus,left parahippocampal gyrus,right amygdala,right olfactory cortex,left superior frontal gyrus,and right insula were significantly increased,and the Re Ho values of the left middle frontal gyrus were significantly decreased.In the slow5 band,the Re Ho values of the left inferior frontal gyrus,left middle frontal gyrus and left superior limbic gyrus were significantly decreased,and the Re Ho values of the left parahippocampal gyrus,right hippocampus and left superior frontal gyrus were significantly increased.(6)Brain regions with differences in DC compared to the two groups after treatment: in the conventional band,DC values in the right superior cerebellar,left superior marginal gyrus,right anterior and paracentral cingulate gyrus,right medial and paracentral cingulate gyrus were significantly increased,and DC values in the right middle frontal gyrus were significantly decreased;in the slow4 band,DC values in the right superior cerebellar,right medial superior frontal gyrus,and right supplementary motor area were significantly decreased,and DC values in the cerebellar earth In the slow5 band,the DC values of the left middle occipital gyrus decreased significantly,and the DC values of the left inferior occipital gyrus,the right superior cerebellar gyrus,the left syrinx,and the left perisylvian cortex increased significantly.3.Correlation analysis.(1)The correlation between the Re Ho ratio of differential brain regions and MMSE scores in the acupuncture group was analyzed,and it was found that MMSE scores were positively correlated with the Re Ho ratios of the right superior frontal gyrus and left superior parietal gyrus in the acupuncture group 3 months after treatment(P<0.05).(2)The correlation between DC ratios of differential brain regions and MMSE scores in the acupuncture group was analyzed,and it was found that MMSE scores were negatively correlated with DC ratios of the left precentral gyrus after 3 months of treatment in the acupuncture group(P<0.05).Conclusions.1.the cognitive function,motor function,and daily living ability of patients improved after treatment in the acupuncture and non-acupuncture groups;however,the acupuncture group activated a wider range of brain areas with greater intensity than the non-acupuncture group.It proves that there is relative specificity between acupuncture and non-acupuncture points.2.Acupuncture caused changes in Re Ho values and DC values in several brain regions in the traditional frequency band,slow4 frequency band and slow5 frequency band,in which the differential brain regions were mainly the superior frontal gyrus,middle frontal gyrus,orbital superior frontal gyrus,anterior cingulate and paracingulate gyrus,precuneus,perisylvian fissure cortex,and syrinx gyrus,and the above brain regions mainly belonged to the FPN(frontoparietal network)and VN(visual network),and acupuncture could enhance FPN and VN functional connections,which may be one of the central mechanisms of action of acupuncture for VaMCI.3.The MMSE scores of the acupuncture group 3 months after treatment were positively correlated with the Re Ho ratio of the right superior frontal gyrus and left superior parietal gyrus and negatively correlated with the DC ratio of the left precentral gyrus;suggesting that the improvement of neurological deficits in VaMCI patients was accompanied by the improvement of functional connectivity of the right superior frontal gyrus and left superior parietal gyrus within the FPN;also suggesting that the assessment of functional network connectivity of the right superior frontal gyrus and left superior parietal gyrus can be used as It also suggests that the assessment of functional network connectivity in the right superior frontal gyrus and left superior parietal gyrus can be used as a potential indicator to evaluate the treatment effect of VaMCI. |
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