| Objective: To validate the clinical efficacy of the Tiaoshen Yizhi acupuncture on episodic memory function in amnestic mild cognitive impairment(a MCI)patients and to investigate whether the neuroimaging mechanisms are related to functional connectivity(FC)by regulating default mode network(DMN).Methods: According to the inclusion and exclusion criteria,a total of 90 a MCI patients were recruited and randomly divided into the acupuncture group,sham acupuncture group,and control group.The acupuncture group received Tiaoshen Yizhi acupuncture,the sham acupuncture group received non acupoint shallow acupuncture,and the control group only received health education.Participants in the two acupuncture groups will receive real acupuncture treatment or placebo acupuncture three times per week,24 sessions over 8consecutive weeks.The outcomes were the episodic memory function,and functional magnetic resonance imaging(f MRI)data using brain functional connectivity analysis of regions of interest(ROI).The z FC values of the significantly different brain regions were extracted to investigate the correlation between changes in a MCI episodic memory and changes in DMN functional connectivity by using Pearson’s correlation analysis.Results: After 8-week intervention,the scores of Auditory verbal learning test-Hua Shan(AVLT-H)second immediate recall,short delay,long delay recall,and recognitive LMT immediate recall were significantly higher than those pre intervention in acupuncture group.The intergroup comparisons showed that the improvements of AVLT-H short delay recall,long delay recall scores and logic memorytest(LMT)immediate recall,delayed recall scores in the acupuncture group were significantly higher than those in the control group,and the changes of LMT delayed recall scores in the acupuncture group were significantly higher than those in the sham acupuncture group.Imaging evidence showed that the functional connectivity between the posterior cingulate cortex(PCC)and bilateral inferior parietal horn gyrus,left insula,hippocampus,left putamen pallidum,inferior temporal gyrus,and cerebellar vermis4＿5 in a MCI patients increased more than those before the intervention,and that the functional connectivity between the PCC and left caudate nucleus decreased more than before the intervention.The functional connectivity changes between PCC and left insula,left insular opercular inferior frontal gyrus,left triangular inferior frontal gyrus,right middle frontal gyrus,and left inferior parietal limbic angular gyrus in acupuncture group compared with sham acupuncture group were found to be significant.The functional connectivity changes between PCC and hippocampus,left putamen pallidum,left insula,inferior frontal gyrus of the trigone,inferior parietal horn gyrus,and inferior temporal gyrus were significant in acupuncture group compared with control group.Correlation analysis revealed that The changes of AVLT-H long delay recall scores were positively correlated with the PCC left hippocampal functional connectivity(r=0.643,P<0.001).The changes of AVLT-H long delay recall were positively correlated with the PCC left insular functional connectivity(r=0.259,P=0.024).The changes of LMT delayed recall score were positively correlated with the PCC right inferior temporal gyrus functional connectivity(r=0.504,P=0.007).The changes of AVLT-H long delay recall score were negatively correlated with the functional connectivity of the PCC left caudate nucleus(r=-0.272,P=0.003)in the acupuncture group.Conclusions: The Tiaoshen Yizhi acupuncture is able to provide some improvement in episodic memory function in a MCI patients.Tiaoshen Yizhi acupuncture significantly increased the functional connectivity between the default network and brain regions involved in global cognitive function in a MCI patients,and acupuncture has the potential to affect episodic memory function in a MCI patients by modulating the DMN centered on PCC. |
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