糖尿病认知功能障碍的脑影像学研究及针刺起效的中枢机制

Brain imaging study on diabetes cognitive impairment and the central effect mechanism of acupuncture on its treatment

糖尿病认知功能障碍(diabetes cognitive impairment,DCI)是由于糖尿病发病日久导致的严重的中枢神经系统病变,以记忆、注意力及执行功能衰退为主要特征。针刺在临床治疗DCI上确有疗效,但机制不明。多模态脑影像学技术已成为活体水平揭示DCI中枢机制的重要手段。本研究通过对T2DM认知障碍的脑影像变化特征及针刺干预对脑区产生的影响进行总结。发现针刺主要通过激活DCI患者额叶、颞叶、脑岛、边缘系统、前额叶皮质等几个脑区的功能活动及调节脑区间的功能连接,从而对DCI患者的认知功能产生影响。同时本研究也提出了今后研究的不足和展望,以期为临床防治和针刺疗法的推广应用提供确切的影像学研究证据。

Diabetes cognitive impairment(DCI)is a severe central nervous system disorder caused by prolonged diabetes and is characterized by a decline in memory,attention and executive function.Acupuncture is confirmed to be effective in the clinical treatment of DCI,but its mechanism is unknown yet.Multimodal brain imaging technology has become an essential means of revealing the central mechanism of DCI in vivo.This study summarizes the characteristics of brain imaging changes in T2DM cognitive impairment and the effects of acupuncture intervention on brain regions,finding that acupuncture mainly affects the cognitive function of DCI patients by activating the functional activities in several brain regions,such as the frontal lobe,temporal lobe,insula,limbic system,and prefrontal cortex,as well as regulating the functional connection between brain regions.At the same time,this study also points out the shortcomings and prospects of future research to provide accurate imaging evidence for clinical DCI prevention and treatment and the promotion and application of acupuncture therapy in this respect.