基于功能磁共振成像技术探讨针刺治疗遗忘型轻度认知障碍患者脑活动效应研究

A study on the brain activity effect of acupuncture at siguan point in amci patients based on fMRI technology

目的:基于功能磁共振成像(Functional Magnetic Resonance Imaging,fMRI)技术探讨针刺治疗遗忘型轻度认知障碍(Amnestic Mild Cognitive Impairment,aMCI)患者脑活动效应。方法:选取黑龙江中医药大学附属第一医院2021年2月-2023年6月收治的遗忘型轻度认知障碍患者80例作为研究对象,根据随机数字表法分为对照组和观察组,每组40例。对照组采用假针刺治疗,观察组采用真针刺治疗。比较两组患者治疗前后的认知功能、记忆力、精神行为症状;并开展fMRI扫描,对治疗前后的f MRI的低频振幅(Amplitude of Low Frequency Fluctuation,ALFF)值与局部一致性(Regional Homogeneity,ReHo)值进行观察比较。结果:治疗后,两组蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)、Rivermead行为记忆能力试验(Rivermead Behavioural Memory Test,RBMT)评分均较治疗前升高,神经精神症状问卷(Neuropsychiatric Inventory,NPI)评分均较治疗前降低,且观察组MoCA评分、RBMT评分均高于对照组,NPI评分低于对照组,组间差异有统计学意义(P<0.05)。相比于治疗前,观察组ALFF值明显升高的区域为左侧中央前回、左侧楔叶,ALFF值明显降低的区域为右侧梭状回,对照组ALFF值明显降低的区域为左侧顶上回。相比于治疗前,观察组分数低频振幅(Fraction Amplitude of Low Frequency Fluctuation,f ALFF)值明显升高的区域为左侧中央后回、右侧颞中回,对照组fALFF明显下降的区域为右侧小脑下部。相比于治疗前,观察组ReHo值明显升高的区域为右侧颞下回,对照组ReHo值明显升高的区域为右侧中央沟盖。结论:针刺治疗不但对遗忘型轻度认知障碍患者的认知功能改善显著,而且还能重塑一致性脑区功能及结构,同时功能指标能对针刺疗效进行预测;不但能为针刺治疗遗忘型轻度认知障碍患者提供客观和准确的理论依据,而且能为疗效评估提供指导。

Objective:Exploring the Brain Activity Effect of Acupuncture on Siguan Points in Patients with Amnesiac Mild Cognitive Impairment(aMCI)Based on Functional Magnetic Resonance Imaging(fMRI)Technology.Methods:Eighty aMCI patients admitted to the hospital from February 2021 to June 2023 were selected as the study subjects and divided into two groups using a random number table method.The control group(40 cases)received sham acupuncture treatment,while the study group(40 cases)received true acupuncture treatment.Compare the cognitive function,memory,and behavioral symptoms of two groups of patients before and after treatment,and conduct fMRI scans to observe and compare the ALEE and ReHo values of fMRI before and after treatment.Result:After treatment,the scores of the Montreal cognitive assessment(MoCA)and the rivermead behavioral memory test(RBMT)in both groups increased compared to before treatment,while the scores of the neuropsychiatric Inventory(NPI)decreased compared to before treatment.The MoCA and RBMT scores in the observation group were higher than those in the control group,while the NPI scores were lower than those in the control group,the difference between groups was statistically significant(P<0.05).Compared to before treatment,the areas with significantly increased ALFF values in the study group were the left anterior cingulate gyrus and left cuneiform lobe.The area with a significant decrease in ALFF value is the right fusiform gyrus.The area where the ALFF value significantly decreased in the control group was the left parietal gyrus.Compared to before treatment,the areas with significantly increased fALFF values in the study group were the left posterior central gyrus and the right middle temporal gyrus.The area where fALFF significantly decreased in the control group was the lower right cerebellum.Compared to before treatment,the area where the ReHo value significantly increased in the study group was the right inferior temporal gyrus.The area where ReHo significantly increased in the control group was the right central sulcus cover.Conclusion:Acupuncture treatment not only significantly improves cognitive function in aMCI patients,but also reshapes consistent brain area function and structure,and functional indicators can predict acupuncture efficacy.Not only can it provide objective and accurate theoretical basis for acupuncture treatment of aMCI patients,but it can also provide guidance for efficacy evaluation.