Abstract
Acupuncture therapy (AT) is a non-pharmacological method of treatment that has been applied to various neurological diseases. However, studies on its longitudinal effect on the neural mechanisms of patients with mild cognitive impairment (MCI) for treatment purposes are still lacking in the literature. In this clinical study, we assess the longitudinal effects of ATs on MCI patients using two methods: (i) Montreal Cognitive Assessment test (MoCA-K, Korean version), and (ii) the hemodynamic response (HR) analyses using functional near-infrared spectroscopy (fNIRS). fNIRS signals of a working memory (WM) task were acquired from the prefrontal cortex. Twelve elderly MCI patients and 12 healthy people were recruited as target and healthy control (HC) groups, respectively. Each group went through an fNIRS scanning procedure three times: The initial data were obtained without any ATs, and subsequently a total of 24 AT sessions were conducted for MCI patients (i.e., MCI-0: the data prior to ATs, MCI-1: after 12 sessions of ATs for 6 weeks, MCI-2: another 12 sessions of ATs for 6 weeks). The mean HR responses of all MCI-0–2 cases were lower than those of HCs. To compare the effects of AT on MCI patients, MoCA-K results, temporal HR data, and spatial activation patterns (i.e., t-maps) were examined. In addition, analyses of functional connectivity (FC) and graph theory upon WM tasks were conducted. With ATs, (i) the averaged MoCA-K test scores were improved (MCI-1, p = 0.002; MCI-2, p = 2.9e–4); (ii) the mean HR response of WM tasks was increased (p < 0.001); and (iii) the t-maps of MCI-1 and MCI-2 were enhanced. Furthermore, an increased FC in the prefrontal cortex in both MCI-1/MCI-2 cases in comparison to MCI-0 was obtained (p < 0.01), and an increasing trend in the graph theory parameters was observed. All these findings reveal that ATs have a positive impact on improving the cognitive function of MCI patients. In conclusion, ATs can be used as a therapeutic tool for MCI patients as a non-pharmacological method (Clinical trial registration number: KCT 0002451 https://cris.nih.go.kr/cris/en/).
Highlights
Alzheimer’s disease (AD) is a neurodegenerative brain disease that begins with a slight failure of memory and gradually becomes acute
There was no statistical difference in the MoCAK test scores of mild cognitive impairment (MCI)-1 and MCI-2 in comparison with healthy control (HC) (i.e., p = 0.0740 for MCI-I vs. HC; p = 0.0998 for MCI-2 vs. HC, two independently sampled t-tests), which reveals significant improvement in the cognitive performance through acupuncture therapy (AT)
As the understanding of normal (i.e., HC) brain functioning and pathological (i.e., MCI or AD) conditions has always been the principal challenge of neuroscience, the conjunction of the resting state (RS) and working memory (WM) task-based analyses may provide more insight to understand the neural mechanisms of MCI patients
Summary
Alzheimer’s disease (AD) is a neurodegenerative brain disease that begins with a slight failure of memory and gradually becomes acute. The prodromal stage of AD is the cognitive disorder known as mild cognitive impairment (MCI), which is characterized by memory impairment related to language, thinking, visual perception, and judgment (Petersen et al, 2001; Petersen, 2004, 2009). This impairment has a large likelihood of developing into AD. Accurate diagnosis of the early stage of AD either through Montreal Cognitive Assessment (MoCA-K, Korean version) test (Lee et al, 2008) and Mini-Mental State Examination (Folstein et al, 1975) or some non-invasive imaging modality (Li et al, 2018) is essential to facilitate early intervention [i.e., acupuncture therapy (AT) or drug-based treatment]. There is an urgent need to explore the changes that may occur in cognition from a baseline if this intervention is applied
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