Modulation of functional activity and connectivity by acupuncture in patients with Alzheimer disease as measured by resting-state fMRI.

Weimin Zheng,Zhiqun Wang,Xingyun Liu,Ying Han,Hao Zhang,Jie Lu,Haiqing Song,Zhuangzhi Su,Kuncheng Li,Kewei Chen

doi:10.1371/journal.pone.0196933

Weimin Zheng, Zhiqun Wang + Show 8 more

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https://doi.org/10.1371/journal.pone.0196933

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Abstract

Acupuncture has been used in the therapy of Alzheimer disease (AD); however, its neural mechanisms are still unclear. The aim of this study is to examine the effect of acupuncture on the functional connectivity in AD by using resting-state functional magnetic resonance imaging (rs-fMRI). Twenty-eight subjects (14 AD and 14 normal controls) participated in this study. The rs-fMRI data were acquired before and after acupuncture stimulation at the acupoints of Tai chong (Liv3) and Hegu (LI4). During the baseline resting state, by using the amplitude of low-frequency fluctuations (ALFF), we found a significantly decreased or increased ALFF in the AD patients relative to the controls. These regions were located in the right superior frontal gyrus (SFG), left postcentral gyrus, subgenual cingulate cortex (SCC), right middle cingulate cortex (MCC), right inferior frontal gyrus (IFG), right hippocampus and the right inferior temporal gyrus (ITG). Then, we selected these brain regions as seeds to investigate whether regional activity and functional connectivity could be modulated by acupuncture in the AD patients. When compared to the pre-acupuncture stage, several of the above regions showed an increased or decreased ALFF after acupuncture in the AD patients. In addition, the functional connectivity between the hippocampus and the precentral gyrus showed enhancement after acupuncture in the AD patients. Finally, there were close correlations between the functional activity, connectivity and clinical performance in the AD patients. The current study confirmed that acupuncture at Tai chong (Liv3) and He gu (LI4) can modulate functional activity and connectivity of specific cognition-related regions in AD patients.

Highlights

Alzheimer disease (AD) is a progressive neurodegenerative disease that manifests with memory deficits and cognitive decline [1, 2]
No significant differences in age and gender was found between the AD and healthy controls (HCs) groups, but the AD group exhibited significantly lower Montreal Cognitive Assessment (MoCA), Mini-mental State Examination (MMSE), Auditory Verbal Learning Test (AVLT) and Clinical Dementia Rate (CDR) scores than those of the HC group (P < 0.001)
A significantly increased amplitude of low-frequency fluctuations (ALFF) was found in the subgenual cingulate cortex (SCC), right middle cingulate cortex (MCC), right inferior frontal gyrus (IFG), right hippocampus and right inferior temporal gyrus (ITG)

Summary

Introduction

Alzheimer disease (AD) is a progressive neurodegenerative disease that manifests with memory deficits and cognitive decline [1, 2]. There are over 24 million people suffering from AD all over the world, and the population may double to an estimated 42 million by 2020 [3]. There is no effective treatment for the disease, which stimulates researchers to find new ways of treating AD. As a classic treatment in traditional Chinese medicine (TCM), acupuncture has increasingly attracted attention, as it is thought to be effective in slowing the progression of AD. The neural mechanism underlying the effects of acupuncture is not very clear at present

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