Abstract
BackgroundDiabetic cognitive impairment (DCI) is a serious chronic complication caused by diabetes. The pathogenesis of DCI is complex, but brain nerve injury and brain nerve cell apoptosis are important pathological changes. Multimodal brain imaging is one of the most important techniques to study the neural mechanism of the brain. For the clinical treatment of DCI, there is no effective targeted Western medicine and a lack of clear drug intervention methods. Therefore, there is an urgent need to find effective complementary and alternative methods and clarify their mechanism. This research seeks to explore the multimodal brain imaging effect of “Adjust Zang-fu and Arouse Spirit” electroacupuncture for DCI.MethodsThis clinical research will be a randomized, sham-controlled pilot trial. Eligible participants will be randomly assigned to the intervention group (n = 60) and the control group (n = 30). The intervention group will be divided into the “Adjust Zang-fu and Arouse Spirit” electroacupuncture group (n = 30) and sham electroacupuncture group (n = 30). All participants will continue to receive routine hypoglycemic therapy. The treatment period is the same in both groups. The primary outcomes include functional magnetic resonance imaging (fMRI), magnetic resonance spectroscopy (MRS), Montreal Cognitive Assessment Scale (MoCA), and Clinical Dementia Rating (CDR). The secondary outcomes include blood glucose and blood lipid tests, Instrumental Activities of Daily Living Scale (IADL), Hachinski Ischemic Scale (HIS), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS). Outcomes will be assessed at baseline and before and after treatment, and adverse events will be examined. Inter- and intragroup analyses will be performed.DiscussionThis randomized controlled study, combined with multimodal brain imaging techniques and a clinical evaluation scale, was designed to explore the mechanism of “Adjust Zang-fu and Arouse Spirit” electroacupuncture in improving the central nervous system in DCI.Trial registrationChinese Clinical Trial Registration ChiCTR2000040268. Registered on 26 November 2020
Highlights
Diabetic cognitive impairment (DCI) is a serious chronic complication caused by diabetes
The existing research still lacks imaging markers to accurately explain the cognitive decline of DCI patients, and there are differences in different experimental image processing techniques, such as processing accuracy, brain region segmentation methods, and a lack of ways to analyze the brain imaging data of DCI patients from an individual point of view
This laboratory is the first laboratory in the world to apply rs-functional magnetic resonance imaging (fMRI) technology to draw the map of functional differences within and between individuals and proposes a new successive recursive method to draw the individual brain network map to improve the reliability of the location results and accurately map the unique functional network organization in each topic [25, 26]
Summary
Diabetic cognitive impairment (DCI) is a serious chronic complication caused by diabetes. Multimodal brain imaging is one of the most important techniques to study the neural mechanism of the brain. Diabetes mellitus (DM) is a chronic disease that causes huge economic and social burdens. Diabetic cognitive impairment (DCI) is a serious chronic complication caused by diabetes and is mainly manifested as deficiency of attention, visual structure, learning function, verbal memory, and calculation ability [3]. It is a state of cognitive impairment between brain aging and dementia that belongs to the early stage of Alzheimer's disease (AD) [4]. DCI brings a serious burden to patients’ families and society, and effective prevention, early diagnosis, management, and treatment of DCI have become the focus of clinical research
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