| The present study was conducted to investgate the intervention effects of healthy olders by electroacupuncture(EA)and high definition transcranial direct current stimulation(HD-t DCS),and to explore the effect of EA / HD-t DCS intervention with consistently influence in a certain period of time.Alzheimer's disease is the most common disease in dementia,which is characterized by serious impairment of memory,accompanied by abnormal decline in other cognitions,as well as severe loss of insight and self-care ability,and obvious symptoms of mental disorders.The risk of developing AD increases with age,studies have indicated that the possibility of more than 80-year olders suffering from AD reached 50%.Due to the rapid development of China's aging process,dementia has become the focus of national concern.Because there is no effective drug treatment,delay or prevention of dementia is very important,early screening and early prevention of the elderly is an important part of delay and prevention of dementia.In this study,electroacupuncture(EA)and HD-t DCS were used to investigate effects of non-drug means on the cognitive aging of normal elderly.The purpose of this study is,1)to verify the feasibility and effectiveness of EA and HD-t DCS in the treatment of cognitive aging;2)to investigate different effects of two physical intervention methods on behavior and brain response,and to explore the underlying neural mechanism of cognitive aging intervention.Methods: Using a parallel randomized controlled trial,all subjects were enrolled in the group before the completion of the set of neuropsychological assessments,excluding patients with MCI/AD;as well as the resting state f MRI scan,excluding the elderly subjects with organic damage in the brain.46 patients were randomly divided into three groups: EA group(15),HD-t DCS(16)and control group(15).Matched age,gender,education,interest,and cognitive ability.For the experimental groups(EA/HD-t DCS),participants received two-week either EA or HD-t DCS intervention.Each intervention lasts 25 minutes,5 times a week,10 times in total.After intervention,the subjects accepted neuropsychological evaluation and resting state f MRI scanning.Participants in EA group received electroacupuncture stimulation after baseline assessments by sterile,single use needle,1-3 cm depth,2 Hz with intensity of 5-10 m A.It was carried out by an experienced acupuncturists registered with the Chinese Medicine Council,who has reached clinical acupuncture experiences.The acupoint selection was based on the theory of traditional Chinese medicine(TCM)and clinical literature on acupuncture therapy for memory loss.The acupoints of present study were as follows: EX-HN1(Sishencong);GV20(Baihui);GV24(Shenting);HT7(Shenmen);PC6(Neiguan);LI4(Hegu);SP6(Sanyinjiao);ST36(Zusanli);KI3(Taixi).While HD-t DCS group received transcranial direct current stimulate with 1.5 m A on left dorsolateral prefrontal cortex(DLPFC).Soterix medical 4×1 ring configuration HD-t DCS adapter was carried out by an experienced researcher.To stimulate left DLPFC,the anode electrode was placed over F3 according to the 10 – 20 international system for EEG electrode placement,surrounded by 4 cathodes at 7.5 cm radius.All the electrodes were high-definition mini electrodes,with a constant current of 1.5 m A intensity lasts for 25 minutes.Control group did not receive any intervention with neuropsychological assessments before and after the same cycle.Results: In order to explore the effectiveness of EA/HD-t DCS,EA/HD-t DCS group was compared with the control group by repeating the method of analysis of variance(ANOVA)with 2(within-group variables: before and after intervention)× 2(between-group variables: intervention group and control group)design.(1)Repeated measurement of variance analysis showed that compared with NC group,EA group showed a significantly improved ability of the visual spatial structure and general cognition.(2)There was a tendency to improve the abstraction ability of the HD-t DCS group(margin significantly)compared with NC group.(3)There was no significant difference in behavioral effects between EA and HD-t DCS groups.By analyzing the local brain activity of the brain,(1)Compared with NC group after intervention,EA group was observed declined Re Ho value in the insula,pulvinar,middle occipital gyrus,cingulate gyrus and fusiform gyrus,as well as increased Re Ho value in the putamen.The decreased Re Ho value in middle occipital gyrus and the increased Re Ho value in the putamen were significantly correlated with cognitive behavioral improvement.(2)Compared with NC group after intervention,HD-t DCS group observed declined Re Ho value in the supermarginal gyrus,middle occipital gyrus,superior occipital gyrus,parahippocampal gyrus and fusiform gyrus,as well as increased Re Ho value in the middle temporal gyrus,middle cingulate gyrus,putamen.The increased Re Ho value in the middle temporal gyrus were significantly correlated with behavioral results of Mo CA.By analyzing the local brain activity of the brain,(1)Compared with NC group after intervention,EA group was observed increased FC between a MPFC and Temp P,PHC and Temp P,v MPFC and PHC,v MPFC and HF+,as well as declined FC between PCC and d MPFC.We also found that the FC changes between v MPFC and HF+ was significantly correlated with cognitive behavioral improvement.(2)Compared with NC group after intervention,HD-t DCS group was observed increased FC between v MPFC and HF+,as well as declined FC between PCC and Dmpfc,dm PFC and Rsp,TPJ and Rsp.Conclusions:(1)Non-cognitive intervention of EA/HD-t DCS is feasible.(2)EA and HD-DCS interventions can regulate aging cognitive abilities,as well as FC and the synchronous brain activity.(3)There was no significant difference in behavioral performance between EA and HD-DCS,but the intervention effects of EA and HD-DCS were different in FC and local synchronous brain activity,suggesting different mechanisms of action.(4)These two methods can indirectly improve the emotional state of participants,and the effect of EA is better than that of HD – t DCS. |
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