Study On Brain Response Mechanism Of Acupuncture At Siguan Point To Subjective Cognitive Decline Based On Multimodal MRI

Objective:Based on multimodal magnetic resonance imaging technology,this study explored the central effect of brain structure and functional damage in patients with subjective cognitive decline(SCD),and elaborated the effect of acupuncture at Siguan points on brain function in patients with SCD and its relationship in cognitive collaboration,to screen out specific imaging markers related to cognitive function remodeling in SCD patients,in order to provide a basis for clinical acupuncture treatment from an imaging perspective.Methods:1 Multidimensional neuropsychological scale scores,parallel structural and fMRI scans were performed on 20 SCD patients and 20 healthy subjects(HC)who met the inclusion criteria.Demographic data and neuropsychological test scores were compared by using SPSS 25.0.The gray matter volume(GMV)imaging data of the subjects were processed and statistically analyzed using the CAT12 and SPM12 software of the MATLAB platform.The independent samples t-test was used for comparison between groups,and gender,age,years of education,and total brain volume(TIV)were used as covariates for regression processing,and the differences in GMV between the two groups were obtained.The initial threshold for multiple comparison correction was P=0.001(uncorrected)at the voxels level and P<0.05 at the cluster level(FWEc correction).2 The PANDA software package and the GRETNA software package of the MATLAB platform were used to preprocess and analyze the brain structure network data,and the global and local topological properties of the brain structure network were calculated based on the graph theory analysis method.The edge connections of the structural network of the two groups of subjects were analyzed based on the Brain Connectivity Software(NBS)method.3 Siguan points in the SCD group were acupuncture,and fMRI data were collected before acupuncture and in the acupuncture state in the SCD group.The DPARSF and SPM12 of the MATLAB platform were used to preprocess and analyze the brain function data of the two groups of subjects.The independent sample t test was used for comparison between groups,and age,gender and years of education were used as covariates for regression processing,and brain functional connectivity networks were established based on the brain regions with significant differences in GMV and ReHo between the two groups as seed points.Paired-samples t-test was used for intra-group comparisons,and multiple comparisons were adjusted as above.4 SPSS25.0 was used to conduct Pearson correlation analysis of imaging indicators and multidimensional neuropsychological scale scores with significant differences.Gender,age and years of education were taken as covariates,P<0.05,which was statistically significant.Results:1 Comparison of general clinical dataAge,gender,years of education,total brain volume(TIV),Brief Mental State Examination(MMSE),Montreal Cognitive Scale(MoCA),Auditory Word Learning Test(AVLT),Immediate Memory,Hamilton Depression Rating Scale(HAMD),Hachinski ischemia index score(HIS),the difference was not statistically significant(P<0.05);Word Classification Fluency Test(VFT),Connection Test(TMT)-A,TMT-B,AVLT delayed memory,AVLT recognition,the difference was statistically significant(P<0.05).2 There were significant differences in structural MRI indexes between SCD group and HC group2.1 GMV results of SCD group and HC groupCompared with the HC group in the SCD group,the right temporal pole middle temporal gyrus,left middle temporal gyrus,right superior temporal gyrus,left fusiform gyrus,left lingual gyrus,right amygdala,right hippocampus,left triangle Inferior frontal gyrus,left dorsolateral superior frontal gyrus,left orbital superior frontal gyrus,left anterior cingulate and paracingulate gyrus,left insula,left precentral gyrus,left superior marginal gyrus gray matter volume reduce.2.2 SCD group and HC group structure network topology attribute results(1)Small-world attributes and global attributes:The structural network of SCD patients conforms to the "small-world" attributes.The local efficiency(Eloc)of the structural network in SCD patients was significantly lower than that in healthy subjects.(2)Node attributes of the local network:Compared with the HC group,the SCD group had the right posterior cingulate gyrus,left posterior cingulate gyrus,left superior temporal gyrus,left middle temporal gyrus,left The nodal efficiency of the lateral precuneus,left anterior cingulate and paracingulate gyrus,left parahippocampal gyrus,and left insula were significantly decreased,P<0.05;in the right medial and paracingulate gyrus,right Lateral parietal inferior angular gyrus,right anterior cingulate and paracingulate gyrus,left temporal pole middle temporal gyrus,left lentiform pallidus,left hippocampus,left posterior cingulate gyrus,left medial and para The local efficiency of nodes in the cingulate gyrus was significantly reduced,P<0.05.(3)Edge connection attribute of local network:compared with HC group,the connection strength of white matter fibers between left lenticular globus pallidus and left inferior frontal gyrus,left middle temporal gyrus of temporal pole,left anterior cingulate gyrus and paracingulate gyrus and left olfactory cortex,bilateral medial superior frontal gyrus,left medial and paracingulate gyrus in SCD group was significantly weakened,P<0.05.(4)Node centrality and core nodes of the network:compared with HC group,the node centrality of the left posterior cingulate gyrus,the right superior marginal gyrus,the right inferior parietal marginal angular gyrus,the left superior temporal gyrus,the left anterior cingulate gyrus and paraccingulate gyrus,the left lingual gyrus and the left precuneus in SCD group decreased significantly(P<0.05);Compared with HC group,the centrality of all core nodes in SCD patients decreased,the difference between groups was not statistically significant,and the distribution of core nodes changed.3 Influence of acupuncture at Siguan point on various indexes of functional MRI in SCD group3.1 Brain regional homogeneity(ReHo)changes(1)Compared with the HC group before acupuncture in the SCD group,the brain regions with increased ReHo values in the SCD group included:the right precentral gyrus,the left rectus gyrus,the left olfactory cortex,and the right hippocampus;Brain regions with decreased ReHo values include:left fusiform gyrus,left lingual gyrus,left anterior cingulate and paracingulate gyrus,right superior temporal gyrus,left insula,right middle temporal gyrus,right Lateral occipital gyrus.(2)Compared with the SCD group before acupuncture,the brain regions with increased ReHo values in the SCD group during acupuncture include:the right hippocampus,right middle frontal gyrus,right middle occipital gyrus,and right middle temporal gyrus;ReHo values decreased Small brain regions include:right temporal pole superior temporal gyrus,bilateral lingual gyrus,right precuneus,bilateral posterior central gyrus,right superior temporal gyrus,and right precentral gyrus.(3)Compared with the HC group in the acupuncture state,the brain regions with increased ReHo value in the SCD group included:the right precentral gyrus,left rectus gyrus,left anterior cingulate and paracingulate gyrus;those with decreased ReHo value Brain regions include:left lingual gyrus,left middle occipital gyrus,right medial and paracingulate gyrus,right posterior central gyrus,left insula,and right temporal pole superior temporal gyrus.3.2 Changes in brain functional connectivity(FC)(1)Comparison between the SCD group and the HC group before acupuncture:According to the difference of GMV and ReHo values between the two groups of subjects,5 seed points(seed)were selected:the left insula(seed 1),the left anterior cingulate and the parapet The cingulate gyrus(seed 2),the right hippocampus(seed 3),the left fusiform gyrus(seed 4),and the right superior temporal gyrus(seed 5)were analyzed for functional connectivity with whole-brain voxels,respectively.The functional connection between seed 1 and the left superior temporal gyrus,left medial and paracingulate gyrus was decreased,and the functional connection with the left middle frontal gyrus was enhanced;The functional connectivity of the right caudate nucleus was enhanced;the functional connectivity of seed 3 to the right parietal and inferior angular gyrus was decreased,and the functional connectivity to the left olfactory cortex was enhanced;The functional connection between seed 4 and left inferior occipital gyrus,right middle occipital gyrus,right inferior frontal gyrus of triangle and right anterior central gyrus decreased;the functional connectivity of seed 5 to the left middle occipital gyrus,right superior occipital gyrus,right middle temporal gyrus,and right lingual gyrus was decreased.(2)Comparison of the acupuncture state in the SCD group and before acupuncture in the SCD group:the functional connections between seed 1 and the right orbital middle frontal gyrus,left middle frontal gyrus,and left superior temporal gyrus were decreased;seed 2 was associated with the right amygdala,The functional connectivity of the right paracentral lobule was decreased;the functional connectivity of seed 3 with the right inferior parietal angular gyrus,the right inferior orbital frontal gyrus,the left precentral gyrus,and the left paracentral lobule was enhanced,and the functional connectivity with the left middle temporal gyrus Decreased;the functional connection of seed 4 with the left dorsolateral superior frontal gyrus and the right superior border gyrus was decreased,and the functional connection with the right parietal and inferior border gyrus was enhanced;seed 5 was connected with the right olfactory cortex,the left middle orbital frontal gyrus,Decreased functional connectivity of the right anterior cingulate and lateral cingulate.(3)Compared with the HC group in the acupuncture state of the SCD group:the functional connection between seed 1 and the left superior temporal gyrus,medial and paracingulate gyrus was decreased;the functional connection between seed 2 and the right amygdala and left middle frontal gyrus Decreased;the functional connection of seed 3 with the left middle temporal gyrus and the left middle orbital frontal gyrus was enhanced;the functional connection of seed 4 with the bilateral middle occipital gyrus and the right precentral gyrus was decreased;the functional connection of seed 5 with the left middle occipital gyrus and the right The lingual gyrus and the right intraorbital suprafrontal gyrus were reduced.4 Correlation between structural and functional imaging indicators and clinical scalesIn SCD group,the efficiency of left insula node was negatively correlated with MTT-A(r=-0.496,P=0.026),the efficiency of left superior temporal gyrus node was negatively correlated with VFT score(R=-0.478,P=0.033),and the efficiency of left anterior cingulate and paracingulate gyrus node was positively correlated with AVLT delayed memory score(R=0.470,P=0.036),local efficiency of left posterior cingulate gyrus node was negatively correlated with AVLT delayed memory score(R=-0.478,P=0.033).The centrality of left posterior cingulate gyrus node was negatively correlated with TMT-B score(R=-0.496,P=0.026).GMV of left insula was positively correlated with AVLT delayed memory score(R=0.588,P=0.006).The ReHo value of right hippocampus was negatively correlated with AVLT instant memory score(R=-0.523,P=0.018).The ReHo value of the right superior temporal gyrus was negatively correlated with AVLT recognition score(r=0.480,P=0.032).The ReHo value of the right middle temporal gyrus was negatively correlated with AVLT recognition score(r=-0.453,P=0.045).The FC values of right hippocampus and right parietal and inferior Angle gyrus were positively correlated with AVLT recognition score(r=0.445,P=0.048).The FC values of right superior temporal gyrus and left middle occipital gyrus were negatively correlated with TMT-B score(r=-0.651,P=0.002).The FC values of left fusiform gyrus and right middle occipital gyrus were negatively correlated with AVLT delayed memory score(r=-0.447,P=0.048).Conclusion:1 In SCD patients,the volume of gray matter in the hippocampus,frontal lobe,temporal lobe and other brain regions is reduced,the topological properties of the structural network are changed,and the functional connectivity of the brain is reduced.2 The brain structure network of SCD patients has the property of small world,but the connectivity of the whole brain structure network of SCD patients is weakened,and the ability to integrate and transmit information is reduced,which affects the complex network involved in regulating cognitive function.3 Acupuncture at Siguan point can regulate the functional connections of other networks such as default network,frontal parietal network and local brain functional activities in SCD patients.This effect may improve cognitive function by reshaping the functional connections of cognitive related brain areas,which provides an objective basis for acupuncture in traditional Chinese medicine to treat subjective cognitive decline.4 Changes in brain structure network topology,GMV and functional indicators in SCD patients are partly correlated with clinical scale scores,reflecting the impairment of multiple cognitive domains in SCD patients,suggesting that changes in corresponding indicators may be an indicator for early diagnosis and evaluation of SCD Specific imaging markers of acupuncture efficacy.