| BackgroundWith the development of economy and medical technology,and the improvement of education,population aging is gradually increasing,which lead to extension of human's average life expectancy.Alzheimer's Disease(AD),a progressive neural degenerative disease,is irreversible and increases with age.AD is an important factor that causes disability in old people,and brings burden for families and society.However,treatment for delaying the progression and improving the prognosis of AD at present is limit.Amnestic mild cognitive impairment(aMCI)is the precursor stage of AD,early indentify and intervention can significantly prevent AD.Researches have demonstrated that repetitive transcranial stimulation(rTMS)and magnetic therapy on cognitive-related acuponits can improve cognitive function of aMCI patients,but the mechanism remains unclear.Thus,based on resting-state functional magnetic resonance imaging(rs-fMRI),we observed the influence of repetitive transcranial magnetic stimulation(rTMS)and cognitive-related acupoint magnetic therapy on brain function of aMCI patients,explore the central mechanism of them on cognitive function,and provide theoretic basis for their clinical applicationObjection1.Explicit the effect of central rTMS on brain function of aMCI patients,explore the central effective mechanism of rTMS on cognitive function.2.Explicit the effect of peripheral acupoint magnetic therapy on brain function of aMCI patients,explore the central effective mechanism of acupoint magnetic therapy on cognitive function.MethodThe first experiment10 participants were recruited,all participants were given rTMS,stimulated the left doesolateral prefrontal(DLPFC),frequency of 10Hz,80%rest motor threshold(RMT),stimulate time was 2 seconds,interval of 8 seconds,repeated 20 times.There were 5 times per week,last for 8 consecutive weeks.For each participant,montreal cognitive assessment scale(MoCA),digit symbol and digit-span of Wechsler Adult Intelligence Scale(WAIS)were detected and fMRI was scanned before and after treatment,scores of scales,ReHo and ALFF value of rs-fMRI were collected and statistical analyzed.The second experiment32 participants were recruited,they were randomly divided into treatment group(16 case)and controlled group(16 case).All of them were given acupoint magnetic therapy.Magnets were attached on the acupoints.In the treatment group,"Tiaoshen Yizhi"acupoints were adopted:body points:Shenmen,Neiguan,Taixi,Fenglong,Taichong;auricular points:heart,kidney,liver,brain.In the controlled group,Yangming meridians acupoints were adopted:Hegu,Waiguan,Quchi,Zusanli,Xiajuxu;auricular points:large intestine,upper limb,shouler,buttocks.New magnets were attached after 3 days,a course of 4 weeks,last for 8 weeks.For each participant,montreal cognitive assessment scale(MoCA)?digit symbol and digit-span of Wechsler Adult Intelligence Scale(WAIS)were detected and fMRI was scanned before and after treatment,scores of scales,ReHo and ALFF value of brain network were collected and statistical analyzed.Results1.Influence of rTMS on cognitive function of aMCI patientsScores of MoCA?digit symbol and digit-span increased,the differences between pretherapy and post-therapy were all of high statistical significance(P<0.01).Of all the cognitive domains of MoCA,view spatial function and executive function?language and recall were improved significantly(P<0.05)2.Influence of rTMS on ReHo and ALFF value in rs-fMRI of aMCI patientsAfter rTMS,ReHo value significantly increased in these brain regions:sub-gyrus of frontal temporal parietal lobe,left superior frontal gyrus,inferior frontal gyrus,insula,superior temporal gyrus,parahippocampus,precuneus and the right cingulate gyrus;ReHo value significantly decreased in these brain regions:left middle occipital gyrus,supramarginal gyrus and superior parietal gyrus.ALFF value significantly increased in these brain regions:sub-gyrus of left frontal temporal lobe,right inferior frontal gyrus,superior temporal gyrus and left precuneus;ALFF value significantly decreased in these brain regions:right superior frontal gyrus,medial frontal gyrus and middle temporal gyrus.3.Influence of acupoint magnetic therapy on cognitive function of aMCI patientsScores of MoCA?digit symbol and digit-span increased in the treatment group,while only scores of MoCA?digit symbol increased in the controlled group,the differences were all of high statistical significance(P<0.01),and differences between treatment group and controlled group were of statistical significance(P<0.05).Of all the cognitive domains in MoCA,view spatial function and executive function,recall were improved significantly,especially recall,other cognitive domains shown no significant improvement.4.Influence of acupoint magnetic therapy on ReHo and ALFF value in rs-fMRI of aMCI patients4.1 Influence of acupoint magnetic therapy on ReHo and ALFF value in rs-fMRI of aMCI patients in the treatment groupAfter treatment,ReHo value significantly increased in these brain regions:left medial frontal gyrus,inferior frontal gyrus,insula,amygdaloid,precentral gyrus,right inferior parietal lobule,cingulate gyrus;ReHo value significantly decreased in these brain regions:right middle temporal gyrus,left middle occipital gyrus and supramarginal gyrus.ALFF value significantly increased in these brain regions:right superior temporal gyrus,precuneus,lingual gyrus,fusiform gyrus and middle occipital gyrus;ALFF value significantly decreased in these brain regions:left superior temporal gyrus,right angular gyrus.4.2 Influence of acupoint magnetic therapy on ReHo and ALFF value in rs-fMRI of aMCI patients in the controlled groupAfter treatment,ReHo value significantly increased in these brain regions:right middle frontal gyrus?middle temporal gyrus and precentral gyrus,left superior frontal gyrus,inferior frontal gyrus,frontal pole and suprior temporal gyrus;ReHo value significantly decreased in these brain regions:right lingual gyrus.ALFF value significantly increased in these brain regions:right medial frontal lobe,superior temporal gyrus,inferior occipital gyrus,precentral gyrus,left lingual gyrus and postcentral gyrus.ALFF value significantly decreased in these brain regions:left middle frontal gyrus,right inferior parietal lobe and posterior-lateral prefrontal lobe.4.3 The comparison of ReHo and ALFF value in rs-fMRI of aMCI patients between treatment group and controlled groupCompare to the controlled group,in the treatment group ReHo value significantly increased in these brain regions:right superior frontal gyrus,middle temporal gyrus,inferior parietal lobe,left parahippocampus and superior occipital gyrus;ReHo value significantly decreased in these brain regions:left superior parietal lobe,right medial frontal gyrus and precentral gyrus.ALFF value significantly increased in these brain regions:left superior frontal gyrus,precuneus,superior occipital gyrus and right middle temporal gyrus.ALFF value significantly decreased in these brain regions:left superior temporal gyrus,right inferior parietal lobe and angular gyrus.Conclusion1.rTMS can strengthen spontaneous activity of cognitive-related brain regions in rs-fMRI,synchronize neurons activities and improve cognitive function;2.Acupoint magnetic therapy can strengthen spontaneous activity of cognitive-related brain regions in rs-fMRI,synchronize neurons activities and improve cognitive function,effects of magnetic therapy on "Tiaoshen Yizhi"acupoints were significantly better than that on Yangming meridians acupoints. |
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