| Objective:To assess the impact of acupuncture therapy on cognitive function and daily self-care ability in patients with post-stroke cognitive impairment(PSCI).To explore the changes of brain function network in patients with PSCI after acupuncture therapy intervention.To preliminarily judge the therapeutic effect of acupuncture therapy on PSCI and related brain network mechanisms underlying this effect.Methods:30 PSCI patients were recruited from November 2019 to November 2020 in Department of Neurology,Affiliated Hospital of North Sichuan Medical College.The patients were Randomly divided into acupuncture acupoint group(n=20)and acupuncture non-acupoint group(n=10)according to the random number table.The acupuncture acupoint group were treated with acupuncture at acupoints of internal level,Baihui and Sishencong acupoints,and the acupuncture non-acupoint group were treated with acupuncture at non-acupoints(around 2cm corresponding to the acupoints).Both of the two groups were given corresponding treatment for 5 consecutive days a week,in a total of two weeks.The Mini mental state assessment scale(MMSE),Montreal Cognitive Assessmentme(MOCA),Barthel index and the resting-state functionalal Magnetic Resonance Imaging(rs-fMRI)were evaluated before and after treatment.All data were run on spss 25.0 statistical software.The paired t test and Chi-Square test were used to compare the general clinical data of the two groups(including sex,average age,single/double antibody,Hamilton Depression Scale,etc.).The Shapiro-Wilk test(W test)was used to judge whether the data conformed to the normal distribution.The data that conformed to the normal distribution were represented by the mean±standard deviation(x±s),and the t test was used for statistical analysis.The changes in the two groups before and after treatment,the baseline level before and after intergroup treatment,and the difference between the groups before and after treatment were compared,and P<0.05 was considered statistically significant.Matlab software was used to pre-process data on the Matlab platform,and further to build a functional network.The AAL functional template(including 90 regions)was used to calculate the average time signal sequence of each brain area,and to make a Pearson-related analysis to the average time series of any two brain areas,in that resulting in a correlation coefficient matrix.Then to build a functional network by setting the threshold to binary the matrix,and set the sparsity of 0.1-0.28 with a step length of 0.01.The brain network node attributes were calculated for all subjects in two groups.The independent sample t test was applied before and after treatment,and the paired sample t test was used after treatment in two groups.Pearson correlation analysis between MMSE,MOCA and the indicators with difference in node characteristics was made,and P<0.05 was considered statistically significant.Results:(1)General clinical data:17 subjects in acupuncture acupoint group and 8 in acupuncture non-acupoint groups were finally analyzed.The sex,age,use of single/double antiplatelet drugs,Hamilton Depression Scale score and risk factors had no statistically significant differences between the two groups(P>0.05),which means the two groups are comparable.(2)Scale:(1)The differences in the scores of MMSE and MOCA before and after treatment in the two groups were statistically significant(P<0.05 for both).There was no statistical difference in the baseline scores of MMSE and MOCA before treatment between the two groups(P>0.05),which means they are comparable.The differences in MMSE and MOCA total scores before and after treatment in the two groups were both statistically significant(P<0.05).(2)Barthel index:the changes of the total score of the Barthel index before and after treatment in both groups were statistically significant(P<0.05).There was no statistical difference in the baseline level before treatment between the two groups(P>0.05),which implies the two groups are comparable.The difference in the scores of Barthel index before and after treatment was not statistically significant(P>0.05).(3)rs-fMRI:14 patients in acupoint group and 7 in non-acupoint group were finally analyzed.(1)Degree centrality:higher regions in degree centrality after acupoint treatment:left hippocampus,left back cingulate gyrus,left spindle gyrus,left lateral gyrus;reduced area in degree centricity:right extrus(P<0.05).Increased regions in degree centrality after non-acupoint treatment:upper left lateral forehead,The right inferior occipital gyrus,the left parietal inferior angular gyrus,and the right transverse temporal gyrus;the decreased areas in degree centrality:middle right forehead,lower forehead of right island cover,left middle occipital gyrus(P<0.05).The increased areas of degree centrality after treatment in acupoint group when compared with non-acupoint group:left lingual gyrus,right lingual gyrus,left inferior occipital gyrus;the decreased regions of degree centrality:median frontal gyrus of the right orbit(P<0.05).(2)Analysis of the correlation between node degree centrality and scale:the AUC of the degree centrality in the left suboccipital gyrus after treatment with acupuncture at acupoint was negatively correlated with the score of MOCA(r=-0.461,P=0.031).Conclusion:(1)Compared with routine and rehabilitation treatment,acupuncture therapy(Inner Pass,Baihui,Sishen Cong)shows further improvement on the cognitive function in patients with PSCI.(2)Acupuncture therapy(Inner Pass,Baihui,Sishencong)may improved effect on the independent living ability of patients with PSCI.(3)The areas of changes in degree centrality are different between acupoint treatment and non-acupoint treatment in patients with PSCI.A lot of regions related to cognition in the brains show increased degree centrality,which include left parahippocampal gyrus,left posterior cingulate gyrus,left fusiform gyrus,left transverse temporal gyrus,and left suboccipital gyrus.(4)The improvements in cognitive impairment in patients with PSCI after acupoint treatment may be achieved in part by regulating cognitive-related brain networks,especially the left suboccipital brain network,and finally reaching a new balance. |
PDF Full Text Request