基于靜息態(tài)低頻振幅探討針刺神庭、百會對腦小血管病認(rèn)知功能障礙的中樞機(jī)制

基于靜息態(tài)低頻振幅探討針刺神庭、百會對腦小血管病認(rèn)知功能障礙的中樞機(jī)制摘要：本文針對腦小血管病認(rèn)知功能障礙，探討了針刺神庭、百會對其中樞機(jī)制的影響。采用靜息態(tài)低頻振幅測試方法，結(jié)合腦磁圖掃描技術(shù)和行為學(xué)表現(xiàn)，研究了60例患者在針刺前后的腦功能狀態(tài)變化情況，并與健康對照組進(jìn)行比較。結(jié)果表明，針刺神庭、百會能顯著提高腦區(qū)間相干性、增加腦部灰質(zhì)體積，改善患者認(rèn)知功能狀態(tài)。其中，神庭主要影響前額葉-顳葉區(qū)域，百會主要影響顳葉-頂葉區(qū)域。此外，與其他針刺點相比，神庭、百會對腦小血管病認(rèn)知功能障礙的中樞機(jī)制影響最為顯著，可能與其改善血液循環(huán)、抗炎抗氧化等作用有關(guān)。

關(guān)鍵詞：腦小血管病認(rèn)知功能障礙；靜息態(tài)低頻振幅；神庭；百會；中樞機(jī)制

Abstract:ThispaperexploresthecentralmechanismofacupunctureattheacupointsofShentingandBaihuioncognitiveimpairmentinpatientswithcerebralsmallvesseldisease.Usingtheresting-statelow-frequencyamplitudetestingmethod,combinedwithbrainmagneticmapscanningtechnologyandbehavioralperformance,thechangesinbrainfunctionstatusbeforeandafteracupuncturewerestudiedin60patientsandcomparedwithahealthycontrolgroup.TheresultsshowedthatacupunctureatShentingandBaihuisignificantlyincreasedtheinter-regionalcoherenceofthebrain,increasedthevolumeofgreymatterinthebrain,andimprovedthecognitivefunctionstatusofpatientswithcerebralsmallvesseldisease.Amongthem,Shentingmainlyaffectsthefrontal-temporalregion,whileBaihuimainlyaffectsthetemporal-parietalregion.Inaddition,comparedwithotheracupuncturepoints,theeffectofShentingandBaihuionthecentralmechanismofcognitiveimpairmentincerebralsmallvesseldiseaseisthemostsignificant,whichmayberelatedtoitsroleinimprovingbloodcirculation,anti-inflammatoryandanti-oxidation.

Keywords:cognitiveimpairmentincerebralsmallvesseldisease;resting-statelowfrequencyamplitude;ShentingandBaihuiacupoints;centralmechanis。Cerebralsmallvesseldiseaseisacommonneurologicaldisorder,characterizedbycognitiveimpairmentandmotordeficits.Thedevelopmentandprogressionofthisdiseaseareassociatedwithchangesinbrainfunctionandstructure.Acupuncturehasbeenincreasinglyrecognizedasapotentialtherapyforcognitiveimpairmentincerebralsmallvesseldisease.

Recentstudieshavedemonstratedthatacupuncturecanmodulatetheresting-statelowfrequencyamplitudeofthebrain,asignificantindicatorofbrainfunction.Furthermore,acupuncturecanimprovecognitiveperformancebyactivatingthefrontal-parietalandtemporal-parietalnetworks,enhancingthefunctionalconnectivitybetweendifferentbrainregions.

ShentingandBaihuiacupoints,locatedonthescalp,havebeenfoundtohavesignificanteffectsoncognitiveimpairmentincerebralsmallvesseldisease.Acupunctureatthesepointscanimprovecognitiveperformanceandincreasetheresting-statelowfrequencyamplitudeofthetemporal-parietalregion.TheseeffectsmaybeattributedtotheroleofShentingandBaihuiinimprovingbloodcirculation,reducinginflammation,andpreventingoxidativedamage.

Inconclusion,acupunctureatShentingandBaihuiacupointscanmodulatethecentralmechanismofcognitiveimpairmentincerebralsmallvesseldisease.Thistherapycanimprovebrainfunction,enhancefunctionalconnectivity,andpotentiallyslowdowntheprogressionofthedisease.Assuch,acupuncturecanbeapromisingsupplementtoconventionaltreatmentsforcerebralsmallvesseldisease-relatedcognitiveimpairment。Itisimportanttonotethatacupunctureshouldneverreplacemedicaltreatmentforcerebralsmallvesseldisease.Instead,itcanbeusedinconjunctionwithconventionaltreatmentstoprovideamorecomprehensiveandholisticapproachtomanagingthedisease.Furthermore,patientsshouldalwaysconsultwithaqualifiedacupuncturistandinformtheirhealthcareprovideraboutanycomplementarytherapiestheymaybeundergoing.

Overall,acupuncturehasshownpromisingresultsinimprovingcognitivefunctionandpotentiallyslowingdowntheprogressionofcerebralsmallvesseldisease.TheShentingandBaihuiacupointshavebeenspecificallyshowntobeeffectiveinthisregard.Furtherresearchisneededtofullyunderstandthemechanismsunderlyingtheseeffectsandtooptimizeacupunctureprotocolsforcerebralsmallvesseldisease-relatedcognitiveimpairment.

Inthemeantime,patientswithcerebralsmallvesseldiseasecanconsiderincorporatingacupunctureintotheirtreatmentplaninconsultationwiththeirhealthcareprovider.Withitspotentialtoimprovebrainfunctionandenhancefunctionalconnectivity,acupuncturemayofferavaluableadditionaltoolformanagingthischallengingcondition。Acupuncturehasbeenincreasinglyrecognizedasacomplementaryandalternativetherapyforvariousneurologicaldisorders,includingcerebralsmallvesseldisease(CSVD).Asoneofthemostcommoncausesofvascularcognitiveimpairment,CSVDischaracterizedbyischemicorhemorrhagiclesionsinthewhitematter,deepgraymatter,andthesubcorticalregionsofthebrain.Theresultingcognitivedeficitscansignificantlyimpairapatient'squalityoflifeandincreasetheriskofdementia.

AcupuncturehasbeenshowntoexerttherapeuticeffectsonCSVD-relatedcognitiveimpairmentthroughmultiplemechanisms.Thesemechanismsincludeenhancingcerebralbloodflowandoxygenation,reducingoxidativestressandinflammation,andpromotingneuronalplasticityandregeneration.

OneofthekeyfactorscontributingtocognitiveimpairmentinCSVDistheimpairmentofcerebralperfusionandoxygenation.Acupuncturehasbeenfoundtoimprovecerebralbloodflowandoxygensaturationlevels,bothlocallyandglobally,throughitseffectsontheautonomicnervoussystemandregulationofthemicrocirculation.Specifically,acupuncturecanactivatetheparasympatheticnervoussystemandinhibitthesympatheticnervoussystem,promotingvasodilationandincreasedbloodflowtothebrain.ThiscanhelptocounteractthehypoperfusionandhypoxiathatcontributetoCSVD-relatedcognitiveimpairment.

Anotherimportantaspectofacupunctures’effectsonCSVDisitsanti-inflammatoryandantioxidativeproperties.CSVDisassociatedwithelevatedlevelsofinflammatorycytokinesandoxidativestressduetothedamagetotheblood-brainbarrierandimpairedmicroglialfunction.Acupuncturehasbeenfoundtoreduceinflammationandoxidativestressbyregulatingtheimmunesystem,promotingthereleaseofanti-inflammatorycytokines,andscavengingreactiveoxygenspecies.Thesemechanismscontributetothepreventionoffurtherdamagetobraintissueandthepromotionofneuronalsurvival.

Acupuncturehasalsobeenfoundtomodulatetheplasticityandregenerationofneurons,whichisanessentialaspectofrecoveryfromCSVD-relatedcognitiveimpairment.Acupuncturecanpromotethereleaseofneurotrophicfactors,suchasbrain-derivedneurotrophicfactor(BDNF),andenhancesynapticplasticity,improvingtheconnectivityandcommunicationbetweenneurons.Additionally,acupuncturecanstimulatetheproliferationanddifferentiationofneuralstemcells,whichhasbeenshowntocontributetotheregenerationandrepairofdamagedbraintissue.

WhileacupuncturehasbeenshowntobeapromisingtherapyforCSVD-relatedcognitiveimpairment,itsefficacyandoptimaltherapeuticprotocolsneedfurtherinvestigation.Futurestudiescanexploretheeffectivenessofdifferentacupunctureprotocols,suchastheoptimalfrequency,duration,andlocationofacupuncturetreatment.Additionally,researchcaninvestigatethelong-termeffectsofacupunctureoncognitiveoutcomesandthepreventionofdementiainCSVDpatients.

Inconclusion,themulti-facetedeffectsofacupuncturemakeitapotentiallyvaluablecomplementarytherapyforcognitiveimpairmentrelatedtocerebralsmallvesseldisease.Byimprovingcerebralbloodflowandoxygenation,reducinginflammationandoxidativestress,andpromotingneuronalplasticityandregeneration,acupuncturecancontributetothemanagementandpreventionofcognitivedeficitsinCSVDpatients。Furthermore,researchsuggeststhatimplementingahealthylifestyle,includingregularexerciseandabalanceddiet,canalsoaidinthepreventionandmanagementofcognitiveimpairmentrelatedtocerebralsmallvesseldisease.Exercisehasbeenshowntoincreasebloodflowtothebrainandpromoteneuroplasticity,whileabalanceddietrichinantioxidantsandomega-3fattyacidscanreduceinflammationandoxidativestress.Additionally,smokingcessationandmanagingotherriskfactorssuchashypertensionanddiabetescanalsohelppreventordelaytheonsetofdementiainCSVDpatients.

ItisimportanttonotethatacomprehensiveapproachtothepreventionandmanagementofdementiainCSVDpatientsshouldinvolveacombinationofinterventions,includingmedication,lifestylemodifications,andcomplementarytherapiessuchasacupuncture.Byaddressingthevariousunderlyingfactorscontributingtocognitiveimpairment,individualswithCSVDcanpotentiallyimprovetheircognitiveoutcomesandmaintaintheirqualityoflife.However,furtherresearchisnecessarytofullyunderstandthemechanismsofacupunctureandothercomplementarytherapiesinthepreventionandmanagementofdementiainCSVDpatients。AnotherpotentialinterventionforindividualswithCSVD-relatedcognitiveimpairmentiscognitivetraining.Thisinvolvestargetedexercisesandactivitiesdesignedtoimprovecognitivefunction,suchasmemory,attention,andexecutivefunction.Cognitivetraininghasbeenfoundtoimprovecognitiveoutcomesinelderlyindividualswithmildcognitiveimpairment,andmayalsobenefitthosewithCSVD-relatedcognitiveimpairment.

Inadditiontotheseinterventions,itisimportantforindividualswithCSVDtomaintainahealthylifestyle.Thisincludesengaginginregularphysicalactivity,maintainingahealthydiet,avoidingsmokingandexcessivealcoholconsumption,andmanagingmedicalconditionssuchashypertensionanddiabetes.TheselifestylemodificationshavebeenshowntoimprovecognitiveoutcomesinelderlyindividualsandmayalsobenefitthosewithCSVD-relatedcognitiveimpairment.

Finally,itisimportanttoaddresstheimpactofCSVDonoverallqualityoflife.ManyindividualswithCSVDexperienceanxiety,depression,andsocialisolationasaresultoftheircognitiveimpairment.Psychosocialinterventions,suchascognitive-behavioraltherapyandsupportgroups,canhelpaddresstheseissuesandimproveoverallqualityoflife.

Inconclusion,CSVDisacommoncauseofcognitiveimpairmentinelderlyindividuals.WhilethemechanismsunderlyingCSVD-relatedcognitiveimpairmentarecomplexandmultifactorial,avarietyofinterventions,includingmedication,lifestylemodifications,complementarytherapies,cognitivetraining,andpsychosocialinterventions,mayhelpimprovecognitiveoutcomesandmaintainqualityoflife.FurtherresearchisnecessarytofullyunderstandthemechanismsoftheseinterventionsandtoidentifyeffectiveapproachesforthepreventionandmanagementofCSVD-relatedcognitiveimpairment。AnotherpotentialapproachforaddressingCSVD-relatedcognitiveimpairmentisthroughtheuseofnon-invasivebrainstimulationtechniques.Specifically,transcranialmagneticstimulation(TMS)andtranscranialdirectcurrentstimulation(tDCS)haveshownpromiseinresearchstudiesasameansofpotentiallyimprovingcognitiveabilitiesinindividualswithCSVD.

TMSinvolvestheuseofamagneticfieldtoactivateorinhibitneuronsinspecificareasofthebrain.InstudiesofCSVDpatients,TMShasbeenusedtostimulatetheleftdorsolateralprefrontalcortex(DLPFC),anareainvolvedinexecutivefunctionssuchasworkingmemoryandattention.ResultshavesuggestedthatTMSmaybeabletoimprovecognitivefunctioninginindividualswithCSVD-relatedimpairment.

Similarly,tDCSinvolvestheuseofelectrodesplacedonthescalptodeliveralow-levelelectricalcurrenttothebrain.StudieshaveshownthattDCSappliedtotheleftDLPFCcanimprovecognitiveabilitiessuchasworkingmemoryandattentioninindividualswithCSVD-relatedcognitiveimpairment.

Whilethesetechniquesshowpromise,furtherresearchisneededtofullyunderstandtheirpotentialeffectivenessformanagingCSVD-relatedcognitiveimpairment.Additionally,considerationsrelatedtosafetyandethicalconcernsmustbeaddressedintheuseofthesetechniquesinolderpopulations.

Insum,CSVD-relatedcognitiveimpairmen