基于静息态低频振幅探讨针刺神庭、百会对脑小血管病认知功能障碍的中枢机制

基于静息态低频振幅探讨针刺神庭、百会对脑小血管病认知功能障碍的中枢机制摘要：本文针对脑小血管病认知功能障碍，探讨了针刺神庭、百会对其中枢机制的影响。采用静息态低频振幅测试方法，结合脑磁图扫描技术和行为学表现，研究了60例患者在针刺前后的脑功能状态变化情况，并与健康对照组进行比较。结果表明，针刺神庭、百会能显著提高脑区间相干性、增加脑部灰质体积，改善患者认知功能状态。其中，神庭主要影响前额叶-颞叶区域，百会主要影响颞叶-顶叶区域。此外，与其他针刺点相比，神庭、百会对脑小血管病认知功能障碍的中枢机制影响最为显著，可能与其改善血液循环、抗炎抗氧化等作用有关。

关键词：脑小血管病认知功能障碍；静息态低频振幅；神庭；百会；中枢机制

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