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Selective Plasticity of Hippocampal Sub-Regions in the Amnestic Mild Cognitive Impairment After Acupuncture
Jinhuan Zhang1,2, Bin Yan1,2, Yongfeng Liu1,2
1Department of Acupuncture, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.
Background:
Acupuncture has been demonstrated to be effective in reducing cognitive decline in patients with amnestic mild cognitive impairment (aMCI). Hippocampal atrophy has been typically reported as a core neuromechanism in the aMCI. However, whether and how hippocampal subregions plasticity exists in aMCI after acupuncture remains largely unknown.
Objectives:
We aimed to explore gray matter alterations in the hippocampal subregions of aMCI after acupuncture.
Methods:
A randomized, controlled, blind research was conducted. A cohort of 53 patients with aMCI was randomly assigned to either the verum acupuncture (VA) group or the sham acupuncture (SA) group. Each group received 24 treatment sessions (three times per week for 8 weeks). Clinical evaluation and magnetic resonance imaging scans were performed at baseline and after treatment for all patients with aMCI. Hippocampal subfield volumes were analyzed using Freesurfer 7.1.1. An interaction effect was used to explore the efficacy of acupuncture. In addition, a correlation analysis was performed to investigate the relationships between the volume of hippocampal subregions and cognitive function in patients with aMCI.
Results:
Mixed-effects analysis revealed a significant group × time interaction for volume in the right subiculum body (p = 0.006), where volume significantly decreased following SA (p = 0.015) but increased following VA. Within-group effects showed that VA significantly increased volume in the right GC-ML-DG head (p = 0.041) and right CA4 body (p = 0.028), while SA increased volume in the right CA4-head (p = 0.035). Directly comparing the magnitude of change between interventions, VA led to significantly greater volume increases than SA in the right subiculum body (p = 0.008), right CA1-body (p = 0.042), whole hippocampus body (p = 0.041), and whole hippocampus (p = 0.028). Clinically, within the VA group, the increase in right subiculum body volume was significantly correlated with improvement in AVLT_N5 (delayed recall) scores (p = 0.013).
Conclusion:
These results suggested that acupuncture could selectively induce structural plasticity in hippocampal subregions associated with cognitive effects in patients with aMCI, which provided potential biomarkers-particularly the right subiculum body-for effective and timely interventions for aMCI.
Trial Registration:
Chinese Clinical Trial Registry (http://www.chictr.org.cn), Registration number: ChiCTR2400084308.
