Electroacupuncture to improve post-stroke cognitive function and modulate cerebral iron deposition: a randomized...

Area of Science:

• Neuroscience
• Integrative Medicine
• Medical Imaging

Background:

• Post-stroke cognitive impairment (PSCI) is a prevalent condition that impedes patient rehabilitation.
• Iron dysregulation and ferroptosis are implicated in PSCI pathogenesis, yet effective treatments targeting these mechanisms are scarce.
• Acupuncture's potential to enhance cognition warrants investigation, particularly its early-intervention effects and underlying iron-related mechanisms.

Purpose of the Study:

• To evaluate the efficacy of electroacupuncture (EA) in improving cognitive function in patients with ischemic stroke-related cognitive impairment (IS-CI).
• To explore the potential role of cerebral iron deposition, assessed via quantitative susceptibility mapping (QSM), in mediating EA's effects on cognition.
• To assess the feasibility and preliminary effects of early EA intervention for IS-CI and elucidate iron-related mechanisms.

Main Methods:

• A single-blind, randomized controlled trial involving 72 IS-CI patients randomized to receive either EA or sham EA (sEA) alongside standard care.
• Interventions administered 5 times weekly for 4 weeks, with cognitive function assessed using the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE).
• A substudy utilizing 3.0T QSM MRI to quantify regional cerebral iron and correlate changes with cognitive outcomes.

Main Results:

• Primary outcome: Change in MoCA scores from baseline to week 4.
• Secondary outcomes: Changes in MMSE, Modified Barthel Index (MBI), Hamilton Anxiety and Depression scales (HAMA, HAMD), Pittsburgh Sleep Quality Index (PSQI), and 3-month PSCI incidence.
• MRI substudy to investigate the relationship between cerebral iron levels and cognitive improvements.

Conclusions:

• This trial will provide insights into the effectiveness of EA for IS-CI and its impact on iron homeostasis.
• Findings may support EA as a therapeutic option for PSCI by targeting iron dysregulation.
• The study aims to establish a link between EA, cognitive function, and cerebral iron metabolism using advanced imaging techniques.