针灸“四关穴”对阿尔茨海默病的脑功能网络调节机制研究

Alzheimer's disease (AD) is one of the major brain diseases which received more attention in recent years. The disconnection syndrome is the main pathophysiological mechanism leading to cognitive decline in AD patients. Both animal experiment and clinical observation have demonstrated that acupuncture can generate treatment effect on AD patients by moderating the neural pathway directly. However, the underlying mechanism remains unclear. By using resting state functional magnetic resonance imaging (fMRI) method, as well as acupuncture and neurology sciences, we will explore the multi-modality data analysis; compare brain connectivity and network parameters changes between pre- and post-acupuncture treatment; analyze the correlation between fMRI changes and neuropsychology test. The present study aims to elucidate the neural mechanism of acupuncture therapy on early AD, provide theoretical evidence from the perspective of functional connectivity. And furthermore, the study will screen the effective acupoints and evaluate therapeutic effect for clinical acupuncture therapy on AD.

阿尔茨海默病（AD）是近年来倍受关注的脑重大疾病之一，失连接综合症是导致AD认知功能下降的重要发病机制，动物实验和临床观察表明，针灸可通过直接调整神经通路产生治疗效应，但其机制仍不清楚。本课题拟通过静息态功能磁共振成像方法，并综合针灸学和神经科学，进行多模态数据融合分析，通过比较针灸"四关穴"治疗前后AD的脑功能连接以及脑网络参数改变，及其与神经心理学测量的相关性分析，阐明早期AD的针灸治疗机制，从功能连接角度为针灸治疗AD提供理论依据，并为临床早期AD治疗筛选有效穴位，客观评价针灸治疗AD的效果。

阿尔茨海默病（AD）是近年来倍受关注的脑重大疾病，作为老年痴呆的主要病因之一，严重影响患者生存质量，给家庭、社会带来巨大经济和精神负担。动物实验和临床观察表明，针灸有瞬时增加局部脑血流等治疗效应，但其长期效应仍不清楚。本研究共搜集109例受试者的临床、MRI多模态资料，并对患者进行随机双盲的针灸治疗及纵向随访，初步结果发现：.1. 轻度认知障碍（MCI）和AD患者的麦纳核、海马亚区、小脑亚区等重点脑区的全脑功能连接改变，可作为AD早期诊断及病程进展的MRI指标；.2. MCI和AD患者的全脑血流灌注减低，并出现显著铁沉积，可能是其发病因素之一；.3. 经规律针灸治疗后，MCI患者的认知下降得到改善，海马功能连接增强，并且二者具有相关性，证实了针灸治疗的长期疗效；.4. 规律针灸治疗后，AD患者的脑血流灌注明显增加，可能是针灸治疗发挥治疗作用的重要机制之一。.本项目对AD针灸治疗进行了全面系统研究，初步证实针灸治疗AD的长期效应，从功能连接及全脑灌注角度为针灸治疗AD提供理论依据，并为临床早期AD治疗筛选有效穴位，客观评价针灸治疗AD的效果奠定基础。