JMIR Publications

ABSTRACT

Background:

Alzheimer’s disease (AD) is the most common cause of dementia, accounting for 60–70% of all cases. Since there is still no treatment for dementia, early diagnosis and prevention are the best approaches. In this context, the cognitive reserve (CR) concept has received considerable attention in dementia researches with regard to prognosis. It originates from discrepancies between the degree of brain pathology and the clinical manifestations. Acupuncture, as a complementary intervention, has long been widely applied in neurological diseases in East Asia. At the macroscale level, how acupuncture stimulation affects neural activity concerning CR in normal aging and dementia is largely unknown.

Objective:

The aim of this study is to investigate the acute neural mechanisms of acupuncture stimulation concerning CR in normal aging and cognitively impaired group using neuroimaging method.

Methods:

This study is a randomized, placebo-controlled trial. Cognitively unimpaired (n=30) and cognitively impaired participants (n=30) will be randomly assigned to the verum or sham acupuncture groups. The verum acupuncture group will receive acupuncture stimulation at acupoints related to cognitive function and gain deqi sensation. The sham acupuncture group will receive superficial needling at non-acupoints not related to cognitive function. Each group will undergo cognitive function tests, functional near-infrared spectroscopy (fNIRS) imaging before and after acupuncture stimulation, and an assessment of CR. The primary outcomes would be differences in resting brain activities according to disease status, differences in resting brain connectivity before and after acupuncture stimulation between two groups, and changes in brain activity in relation with CR index. The secondary outcomes would be brain connectivity or network metrics associated with CR and differences in neural activity between the cognitive task and resting states.

Results:

The recruitment began in August 2023 and, to date, there have been the 50 participants, divided into 20 in the cognitively impaired group and 30 in the unimpaired group. The recruitment process will continue until February 2025.

Conclusions:

CR refers to the individual susceptibility to age-related brain changes and pathologies in cognitive impairment, thus a factor affecting the trajectories of the disease. Although acupuncture is a widely used intervention for various neurological diseases, including dementia, its mechanism associated with CR at the macroscale has not been clearly identified. This study could contribute to identify the neural mechanisms of acupuncture stimulation associated with CR using neuroimaging method and provide a basis for future longitudinal researches. Clinical Trial: Clinical Research Information Service of the Republic of Korea (CRIS), one of the WHO ICTRP Primary Registries; KCT0008719 (https://cris.nih.go.kr/cris/search/detailSearch.do/25391)