Effect of acupuncture on episodic memory for amnesia-type mild cognitive impairment: study protocol of a multicenter, randomized, controlled trial.

BACKGROUND: Amnesic mild cognitive impairment (aMCI) is the main subtype of mild cognitive impairment (MCI) and has the highest risk of conversion to Alzheimer's disease (AD) among all MCI subtypes. Episodic memory impairment is the early cognitive impairment of aMCI, which has become an important target for AD prevention. Previous clinical evidence has shown that acupuncture can improve the cognitive ability of MCI patients. This experiment aimed to observe the efficacy and neural mechanism of TiaoshenYizhi acupuncture on the episodic memory of patients with aMCI. METHODS: In this multicenter, parallel-group, double-blind, randomized controlled trial, 360 aMCI participants will be recruited from six subcenters and randomly assigned to the acupuncture group, sham acupuncture group, and control group. The acupuncture group will receive TiaoshenYizhi (TSYZ) acupuncture, the sham acupuncture group will use streitberger sham acupuncture, and the control group will only receive free health education. Participants in the two acupuncture groups will receive real acupuncture treatment or placebo acupuncture three times per week, 24 sessions over 8 consecutive weeks. The primary outcome will be global cognitive ability. Secondary outcomes will be a specific cognitive domain, including episodic memory and execution ability, electroencephalogram, and functional magnetic resonance imaging data. Outcomes will be measured at baseline and the fourth and eighth weeks after randomization. Repeated measurement analysis of variance and a mixed linear model will be used to observe the intervention effect. DISCUSSION: The protocol will give a detailed procedure to the multicenter clinical trial to further evaluate the efficacy and neural mechanism of TiaoshenYizhi acupuncture on episodic memory in patients with aMCI. From this research, we expect to provide clinical evidence for early aMCI management. TRIAL REGISTRATION: http://www.chictr.org.cn/edit.aspx?pid=142612&htm=4 , identifier: ChiCTR2100054009.

Effect of a Baduanjin intervention on the risk of falls in the elderly individuals with mild cognitive impairment: a study protocol for a randomized controlled trial.

BACKGROUND: Falls are a global public problem and may be an important cause of death in older adults. However, older adults with mild cognitive impairment(MCI) are more likely to fall and suffer more damage than older adults with normal cognitive function, which shows the importance of preventing falls. More and more evidence shows that Baduanjin can improve the balance function of the elderly and reduce the risk of falls in the elderly with MCI, but the mechanism is still unclear. The main purpose of this study is to verify the intervention effect of Baduanjin training on the risk of falls in elderly people with MCI and to elucidate the underlying mechanism of Baduanjin training in reducing the risk of falls in MCI patients. METHODS: In this prospective study, outcome assessor-blind, three-arm randomized controlled trial, a total of 72 eligible participants will be randomly allocated (1:1:1) into the 12-week Baduanjin exercise intervention (60 min per session, three sessions per week), the 12-week brisk walking group(60 min per session, three sessions per week) or the 12-week health education group. Primary outcome is the Fall-Risk Self-Assessment Questionnaire(FRQ), and secondary outcomes are fall efficacy index, gait assessment, balance function, lower limb muscle strength, cognitive function, activities of daily living(ADL) and MRI scans. In addition to the MRI scans, which will be measured before and after the intervention,other primary and secondary outcomes will be assessed at baseline, 6 weeks, and 12 weeks (at the end of the intervention) and after an additional 12-week follow-up period. The mixed linear model will be conducted to observe the intervention effects. DISCUSSION: This trial will investigate the effect of Baduanjin exercise on the prevention of falls in elderly individuals with MCI, explore the imaging mechanism of Baduanjin exercise to reduce the risk of falls in elderly individuals with MCI from the perspective of vestibular neural network, and provide strong evidence for Baduanjin exercise to reduce the risk of falls in elderly individuals with MCI, as well as provide new ideas and approaches for the central mechanism of Traditional Chinese Medicine(TRC) rehabilitation methods to intervene in falls in elderly. TRIAL REGISTRATION: Chictr.org.cn, ID: ChiCTR2200057520. Registered on 14 March 2022, https://www.chictr.org.cn/showproj.html?proj=146592 .

Phase Lag Index of Resting-State EEG for Identification of Mild Cognitive Impairment Patients with Type 2 Diabetes.

Mild cognitive impairment (MCI) is one of the important comorbidities of type 2 diabetes mellitus (T2DM). It is critical to find appropriate methods for early diagnosis and objective assessment of mild cognitive impairment patients with type 2 diabetes (T2DM-MCI). Our study aimed to investigate potential early alterations in phase lag index (PLI) and determine whether it can distinguish between T2DM-MCI and normal controls with T2DM (T2DM-NC). EEG was recorded in 30 T2DM-MCI patients and 30 T2DM-NC patients. The phase lag index was computed and used in a logistic regression model to discriminate between groups. The correlation between the phase lag index and Montreal Cognitive Assessment (MoCA) score was assessed. The α-band phase lag index was significantly decreased in the T2DM-MCI group compared with the T2DM-NC group and showed a moderate degree of classification accuracy. The MoCA score was positively correlated with the α-band phase lag index (r = 0.4812, moderate association, p = 0.015). This work shows that the functional connectivity analysis of EEG may offer an effective way to track the cortical dysfunction linked to the cognitive deterioration of T2DM patients, and the α-band phase lag index may have a role in guiding the diagnosis of T2DM-MCI.

Alterations in Corticocortical Vestibular Network Functional Connectivity Are Associated with Decreased Balance Ability in Elderly Individuals with Mild Cognitive Impairment.

The corticocortical vestibular network (CVN) plays an important role in maintaining balance and stability. In order to clarify the specific relationship between the CVN and the balance ability of patients with mild cognitive impairment (MCI), we recruited 30 MCI patients in the community. According to age and sex, they were 1:1 matched to 30 older adults with normal cognitive function. We evaluated balance ability and performed MRI scanning in the two groups of participants. We analyzed functional connectivity within the CVN based on the region of interest. Then, we performed a Pearson correlation analysis between the functional connection and the Berg Balance Scale scores. The research results show that compared with the control group, there were three pairs of functional connections (hMST_R−Premotor_R, PFcm_R−SMA_L, and hMST_L−VIP_R) that were significantly decreased in the CVNs of the MCI group (p < 0.05). Further correlation analysis showed that there was a significant positive correlation between hMST_R−Premotor_R functional connectivity and BBS score (r = 0.364, p = 0.004). The decline in balance ability and increase in fall risk in patients with MCI may be closely related to the change in the internal connection mode of the corticocortical vestibular network.