Effects and Neuroimaging Findings of Acupuncture for Amnestic Mild Cognitive Impairment: A Randomized Controlled Trial

Abstract Aim Due to the limited evidence, the effects and neuroimaging mechanisms of acupuncture for amnestic mild cognitive impairment (aMCI) are still needed to investigate. Our objectives were to assess the effects and investigate its therapy‐driven modification in functional neural response. Methods Right‐handed aMCI patients were enrolled and randomly assigned to an acupuncture group (AG) or a waitlist control group (WG) in the randomized clinical trial using computer‐generated randomization sequence method. Twenty normal cognition individuals were included in the normal control (NC) group. The primary outcomes were the changes in the Alzheimer's Disease Assessment Scale‐Cognitive (ADAS‐Cog) subscale score from baseline to the 12th and 24th week. Acupuncture's neural responses were investigated by detecting changes in regional homogeneity (ReHo), seed‐based functional connectivity (FC), and effective connectivity (EC) from baseline to the 12th week. Generalized estimating equations and correlational analyses were employed. Results Overall, 343 participants were screened, and 72 aMCI patients were included. The ADAS‐Cog score changes at Weeks 12 and 24 of AG were significantly higher than that of WG. In neural response, aMCI patients had higher ReHo in the left dorsolateral prefrontal cortex (DLPFC.L) compared to NCs. Acupuncture significantly reduced ReHo in the DLPFC.L and its FC with the left anterior cingulate cortex (ACC.L) compared to the WG. The causal evidence for decreased EC from the DLPFC.L to the ACC.L after acupuncture, which correlated with change in ADAS‐Cog score. Conclusion Acupuncture was effective in overall cognitive function in aMCI patients, and the effect was associated with the DLPFC.L‐ACC.L circuit.