Effect of acupuncture at the acupoints for Yizhi Tiaoshen on the functional connectivity between the hippocampus and the brain in the patients with Alzheimer's disease / 中国针灸

OBJECTIVES@#To analyze the effect of acupuncture at the acupoints for Yizhi Tiaoshen (benefiting the intelligence and regulating the spirit) on the functional connectivity between the hippocampus and the whole brain in the patients with Alzheimer's disease (AD), and reveal the brain function mechanism of acupuncture in treatment of AD using resting state functional magnetic resonance imaging (rs-fMRI).@*METHODS@#Sixty patients with mild to moderate AD were randomly divided into an acupuncture + medication group (30 cases, 3 cases dropped out) and a western medication group (30 cases, 2 cases dropped out). In the western medication group, the donepezil hydrochloride tablets were administered orally, 2.5 mg to 5 mg each time, once daily; and adjusted to be 10 mg each time after 4 weeks of medication. Besides the therapy as the western medication group, in the acupuncture + medication group, acupuncture was supplemented at the acupoints for Yizhi Tiaoshen, i.e. Baihui (GV 20), Sishencong (EX-HN 1), and bilateral Shenmen (HT 7), Neiguan (PC 6), Zusanli (ST 36), Sanyinjiao (SP 6) and Xuanzhong (GB 39). The needles were retained for 30 min in one treatment, once daily; and 6 treatments were required weekly. The duration of treatment was 6 weeks in each group. The general cognitive function was assessed by the mini-mental state examination (MMSE) and Alzheimer's disease assessment scale-cognitive part (ADAS-Cog) before and after treatment in the two groups. Using the rs-fMRI, the changes in the functional connectivity (FC) of the left hippocampus and the whole brain before and after treatment were analyzed in the patients of the two groups (11 cases in the acupuncture + medication group and 12 cases in the western medication group).@*RESULTS@#After treatment, compared with those before treatment, MMSE scores increased and ADAS-Cog scores decreased in the two groups (P<0.05); MMSE score was higher, while the ADAS-Cog score was lower in the acupuncture + medication group when compared with those in the western medication group (P≤0.05). After treatment, in the western medication group, FC of the left hippocampus was enhanced with the left fusiform gyrus, the inferior frontal gyrus of the left triangular region, the bilateral superior temporal gyrus and the right superior parietal gyrus (P<0.05), while FC was weakened with the left inferior temporal gyrus, the left middle frontal gyrus and the right dorsolateral superior frontal gyrus when compared with that before treatment (P<0.05). After treatment, in the acupuncture + medication group, FC of the left hippocampus was increased with the right gyrus rectus, the left inferior occipital gyrus, the right superior temporal gyrus and the left middle occipital gyrus (P<0.05), and it was declined with the left thalamus (P<0.05) when compared with those before treatment. After treatment, in the acupuncture + medication group, FC of the left hippocampus was strengthened with the bilateral inferior temporal gyrus, the bilateral middle temporal gyrus, the right gyrus rectus, the bilateral superior occipital gyrus, the left lenticular nucleus putamen, the left calcarine fissure and surrounding cortex, the inferior frontal gyrus of the left insulae operculum, the left medial superior frontal gyrus and the right posterior central gyrus (P<0.05) compared with that of the western medication group.@*CONCLUSIONS@#Acupuncture at the acupoints for Yizhi Tiaoshen improves the cognitive function of AD patients, and its main brain functional mechanism is related to intensifying the functional connectivity of the left hippocampus with the default network (inferior temporal gyrus, middle temporal gyrus and superior frontal gyrus, gyrus rectus), as well as with the sensory (posterior central gyrus) and visual (calcarine fissure and surrounding cortex and superior occipital gyrus) brain regions.

Experimental research on forecasting index of biological image aerobic exercise analysis of artificial neural network / Pesquisa experimental sobre índice de previsão de imagem biológica análise de exercício aeróbio de rede neural artificial / Investigación experimental sobre índice de pronóstico de imágenes biológicas análisis de ejercicio aeróbico de redes neuronales artificiales

ABSTRACT Objective: The paper uses artificial neural network images to explore the effects of aerobic exercise on the gamma rhythm of theta period in the awake hippocampal CA1 area of APP/PS1/tau mice and the low-frequency gamma rhythm of the sleep state hippocampal CA1 area SWR period. Methods: Clean grade 6-month-old APP/PS1/tau mice were randomly divided into quiet group (AS) and exercise group (AE), C57BL/6J control group mice were randomly divided into quiet group (CS) and exercise group (CE). The AE group and the CE group performed 12-week treadmill exercise, 5d/week, 60min/d, the first 10min exercise load was 12m/min, the last 50min was 15m/min treadmill slope was 0°. Eight-arm maze detection of behavioral changes in mice; multi-channel in vivo recording technology to record the electrical signals of the awake state and sleep state in the hippocampal CA1 area, MATLAB extracts the awake state theta period and sleep state SWR period, multi-window spectrum estimation method Perform time-frequency analysis and power spectral density analysis. Results: 12 weeks of aerobic exercise can significantly improve the working memory and reference memory of the AS group, increase the gamma energy in theta period of the awake hippocampus CA1 area and the low-frequency gamma energy in the sleep state CA1 area SWR period. Conclusions: Aerobic exercise can improve the neural network state of the AD model and increase the gamma energy in theta period of the hippocampus CA1 area, and the low-frequency gamma energy in the SWR period is one of the neural network mechanisms for its overall behavioral improvement. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Objetivo: o artigo usa imagens de redes neurais artificiais para explorar os efeitos do exercício aeróbio no ritmo gama do período teta na área CA1 do hipocampo desperto de camundongos APP/PS1/tau e o ritmo gama de baixa frequência da área CA1 do hipocampo do estado de sono Período SWR. Métodos: Camundongos APP/PS1/tau de grau limpo de 6 meses de idade foram divididos aleatoriamente em grupo quieto (AS) e grupo de exercício (AE), os camundongos do grupo controle C57BL/6J foram divididos aleatoriamente em grupo quieto (CS) e grupo de exercício (CE). O grupo AE e o grupo CE realizaram 12 semanas de exercício em esteira, 5d/semana, 60min/d, a primeira carga de exercício de 10min foi de 12m/min, a última de 50min foi de 15m/min e a inclinação da esteira foi de 0 °. Detecção de labirinto de oito braços de mudanças comportamentais em camundongos; tecnologia de gravação in vivo multicanal para registrar os sinais elétricos do estado de vigília e do estado de sono na área CA1 do hipocampo, MATLAB extrai o período de tempo teta do estado de vigília e o período de tempo SWR do estado de sono, método de estimativa de espectro de múltiplas janelas. e análise de densidade espectral de potência. Resultados: 12 semanas de exercícios aeróbicos podem melhorar significativamente a memória de trabalho e a memória de referência do grupo AS, aumentar a energia gama no período teta da área CA1 do hipocampo acordado e a energia gama de baixa frequência na área CA1 do estado de sono período SWR. Conclusões: O exercício aeróbico pode melhorar o estado da rede neural do modelo AD e aumentar a energia gama no período teta da área CA1 do hipocampo e a energia gama de baixa frequência no período SWR é um dos mecanismos da rede neural para seu comportamento geral. Nível de evidência II; Estudos terapêuticos- investigação dos resultados do tratamento.

RESUMEN Objetivo: El artículo utiliza imágenes de redes neuronales artificiales para explorar los efectos del ejercicio aeróbico en el ritmo gamma del período theta en el área CA1 del hipocampo despierto de ratones APP/PS1/tau y el ritmo gamma de baja frecuencia del área CA1 del hipocampo en estado de sueño. Período de ROE. Métodos: Se dividieron aleatoriamente ratones APP/PS1/tau de 6 meses de edad de grado limpio en grupo tranquilo (AS) y grupo de ejercicio (AE), los ratones del grupo de control C57BL/6J se dividieron aleatoriamente en grupo tranquilo (CS) y grupo de ejercicio (CE). El grupo de EA y el grupo de EC realizaron 12 semanas de ejercicio en cinta rodante, 5 días a la semana, 60 min/d, la primera carga de ejercicio de 10 min fue de 12 m/min, los últimos 50 min fueron de 15 m/min y la pendiente de la cinta fue de 0 °. Detección en laberinto de ocho brazos de cambios de comportamiento en ratones; tecnología de grabación in vivo multicanal para registrar las señales eléctricas del estado despierto y del estado de sueño en el área CA1 del hipocampo, MATLAB extrae el período de tiempo theta del estado despierto y el período de tiempo de SWR del estado de suspensión, método de estimación de espectro de múltiples ventanas Realizar análisis de tiempo-frecuencia y análisis de densidad espectral de potencia. Resultados: 12 semanas de ejercicio aeróbico pueden mejorar significativamente la memoria de trabajo y la memoria de referencia del grupo AS, aumentar la energía gamma en el período theta del área CA1 del hipocampo despierto y la energía gamma de baja frecuencia en el período SWR del área CA1 del estado de sueño. Conclusiones: El ejercicio aeróbico puede mejorar el estado de la red neuronal del modelo AD y aumentar la energía gamma en el período theta del área del hipocampo CA1 y la energía gamma de baja frecuencia en el período SWR es uno de los mecanismos de la red neuronal para su comportamiento general. Nivel de evidencia II; Estudios terapéuticos- investigación de los resultados del tratamiento.

Dynamic change of hippocampal volume in children with recurrent febrile seizures / 中国当代儿科杂志

OBJECTIVE@#To study the change and significance of hippocampal volume (HCV) in children with recurrent febrile seizures.@*METHODS@#A retrospective analysis was performed on the medical data and examination results of 34 children with recurrent febrile seizures who underwent two magnetic resonance plain scans of the head and the hippocampus from January 1, 2013 to September 30, 2019. According to the follow-up time, they were divided into the first follow-up group and the second follow-up group. According to prognosis, they were divided into a febrile seizure group, a non-febrile group and an epilepsy group. The change in HCV was analyzed and compared.@*RESULTS@#Total HCV was positively correlated with age (@*CONCLUSIONS@#HCV gradually increases with age in children with recurrent febrile seizures. Persistent seizures may damage the development of the hippocampus.

Structural Volume of Hippocampus and Alzheimers Disease

RESUMO Pesquisas recentes demonstram que o hipocampo apresenta uma redução de volume no final da idade adulta, mantendo uma estreita relação com o declínio cognitivo. A aquisição da imagem por diversos métodos de medição de volume nos leva a encontrar na ressonância magnética o método de destaque, pois permite quantificar o volume de determinadas estruturas cerebrais utilizando a reconstrução computadorizada tridimensional das imagens obtidas. OBJETIVOS Confirmar a existência de diferenças entre o volume hipocampal e o declínio cognitivo leve, doença de Alzheimer e cognição normal. MÉTODOS Levantamento bibliográfico de estudos que apresentassem dados referentes aos distúrbios da doença de Alzheimer, alterações macroscópicas cerebrais detectadas com softwares na ressonância magnética e segmentação. Foram adicionados estudos apenas da medição volumétrica do hipocampo, objetivando-se chegar a valores que possam estabelecer uma correlação do menor valor estrutural hipocampal e risco de desenvolvimento da doença. RESULTADOS Um total de 1.070 indivíduos foi analisado em seis estudos clínicos, demonstrando a relação da diminuição do hipocampo na neuroimagem, correlacionado com o comprometimento cognitivo leve e doença de Alzheimer. CONCLUSÕES O desenvolvimento de um valor padrão para esse fim seria bastante útil na coleta de dados, permitindo melhor compreensão de algumas alterações que podem ocorrer na cognição, determinar valores prognósticos e até, em um futuro próximo, fator de risco imagiológico para a doença.

Global hippocampal atrophy in major depressive disorder: a meta-analysis of magnetic resonance imaging studies / Atrofia global do hipocampo no transtorno depressivo maior: uma metanálise de estudos com ressonância magnética

Abstract Introduction: Major depressive disorder (MDD), an incapacitating mental disorder, is characterized by episodes of at least 2 weeks of apparent changes in mood, cognition, and neurovegetative functions. Many neuroimaging studies using magnetic resonance imaging (MRI) have examined morphometric changes in patients with MDD, but the results are not conclusive. This study aims to review the literature and perform a meta-analysis on hippocampal volume (HcV) in patients with MDD. Methods: Studies on HcV in patients with MDD diagnosis were identified from major databases (MEDLINE, EMBASE, The Cochrane Library, Scopus, PsycINFO, and SciELO) using the search terms depression, major depressive disorder, MDD, unipolar, magnetic resonance imaging, MRI, and hippocampus. Results: A meta-analysis of 29 studies fulfilling specific criteria was performed. The sample included 1327 patients and 1004 healthy participants. The studies were highly heterogeneous with respect to age, sex, age of onset, and average illness duration. However, the pooled effect size of depression was significant in both hippocampi. MDD was associated with right (-0.43; 95% confidence interval [95%CI] −0.66 to −0.21) and left (-0.40; 95%CI −0.66 to −0.15) hippocampal atrophy. Conclusions: MDD seems to be associated with global HcV atrophy. Larger longitudinal follow-up studies designed to analyze the influence of sociodemographic variables on this relationship are required to yield better evidence about this topic.

Resumo Introdução: O transtorno depressivo maior (TDM) é uma doença mental incapacitante caracterizada por episódios de pelo menos 2 semanas de mudanças claras no afeto, cognição e funções neurovegetativas. Vários estudos de neuroimagem, realizados através de imagem de ressonância magnética (IRM), examinaram mudanças morfométricas em pacientes com TDM, com resultados não conclusivos. Este estudo tem como objetivo revisar a literatura e realizar uma metanálise sobre o volume do hipocampo (VHc) em pacientes com TDM. Métodos: Estudos de VHc em pacientes com TDM foram identificados a partir dos principais bancos de dados (MEDLINE, EMBASE, The Cochrane Library, Scopus, PsycINFO e SciELO) usando os seguintes termos: depression, major depressive disorder, MDD, unipolar, magnetic resonance imaging, MRI e hippocampus. Resultados: Foi realizada uma metanálise de 29 estudos que preencheram os critérios específicos. A amostra foi composta por 1327 pacientes e 1004 indivíduos saudáveis. Os estudos foram altamente heterogêneos em relação a idade, gênero, idade do primeiro episódio e duração média da doença, mas o efeito combinado da depressão foi significativo em ambos os hipocampos. O TDM foi associado à atrofia do hipocampo à direita [-0,43; intervalo de confiança de 95% (IC95%) −0,66 a −0,21] e à esquerda (-0,40; IC95% −0,66 a −0,15). Conclusões: O TDM parece estar associado à atrofia global do VHc. Estudos longitudinais com maior tempo de seguimento, projetados para analisar a influência dos fatores sociodemográficos nessa relação, são necessários para obter evidências mais robustas.

Volumetría hipocampal: análisis comparativo de los métodos de evaluación en enfermedad de Alzheimer / Hippocampal Volumetry: Comparative Analysis of Evaluation Methods in Alzheimer's Disease

Objetivo La atrofia hipocampal es uno de los biomarcadores radiológicos más sensibles de la enfermedad de Alzheimer (EA) y existen diferentes métodos para evaluarla: análisis subjetivo visual (ASV), análisis objetivo manual (AOM) y análisis objetivo automático (AOA). Nos proponemos comparar esos métodos, y evaluar si el AOA presenta una confiabilidad cercana al AOM (método de referencia) y superior al ASV. Materiales y Métodos Se seleccionaron retrospectivamente imágenes de resonancia magnética (RM) fast spoiled gradient-echo (FSPGR) de 28 sujetos (14 con deterioro cognitivo leve, 7 con EAy 7 controles). El ASV fue realizado por 10 radiólogos, clasificando la atrofia hipocampal en: nula, leve, moderada o severa. El AOM se basó en la segmentación manual de los hipocampos por dos operadores. El AOA fue realizada por medio del software FreeSurfer 5.3. Se calcularon coeficientes de correlación rho de Spearman para las variables discretas y coeficientes de correlación intraclase para las variables continuas. Resultados Los coeficientes de correlación entre los dos operadores que realizaron el AOM fueron de 0,88 (p < 0,0001) para los hipocampos izquierdos y de 0,86 (p < 0,0001) para los hipocampos derechos. El coeficiente de correlación entre todos los ASV (promediados) y AOM fue de-0,81 (IC 95%-0,96- -0,66). Los coeficientes de correlación entre el AOA y el AOM fue de 0,54 (p < 0,0001) para los hipocampos izquierdos y de 0,61 (p < 0,0001) para los hipocampos derechos. Conclusión Si bien el AOA tiene moderada correlación con el método de referencia, no es superior al ASV promedio y se deberían tomar recaudos antes de ser implementado en la práctica asistencial.

Objective Hippocampal atrophy is one of the most sensible radiological biomarkers of Alzheimer's disease. There are different methods to evaluate atrophy: visual subjective analysis (VSA), manual objective analysis (MOA) and automatic objective analysis (AOA). We will compare these methods and evaluate if AOA has a confidence similar to MOA (gold standard), and better than VSA. Materials and Methods We retrospectively selected 3D FSPGR MRI from 28 subjects of whom 14 had mild cognitive impairment, 7 Alzheimer's disease and 7 controls. VSA was performed by 10 radiologists who classified hippocampal atrophy in none, mild, moderate and severe. ForMOA, two operatorsmanually segmented both hippocampus from all subjects. AOA was performed by FreeSurfer 5.3. Spearman's rho correlation coefficient was calculated for discrete variables and intraclass correlation coefficient was calculated for continuous variables. Results Correlation coefficients between the operators that performed MOA was 0.88 (p < 0.0001) for left hippocampi and 0.86 (p < 0,0001) for right hippocampi. Correlation coefficients between mean VSA and MOA was-0,81 (95% CI-0,96- -0,66). Correlation coefficients between AOA and AOM was 0.54 (p < 0.0001) for left hippocampi and 0.61 (p < 0.0001) for right hippocampi. Conclusion Even though AOA has moderate correlation with the gold standard it is not superior to average VSA and should be implemented with care in clinical practice.

Electroacupuncture ameliorate learning and memory by improving N -acetylaspartate and glutamate metabolism in APP/PS1 mice

OBJECTIVE: To explore the precise mechanism of electroacupuncture (EA) to delay cognitive impairment in Alzheimer disease. Methods N -Acetylaspartate (NAA), glutamate (Glu) and myoinositol (mI) metabolism were measured by magnetic resonance spectroscopy, learning and memory of APP/PS1 mouse was evaluated by the Morris water maze test and the step-down avoidance test, neuron survival number and neuronal structure in the hippocampus were observed by Nissl staining, and BDNF and phosphorylated TrkB detected by Western blot. RESULTS: EA at DU20 acupuncture significantly improve learning and memory in behavioral tests, up-regulate NAA, Glu and mI metabolism, increase the surviving neurons in hippocampus, and promote the expression of BDNF and TrkB in the APP/PS1 transgenic mice. CONCLUSION: These findings suggested that EA is a potential therapeutic for ameliorate cognitive dysfunction, and it might be due to EA could improve NAA and Glu metabolism by upregulation of BDNF in APP/PS1 mice.