Effect of acupoint with moxa cone on 1H-MRS of hippocampus and posterior cingulate gyrus in patients with mild cognitive impairment

Abstract Background: Mild cognitive impairment (MCI) is often the prodromal stage to Alzheimer's disease (AD). Most patients with MCI harbor the pathologic changes of AD and experience progressive brain metabolites change. We investigated the changes of metabolites in bilateral hippocampus (HIP) and posterior cingulate gyrus (PCG) in MCI patients, and observed the effects of moxa cone moxibustion on the metabolites of bilateral hippocampus and posterior cingulate gyrus in patients with MCI.Methods: Sixty-nine patients with MCI and sixty-seven cases of age-matched normal controls (NC) were enrolled in this study.MCI patients were randomly divided into drug group(Drug, n=24),sham acupoint group(Sham, n=20) and acupoint group(Acupoint, n=25).All subjects received proton magnetic resonance spectroscopy (1H-MRS) for measurement of NAA/tCr and Cho/tCr ratios in bilateral hippocampus and posterior cingulate gyrus before and after treatment. Mini-Mental Status Examination(MMSE) and Montreal Cognitive Assessment(MoCA) were used to evaluate cognitive function.Results: MCI patients were characterized by lower NAA/tCr in bilateral hippocampus and posterior cingulate gyrus and Cho/tCr in right hippocampus compared to those in NC group(P < 0.05). After two months treatment, NAA/tCr in bilateral hippocampus and posterior cingulate gyrus and Cho/tCr in right hippocampus were increased in the three treatment groups, and there was no significant difference compared to NC group(P > 0.05).NAA/tCr in right hippocampus and Cho/tCr of right posterior cingulate gyrus of acupoint group was significantly higher than those in sham acupoint group(P < 0.05) and NC group(P < 0.05).The scores of MMSE and MOCA in the acupoint group and sham acupoint group were better than those in the drug group, especially in the long-term efficacy.Conclusions: Moxa cone moxibustion may improve the cognitive function of MCI patients by regulating the abnormal metabolites of bilateral hippocampus and posterior cingulate gyrus. MRS can provide objective imaging basis for moxibustion prevention and treatment of MCI.Trial Registration: ChiCTR-IPR-16009144 (Retroactively registered on 26 AUG 2016)