Abstract
OBJECT: On the basis of determining the clinical effect of moxibustion on vascular dementia (VD), this study explored the central mechanism of moxibustion on VD through fMRI. METHOD: Fifty-five VD patients formed the observation group (treated with moxibustion at GV20, GV14, and GV24; 20 min/acupoint, once every other day, three times a week) and 50 healthy individuals served as the control group. The Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were administered, and fMRI data collected, pre- and post-treatment for the observation group, and once for the control group. Amplitude of low-frequency fluctuation (ALFF) was analyzed for pre-treatment fMRI data of both groups. Regions of interest (ROI) were defined by discrepant brain regions, and functional connectivity (FC) was analyzed for the observation group. RESULT: After moxibustion treatment, MoCA scores increased with a mean difference (MD) of 2.0385 (95% CI, 1.6867 to 2.3902), and MMSE scores with an MD of 3.3077 (95% CI, 2.7997 to 3.8156), both significantly (p < 0.01). Regarding fMRI findings, baseline ALFF alterations in VD patients vs. controls included increased values in the bilateral hippocampus (HIP), precuneus, and left middle temporal gyrus (MTG), and decreased values in the left posterior cingulate cortex (PCC) and insula (INS) (FDR-corrected p < 0.05). After moxibustion treatment, significant FC increases were observed: left PCC with right superior/inferior temporal gyrus, left INS with right superior temporal gyrus/superior occipital gyrus and left inferior temporal gyrus, left HIP with right superior temporal gyrus and left PCC, and right HIP with bilateral postcentral gyrus and left fusiform gyrus (GRF-corrected: voxel p < 0.005, cluster p < 0.05). Additionally, pre-treatment left MTG ALFF was negatively correlated with MMSE (p < 0.05, r = -0.486). Post-treatment, FC of left PCC-right superior/inferior temporal gyrus (r = 0.650/0.638), left HIP-left PCC (r = 0.456), and right HIP-left fusiform gyrus (r = 0.411) were positively correlated with MMSE (p < 0.05). DISCUSSION: Moxibustion can effectively improve the cognitive dysfunction in VD patients, possibly by promoting DMN functional recovery and facilitating functional reorganization.