Acupuncture Interventions for Alzheimer’s Disease and Vascular Cognitive Disorders: A Review of Mechanisms

Abstract

Cognitive impairment (CI) related to Alzheimer’s disease (AD) and vascular cognitive disorders (VCDs) has become a key problem worldwide. Importantly, CI is a neuropsychiatric abnormality mainly characterized by learning and memory impairments. The hippocampus is an important brain region controlling learning and memory. Recent studies have highlighted the effects of acupuncture on memory deficits in AD and VCDs. By reviewing the literature published on this topic in the past five years, the present study intends to summarize the effects of acupuncture on memory impairment in AD and VCDs. Focusing on hippocampal synaptic plasticity, we reviewed the mechanisms underlying the effects of acupuncture on memory impairments through regulation of synaptic proteins, AD characteristic proteins, intestinal microbiota, neuroinflammation, microRNA expression, orexin system, energy metabolism, etc., suggesting that hippocampal synaptic plasticity may be the common as well as the core link underlying the above mechanisms. We also discussed the potential strategies to improve the effect of acupuncture. Additionally, the effects of acupuncture on synaptic plasticity through the regulation of vascular–glia–neuron unit were further discussed.

Hippocampal synaptic plasticity injury mediated by SIRT1 downregulation is involved in chronic pain‐related cognitive dysfunction

“…Rapid synaptic plasticity is necessary for memory development and maintenance in the hippocampus 43,44 . An increasing number of studies indicate that impairment of hippocampal synaptic plasticity in neurodegenerative diseases such as Alzheimer's disease (AD) and Parkinson's disease (PD) has been proven to be associated with cognitive decline 12,45–50 . Short‐chain fatty acid supplementation improves aberrant synaptic transmission in the hippocampal CA1 region, consequently reducing cognitive impairment caused by prolonged postoperative pain 51 .…”

Recognizing Alzheimer's disease from perspective of oligodendrocytes: Phenomena or pathogenesis?

“…Aberrant OLs‐vascular cells interactions can damage BBB, which triggers CNS inflammation 95 . Although the causes of AD and vascular dementia (VD) are not entirely same, they share common neurological abnormalities 15,16 . VD is mainly caused by abnormal vascular function, including inhibition of cerebral blood flow or destruction of the BBB.…”

“…Fortunately, aducanumab has been approved for clinical use in the treatment of AD. As an alternative treatment of AD, traditional Chinese medicine has also demonstrated the potential to treat or prevent AD 4,5,14,16 . If, as mentioned in the above literature, OLs can also regulate Aβ, treatment strategies can be designed around OLs to suppress Aβ deposition.…”

“…95 Although the causes of AD and vascular dementia (VD) are not entirely same, they share common neurological abnormalities. 15,16 VD is mainly caused by abnormal vascular function, including inhibition of cerebral blood flow or destruction of the BBB. In fact, vascular abnormalities also induce the progression of AD.…”

“…Classical neuropathological changes in AD, including the accumulation of amyloid plaque and the presence of neurofibrillary tangles, are responsible for neuronal loss and synaptic dysfunction, [13][14][15][16] but they may also induce death of OLs and myelin damage. 17,18 There is also evidence to show that myelin pathology may precede Aβ and tau pathologies in AD.…”