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Peer-reviewedCC BY 4.0Frontiers in Neurology

Acupuncture-related brain network findings across clinical stages of the Alzheimer’s disease continuum: a critical review of functional MRI evidence

  1. 1Graduate School of Heilongjiang University of Chinese Medicine
  2. 2Division of CT and MRI, First Affiliated Hospital, Heilongjiang University of Chinese Medicine

Abstract

Brain network abnormalities are observed across the Alzheimer’s disease (AD) continuum, but the relationship between clinical stage, acupuncture-related functional brain changes, and cognitive outcomes remains unclear. This review examined clinical blood oxygen level-dependent functional MRI studies of acupuncture in subjective cognitive decline (SCD), mild cognitive impairment (MCI, including amnestic MCI [aMCI]), and AD dementia. PubMed, Web of Science Core Collection, and China National Knowledge Infrastructure (CNKI) were searched for relevant studies. The evidence was synthesized narratively by clinical stage, with attention to study design, acupuncture protocols, control conditions, imaging methods, brain–cognition associations, biomarker status, and possible cohort overlap. In SCD, the limited available evidence mainly involved changes in regional spontaneous activity, hippocampal connectivity, and network organization. In MCI, including aMCI, reported changes involved memory- and limbic-related regions, DLPFC–ACC connectivity, and locus coeruleus-related pathways. In AD dementia, reported changes mainly involved the hippocampus and posterior medial memory-related regions, with earlier studies mainly examining short-term responses and two longitudinal cohorts assessing changes over a treatment course. Across the reviewed literature, findings in MCI, including aMCI, involved a broader range of brain regions and networks, whereas those in AD dementia were more often centered on the hippocampus and posterior medial memory-related regions. These differences are difficult to attribute to clinical stage alone, given substantial differences across studies in acupuncture protocols, control conditions, imaging methods, sample size, biomarker confirmation, and follow-up. Larger longitudinal studies with biomarker confirmation where possible and complementary imaging modalities are needed to determine whether the observed differences are related to clinical stage and how the imaging changes relate to cognitive outcomes.

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BibTeX
@article{bai2026acupuncturerelated,
  title = {{Acupuncture-related brain network findings across clinical stages of the Alzheimer’s disease continuum: a critical review of functional MRI evidence}},
  author = {Xue Bai and Yahong Ji and Hengyu Ruan and Wenhao Zhang and Yunlong Ma and Xiaoxu Jiang and Xiaohui Liu and Feng Wang},
  journal = {Frontiers in Neurology},
  year = {2026},
  month = oct,
  doi = {10.3389/fneur.2026.1977763},
  url = {https://www.frontiersin.org/articles/10.3389/fneur.2026.1977763/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Acupuncture-related brain network findings across clinical stages of the Alzheimer’s disease continuum: a critical review of functional MRI evidence
AU  - Xue Bai
AU  - Yahong Ji
AU  - Hengyu Ruan
AU  - Wenhao Zhang
AU  - Yunlong Ma
AU  - Xiaoxu Jiang
AU  - Xiaohui Liu
AU  - Feng Wang
PY  - 2026
DA  - 2026/10/28
JO  - Frontiers in Neurology
DO  - 10.3389/fneur.2026.1977763
UR  - https://www.frontiersin.org/articles/10.3389/fneur.2026.1977763/full
AB  - Brain network abnormalities are observed across the Alzheimer’s disease (AD) continuum, but the relationship between clinical stage, acupuncture-related functional brain changes, and cognitive outcomes remains unclear. This review examined clinical blood oxygen level-dependent functional MRI studies of acupuncture in subjective cognitive decline (SCD), mild cognitive impairment (MCI, including amnestic MCI [aMCI]), and AD dementia. PubMed, Web of Science Core Collection, and China National Knowledge Infrastructure (CNKI) were searched for relevant studies. The evidence was synthesized narratively by clinical stage, with attention to study design, acupuncture protocols, control conditions, imaging methods, brain–cognition associations, biomarker status, and possible cohort overlap. In SCD, the limited available evidence mainly involved changes in regional spontaneous activity, hippocampal connectivity, and network organization. In MCI, including aMCI, reported changes involved memory- and limbic-related regions, DLPFC–ACC connectivity, and locus coeruleus-related pathways. In AD dementia, reported changes mainly involved the hippocampus and posterior medial memory-related regions, with earlier studies mainly examining short-term responses and two longitudinal cohorts assessing changes over a treatment course. Across the reviewed literature, findings in MCI, including aMCI, involved a broader range of brain regions and networks, whereas those in AD dementia were more often centered on the hippocampus and posterior medial memory-related regions. These differences are difficult to attribute to clinical stage alone, given substantial differences across studies in acupuncture protocols, control conditions, imaging methods, sample size, biomarker confirmation, and follow-up. Larger longitudinal studies with biomarker confirmation where possible and complementary imaging modalities are needed to determine whether the observed differences are related to clinical stage and how the imaging changes relate to cognitive outcomes.
SN  - 1664-2295
ER  -