Brain Injuries, Traumatic Clinical Trial
Official title:
The Effects of Acupuncture on the Risk of AD After TBI: A Randomized Controlled Trial
Traumatic brain injury (TBI) is a severely disabling injury which affects 150-200 people per
million annually. Increasing evidence suggests that TBI may be a major risk of dementia,
Alzheimer's disease (AD) in particular. Postmortem evidence has shown that beta-amyloid (Aβ)
deposits, one of the most validated pathological biomarkers of AD, are present in the brains
of severe TBI patients. Although the underlying mechanisms remain unclear, the axonal injury
may play a role. Imaging investigations have revealed Aβ density maps of TBI patients
overlapped with those of AD patients, and increased Aβdensity not only associated with
prolonged TBI duration but also associated with decreased white matter integrity. Hence, the
increasing accumulation in Aβ due to TBI may contribute to the initiation of the pathological
alterations seen in AD. Treatment of TBI may not only be of benefit for the injury itself but
also act to block the pathological changes in AD.
As a part of the clinical arm of the project, in this subproject investigators will conduct a
single-blind, block-randomized clinical trial to investigate the efficacy of acupuncture in
TBI. More specifically, investigators hypothesize that acupuncture intervention will elicit
neuroprotective processes and thereby reduce axonal damage in TBI, manifested as (1)
decreased plasma levels of Aβ peptide, tau, and glial fibrillary acidic protein (GFAP) and
(2) increased white matter integrity after acupuncture. Ninety-six participants will be
randomly allocated to the acupuncture intervention (verum acupuncture) or control group (sham
acupuncture) in a 1:1 ratio. All participants will receive 20 minutes of acupuncture
treatment twice a week for 2 weeks. A set of commonly used acupoints for TBI treatment will
be manually stimulated every 10 minutes. The multi-modality magnetic resonance imaging (T1,
T2, and diffusion tensor imaging) and blood sample will be taken before and after the
acupuncture session to measure the white matter integrity in brain and plasma levels of Aβ
peptide, tau, and GFAP, respectively. After integrate these data with other subprojects, we
can provide synergic and integrative mechanisms of the effects of acupuncture on the risk of
AD after TBI.
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