基于诱发电位的头针疗法对神经系统疾病相关认知障碍的神经调控机制研究进展

Advances in the Neural Modulation Mechanisms of Scalp Acupuncture for Cognitive Impairment Associated with Neurological Disorders from an Evoked Potentials Perspective

摘要: 目的：本文旨在系统综述基于诱发电位(Evoked Potentials, EPs)技术评估头针疗法对神经系统疾病相关认知障碍干预效果的研究进展，探讨其潜在的神经电生理调控机制，为头针在神经康复领域的科学应用提供理论依据与方法学支持。方法：通过检索近年来国内外关于头针联合诱发电位(特别是事件相关电位，ERP)的临床与基础研究文献，重点分析P300、CNV、MMN及运动相关皮层电位(MRCPs)等成分在脑卒中、创伤性脑损伤等器质性脑病所致认知障碍中的应用价值，并结合神经解剖与脑网络理论，梳理头针调节皮层兴奋性与功能连接的可能通路。结果：现有证据表明，头针干预可显著改善患者的认知功能，表现为P300潜伏期缩短、波幅升高，MMN自动加工能力增强，CNV注意准备水平提升，且这些变化与临床认知量表评分改善高度一致。机制上，头针可能通过激活前额–顶叶注意网络、调节丘脑–皮层感觉门控通路，以及重建默认模式网络与突显网络的动态平衡，实现对认知与情绪相关脑功能的调控。MRCPs在运动计划评估中的应用亦初显潜力。结论：诱发电位为头针疗法干预神经系统相关认知障碍提供了客观、可量化的神经电生理指标。未来研究应聚焦于标准化操作流程、多模态融合验证及“证候–脑电特征”映射模型构建，推动头针从经验治疗向精准神经调控转化。

Abstract: Objective: This article aims to systematically review the research progress on the intervention effect of scalp acupuncture on cognitive impairment related to neurological diseases based on evoked potentials (EPs) technology, explore its potential neurophysiological regulation mechanism, and provide theoretical basis and methodological support for the scientific application of scalp acupuncture in the field of neurorehabilitation. Methods: Clinical and basic research literature on scalp acupuncture combined with evoked potentials (especially event-related potentials, ERPs) in recent years was retrieved from domestic and international sources. The application value of components such as P300, CNV, MMN, and motor-related cortical potentials (MRCPs) in cognitive impairment caused by organic brain diseases such as stroke and traumatic brain injury was analyzed. Based on neuroanatomy and brain network theory, possible pathways for scalp acupuncture to regulate cortical excitability and functional connectivity were identified. Results: Existing evidence shows that scalp acupuncture intervention can significantly improve patients’ cognitive function, manifested as shortened P300 latency and increased amplitude, enhanced automatic processing ability of MMN, and improved attentional readiness level of CNV. These changes are highly consistent with improvements in clinical cognitive scale scores. Mechanistically, scalp acupuncture may regulate cognitive and emotion-related brain functions by activating the prefrontal-parietal attention network, modulating the thalamus-cortex sensory gating pathway, and reconstructing the dynamic balance between the default mode network and the salience network. The application of MRCPs in motor planning assessment also shows initial potential. Conclusion: Evoked potentials provide objective and quantifiable neurophysiological indicators for scalp acupuncture therapy in intervening in neurological cognitive impairments. Future research should focus on standardized operating procedures, multimodal fusion validation, and the construction of a “syndrome-EEG feature” mapping model to promote the transformation of scalp acupuncture from empirical treatment to precise neuromodulation.