Acupuncture Improves Poststroke Cognitive Impairment by Regulating the miR-18a-5p

Abstract

Background Poststroke cognitive impairment (PSCI) severely impacts patients’ lives. Acupuncture shows potential in improving PSCI, yet the molecular mechanism remains unclear. Aims This study aimed to investigate the potential efficacy of acupuncture in alleviating PSCI symptoms by regulating miR-18a-5p. Methods The study assessed mental status and self-care capacity in 107 PSCI cases and 102 healthy participants through the Mini-Mental State Examination, Revised Hasegawa’s Dementia Scale, and activities of daily living evaluation. Male Sprague–Dawley rats underwent middle cerebral artery occlusion (MCAO) to induce PSCI. Cognitive performance in this model was then examined via the Morris water maze assessment and the novel object recognition test. The diagnostic value and relevance of miR-18a-5p for PSCI were assessed using the receiver operating characteristic curve and Spearman correlation coefficient. The targeting relationship between miR-18a-5p and hypoxia-inducible factor 1-alpha (HIF-1α) was verified by dual-luciferase reporter and ribonucleic acid immunoprecipitation assay. Inflammatory cytokine concentrations were measured using enzyme-linked immunosorbent assay. Results Serum miR-18a-5p expression was significantly reduced in PSCI patients compared to controls, but acupuncture intervention effectively increased its levels. Furthermore, higher miR-18a-5p concentrations correlated with better cognitive function and enhanced daily living capacity. After MCAO surgery, Zea-Longa score and cognitive deficits were increased in rats, and acupuncture and overexpression of miR-18a-5p improved cognitive dysfunction. In the hippocampal tissue of MCAO rats, miR-18a-5p expression was reduced, and acupuncture and overexpression of miR-18a-5p reversed the downregulation trend, whereas HIF-1α expression and inflammatory cytokine concentrations exhibited opposite changes. Conclusions Acupuncture alleviates PSCI by modulating miR-18a-5p, providing a novel therapeutic target.