Resting-State fMRI Reveals the Neural Correlates of Acupuncture in the Treatment of Vascular Cognitive Impairment

Vascular cognitive impairment (VCI) represents a spectrum of cognitive deficits caused by cerebrovascular pathology, affecting multiple cognitive domains including memory, executive function, and attention. While pharmacological interventions for VCI remain limited, growing evidence supports acupuncture as an effective and safe therapeutic approach that improves both global cognition and activities of daily living in affected patients. Nevertheless, the neurobiological mechanisms underlying acupuncture's therapeutic effects require further elucidation. Resting-state functional magnetic resonance imaging (rs-fMRI) has emerged as a powerful neuroimaging tool for investigating brain function in cognitive disorders. This technique detects blood oxygen level-dependent (BOLD) signals that reflect spontaneous neuronal activity during rest, providing insights into functional connectivity patterns and regional brain activity. In neurodegenerative conditions, rs-fMRI has successfully characterized alterations in functional networks and identified potential biomarkers of cognitive impairment. This review not only summarizes the existing evidence on the efficacy of acupuncture in treating VCI, but also synthesizes the current evidence from rs-fMRI studies to elucidate how acupuncture improves cognitive function in VCI patients through central mechanisms.