{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:03:47Z","timestamp":1790701427453,"version":"4.1.0"},"reference-count":59,"publisher":"IMR Press","issue":"9","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Natural Science Foundation of China","award":["82074548"],"award-info":[{"award-number":["82074548"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Natural Science Foundation of Jilin Province","award":["YDZJ202401680ZYTS"],"award-info":[{"award-number":["YDZJ202401680ZYTS"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Integr. Neurosci."],"abstract":"<jats:p>Background: Type 2 diabetes mellitus-associated cognitive dysfunction (T2DACD) is strongly linked to disruption of cognition-supporting brain networks. Electroacupuncture (EA) has increasingly been examined as a nonpharmacological intervention targeting cognitive impairment; however, the longitudinal neurobiological patterns accompanying EA in T2DACD have not been fully characterized. In this exploratory pilot study, we evaluated alterations in resting-state functional connectivity (RSFC) across hippocampal subregions and default mode network (DMN) nodes in individuals with T2DACD. Methods: For this exploratory, open-label, non-randomized, uncontrolled pilot investigation, we enrolled 20 individuals with T2DACD and 26 healthy controls (HCs). Longitudinal analyses included 15 participants who had usable post-treatment data. T2DACD was defined according to clinical type 2 diabetes mellitus criteria, and a Montreal Cognitive Assessment (MoCA) score &lt;26. Patients underwent an 8-week Adjust Zang-fu and Arouse Spirit electroacupuncture (AZASE) intervention. Cognitive, emotional, metabolic, and seed-based resting-state functional magnetic resonance imaging (rs-fMRI) outcomes were evaluated. Clinical longitudinal analyses were carried out according to protocol, whereas imaging analyses were limited to participants with usable scans after treatment. Results: At baseline, individuals with T2DACD showed lower MoCA scores than HCs and had poorer executive and working-memory outcomes. Among the 15 participants with complete longitudinal neuroimaging data, MoCA scores increased from 23.27 \u00b1 1.71 to 26.07 \u00b1 1.53 over the intervention period. Within-group alterations were observed for Flanker-conflict reaction time and accuracy, Stroop-conflict reaction time, 1-back reaction time, Self-Rating Anxiety Scale score, and Hamilton Depression Rating Scale score. Omnibus group analyses detected significant effects for the left anterior hippocampus-left angular gyrus connection and the left posterior hippocampus-right middle occipital gyrus connection. Post-treatment scans demonstrated reduced RSFC in several hippocampal-DMN and intra-DMN connections. The association between change in left anterior hippocampus-left angular gyrus RSFC and change in Stroop-conflict performance was no longer statistically significant after Bonferroni correction. For neuroimaging outcomes, cluster-level family-wise error (FWE) correction (p &lt; 0.05) was applied to control for multiple comparisons; clinical outcomes are reported descriptively as hypothesis-generating findings. Conclusions: In this exploratory pilot study, we identified preliminary alterations in cognitive outcomes and hippocampal-DMN connections over an 8-week EA intervention in individuals with T2DACD. In view of the small sample size and the open-label, non-randomized, uncontrolled design, the findings should be interpreted as hypothesis-generating observations rather than definitive evidence of a specific causal treatment effect. Larger controlled studies will be needed to determine whether the observed neural and behavioral alterations are reproducible and clinically meaningful in practice. Clinical Trial Registration: No: ChiCTR2000040268, https:\/\/www.chictr.org.cn\/hvshowproject.html?id=76145&amp;v=1.3.<\/jats:p>","DOI":"10.31083\/jin52929","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:16:31Z","timestamp":1790698591000},"source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal Changes in Hippocampal-Default Mode Network Connectivity and Cognition During Electroacupuncture Intervention in Type 2 Diabetes-Associated Cognitive Decline: A Pilot Resting-State fMRI Study"],"prefix":"10.31083","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5948-2249","authenticated-orcid":true,"given":"Lin","family":"Yao","sequence":"first","affiliation":[{"name":"Institute of Acupuncture and Massage, Northeast Asian Institute of Traditional Chinese Medicine, Changchun University of Chinese Medicine, 130117 Changchun, Jilin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0039-6661","authenticated-orcid":true,"given":"Meng-yuan","family":"Li","sequence":"additional","affiliation":[{"name":"Institute of Acupuncture and Massage, Northeast Asian Institute of Traditional Chinese Medicine, Changchun University of Chinese Medicine, 130117 Changchun, Jilin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8858-8571","authenticated-orcid":true,"given":"Yan-ze","family":"Liu","sequence":"additional","affiliation":[{"name":"Acupuncture and Tuina Center, The Third Affiliated Clinical Hospital of Changchun University of Chinese Medicine, 130117 Changchun, Jilin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2597-4106","authenticated-orcid":true,"given":"Jia-zhen","family":"Cao","sequence":"additional","affiliation":[{"name":"College of nursing, Changchun University of Chinese Medicine, 130117 Changchun, Jilin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3132-3762","authenticated-orcid":true,"given":"Zheng","family":"Lian","sequence":"additional","affiliation":[{"name":"College of Acupuncture and Massage, Changchun University of Chinese Medicine, 130117 Changchun, Jilin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0704-5997","authenticated-orcid":true,"given":"Hong-nan","family":"Zhu","sequence":"additional","affiliation":[{"name":"College of Acupuncture and Massage, Changchun University of Chinese Medicine, 130117 Changchun, Jilin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5375-7558","authenticated-orcid":true,"given":"Hai-peng","family":"Huang","sequence":"additional","affiliation":[{"name":"College of Acupuncture and Massage, Changchun University of Chinese Medicine, 130117 Changchun, Jilin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9956-5671","authenticated-orcid":true,"given":"Zhen","family":"Zhong","sequence":"additional","affiliation":[{"name":"College of Acupuncture and Massage, Changchun University of Chinese Medicine, 130117 Changchun, Jilin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3147-5581","authenticated-orcid":true,"given":"Hong-feng","family":"Wang","sequence":"additional","affiliation":[{"name":"College of Acupuncture and Massage, Changchun University of Chinese Medicine, 130117 Changchun, Jilin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Genitsaridi I, Salpea P, Salim A, Sajjadi SF, Tomic D, James S, et al. 11th edition of the IDF Diabetes Atlas: global, regional, and national diabetes prevalence estimates for 2024 and projections for 2050. 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