Zhang, Zhenzhen

Keywords: acupuncture, memory, blood circulation, insufficient blood supply, head acupuncture, acupoints

On a day in May 2024, 54-year-old Erica walked into my clinic, with a main complaint of dizziness, stiff neck muscles, and pain. The pain was dull, limiting her ability to turn her head, especially when driving. Through inquiry, I learned that she had experienced a severe car accident 10 years ago; although she sustained no fractures, she had suffered from long-term dizziness, headaches, and neck pain since then. Various treatments had provided some relief, but none had cured her condition. An X-ray examination one year ago revealed mild cervical spondylosis. In the past three months, her children complained that she often forgets things; notably, three days before, her daughter asked her to pick up her grandson from kindergarten in the afternoon, which she completely forgot. She believed that her dizziness prevented her from concentrating, leaving her mind foggy and unable to remember things.

A. Vascular Factors in Memory Decline

We often find that memory decline often accompanies a patients’ main complaints. Whether traditional Chinese medicine can help these patients improve their memory is sometimes uncertain to the practitioners. As TCM doctors, we always treat based on syndrome differentiation and seek the root cause of the disease. Treating according to the cause is the fundamental approach; however, when patients present with complex pathogenic factors that have already caused bodily damage, it is often impractical to start treatment solely from the root cause. In such cases, it is necessary to adopt measures that interrupt the progression and reduce or eliminate ongoing harm.

There are many causes of memory decline, for example:

• Age: Aging leads to decreased vascular elasticity and insufficient blood and oxygen supply, resulting in cognitive decline.
• Hypertension: Long-term high blood pressure can damage small cerebral vessels, leading to microinfarctions and insufficient cerebral blood supply, thus affecting memory.
• Diabetes: Accelerates vascular sclerosis and affects brain blood supply.
• Atherosclerosis: Causes narrowing of cerebral arteries, reducing blood flow and impairing cognitive function.
• Smoking: Nicotine causes cerebral vessel constriction, reducing brain blood flow and increasing the risk of stroke and memory decline.

Other chronic diseases, stress, insomnia, malnutrition, and cervical injuries from car accidents may also lead to insufficient cerebral blood supply, causing gradual memory loss.

Clinically, TCM practitioners may not be able to correct the underlying causes directly, but they can target the vascular factors to help improve memory. Memory decline due to vascular causes is often the result of circulatory disorders, where cerebral nerve cells suffer from ischemia, hypoxia, and nutrient deficiency, leading to cellular damage or death, and consequently loss of memory, thinking, or judgment ability.

In the cerebral blood circulation system, the impaired blood supply from the carotid and vertebrobasilar arteries can affect memory. Their branches—such as the posterior cerebral artery (PCA) and middle cerebral artery (MCA)—if insufficient, can impact the hippocampus, temporal lobe, frontal lobe, and posterior cingulate cortex, leading to deficits in long-term, spatial, working, and language memory; insufficient blood supply to the cerebellum can impair motor memory.

Early signs of memory impairment include forgetting recent events while clearly recalling past events, along with scattered attention and slow thinking; later stages may progress to vascular dementia (VaD).

Besides the use of herbal medicine, TCM treatment for memory decline also includes acupuncture methods, as described below:

B. Acupuncture Treatment Methods

1. Scalp/Head Acupuncture

This method aims to stimulate brain functional areas to increase local blood flow and promote the recovery of neural function.

1.1 “Jin San Zhen” (Jin’s Three-Needle Therapy): These are commonly used combinations with three closely located points that produce a synergistic effect, developed by the contemporary acupuncturist professor Jin Rui. For memory loss the appropriate point groups are:

“Mind Three Needles/Zhi San Zhen”: Shenting GV24 (singular) and Benshen GB13 (bilateral). These three points correspond to the frontal lobe, which plays a key role in regulating emotion and intelligence and is closely related to cognition. Acupuncture at these points may enhance blood flow to the prefrontal cortex and improve behavioral disturbances related to emotion and intelligence. According to TCM, Benshen GB13 connects with the Yangwei vessel, maintaining the body’s yang channels, and is used to treat forgetfulness, senile dementia, and vascular dementia.

“Temporal Three Needles”: The points are located approximately two cun above the earlobe along the hairline, one point in line with the center of the ear, or lateral to GV20, and one on each side a cun to the front nd back; these correspond to the temporal lobe, which includes the hippocampus and are related to memory and other cognitive functions.

**“Cranial Three Needles”：**It includes Naohou DU 17, about 2.5 inches directly above the middle of the posterior hairline, and on both sides of Naokong GB19, the outer side of the upper edge of the external occipital protuberance, about 2.5 inches lateral to the midline of the head. These correspond to the occipital lobe, associated with visual information processing and improving visual memory.

1.2 Other Scalp Acupuncture Points：

**- Baihui GV20 and Sishencong：**Located at the vertex, these points promote cerebral circulation, improve cognitive function, enhance concentration, and improve memory. Acupuncture at Baihui GV20 plus Sishencong has been shown (via fMRI studies) to improve cognitive function in Alzheimer’s patients.

**- Yintang：**Located between the eyebrows in the frontal lobe, it may improve attention and memory.

**- Fengchi GB20：**Located below the occipital bone at the back of the neck; the deep muscles in this area contain the vertebral artery, which can improve cerebral blood supply and alleviate dizziness and forgetfulness.

Furthermore, studies on points such as Xuanlu GB5 and Xuanli GB6 (corresponding to the frontal lobe), Qubin GB7, Shuai gu GB8 and Fubai GB10 (corresponding to the temporal lobe), indicate that needling these points is associated with improvements in cognitive function.

2. Systemic Point Selection：

Based on the individual’s condition, a syndrome-differentiated selection of points throughout the body is performed, with emphasis on points that research has shown to improve cerebral blood supply and cognitive ability, including memory. For example:

**-Neiguan PC6：**Relieves anxiety and regulates cardiac and spleen-stomach functions, thereby enhancing cognitive function.

**-Qihai CV6：**Known as the “Sea of Qi,” it improves overall blood and qi circulation, aiding in oxygen and blood supply to the brain.

**-Hegu LI4：**Regulates the flow of qi and blood throughout the body, improving cerebral operational efficiency.

**-Taichong LV3：**Improves vascular elasticity, enhances brain oxygenation, stabilizes mood and cognitive function; studies show that needling Hegu LI4 and Taichong LV3 can modulate the sympathetic nervous system and increase cerebral blood perfusion.

**-Yongquan KD1：**Improves neurotransmitter function, enhances memory, nourishes the brain, and improves cognitive capacity.

**-Zusanli ST36：**Enhances endurance and promotes qi and blood circulation; it also modulates spleen-stomach function, increases immunity, and

strengthens the gut-brain axis, thereby improving cognitive function.

3. Auricular Acupuncture:

Select ear points related to stimulating the heart, spleen, kidney, liver, Shenmen, and endocrine function to achieve a brain-nourishing and intelligence-enhancing effect. In particular, using ear seeds or press balls can provide stimulation lasting 2-3 days or longer.

4. Electroacupuncture (EA)

Research indicates that low-frequency electrical stimulation can increase cerebral blood flow and activate neurotransmitters such as acetylcholine and dopamine.

Points may include ear acupuncture points (e.g., Heart and Shenmen) as well as Yintang, Baihui GV20 plus Sishencong, among others.

5. Moxibustion

Adding moxibustion can enhance vascular dilation, improve microcirculation, and thereby increase cerebral blood flow.

C. Clinical Example

Taking Erica as an example, a specific treatment protocol might involve selecting the following points: “Zhi San Zhen” (Shenting GV24 with Benshen GB13 bilateral), “Temporal Three Needles,” Baihui GV20, Fengchi GB20, Dazhui GV14, Zusanli ST36, Taichong LV3, and Sanyinjiao SP6. Treatment is administered twice weekly for 8 weeks, then gradually reduced to once weekly or once every two weeks.

Adjunct methods: Occasionally, add electroacupuncture at Yintang plus Baihui GV20 for 30 minutes per session, or perform warm needle moxibustion at Baihui GV20 and Fengchi GB20 for 10 minutes, or use moxibustion at Shenting GV24 and Zusanli ST36 to enhance blood circulation.

Outcome: After the first two months of treatment, the patient’s dizziness and headache completely disappeared, the stiffness of the cervical spine was significantly relieved, the pain was greatly reduced, and no serious amnesia occurred. The treatment lasted for 5 months, and the effect was still good, so the treatment was terminated.

Lifestyle guidance is also crucial, including daily self-relaxation exercises for the head and neck muscles and reducing screen time, etc.

Summary

Memory decline is not limited to the elderly; many young people may also be affected, though it is more common in older adults. There are many causes of memory decline. This article emphasizes that cerebral circulatory disorders can lead to ischemia and hypoxia in brain nerve cells, resulting in cognitive decline and forgetfulness. TCM practitioners can effectively intervene with non-pharmacological methods such as acupuncture and herbal medicine. This article, based on the author’s clinical experience and related literature, introduces several specific acupuncture points effective for improving memory. The proposed simple and practical treatment protocol is provided for clinical reference and validation by peers.