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Kong L, Hu J, Yue M, Xin X, Lin F, Hu Y, Wang X. Visual analysis of research hotspots and trends of external therapies in traditional Chinese medicine for depression. Heliyon 2024; 10:e36918. [PMID: 39286159 PMCID: PMC11402998 DOI: 10.1016/j.heliyon.2024.e36918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 07/05/2024] [Accepted: 08/23/2024] [Indexed: 09/19/2024] Open
Abstract
Objective Based on the visualization and analysis of the CiteSpace software, we aimed to explore the current research status and development trend of depression caused by external therapies in traditional Chinese medicine (TCM) and to provide a reference for further research in this field. Methods In the China National Knowledge Infrastructure, Wanfang, Web of Science, and PubMed databases, relevant articles on external therapies in TCM for depression were selected as the research objects, and CiteSpace performed the bibliometric analysis. Results In total, 1672 Chinese and 441 English articles were included after CiteSpace was used to remove duplicate articles and perform manual screening. The Chinese articles were analyzed, and the overall issuance showed an upward trend; the core author was Tu Ya, and the institution with the highest article production was Heilongjiang University of Traditional Chinese Medicine. The English articles were analyzed, and the overall issuance showed an upward trend; the core author was Macpherson, Hugh, and the institution with the highest article production was Guangzhou University of Traditional Chinese Medicine. China ranked first in terms of number and centrality of publications, followed by the United States. The keywords of Chinese and English articles were analyzed to conclude that the research trends in this field were an exploration of therapeutic mechanisms, acupoint application therapy, and assessment of sleep quality, and the research hotspots were the clinical application of external therapies in TCM and the types of underlying diseases. Conclusion This study comprehensively and objectively summarized the relevant literature on external therapies in TCM for depression. It highlights the direction for further exploration by revealing and analyzing the research hotspots and trends in this field.
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Affiliation(s)
- Lingzu Kong
- College of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, 130117, China
| | - Jinglin Hu
- College of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, 130117, China
| | - Ming Yue
- College of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, 130117, China
| | - Xiaoqi Xin
- College of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, 130117, China
| | - Fengbei Lin
- College of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, 130117, China
| | - Yinghua Hu
- Teaching and Research Office of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, 130117, China
| | - Xichen Wang
- School of Medical Information, Changchun University of Chinese Medicine, Changchun, Jilin, 130117, China
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Zhao B, Li Z, Shi C, Liu Y, Sun Y, Li B, Zhang J, Gong Z, Wang Y, Ma X, Yang X, Jiang H, Fu Y, Wang X, Li Y, Liu H, Bao T, Fei Y. Acupuncture as Add-on Therapy to SSRIs Can Improve Outcomes of Treatment for Anxious Depression: Subgroup Analysis of the AcuSDep Trial. Neuropsychiatr Dis Treat 2024; 20:1049-1064. [PMID: 38770535 PMCID: PMC11104384 DOI: 10.2147/ndt.s446034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 04/22/2024] [Indexed: 05/22/2024] Open
Abstract
Purpose Anxious depression (AD) is a common, distinct depression subtype. This exploratory subgroup analysis aimed to explore the effects of acupuncture as an add-on therapy of selective serotonin reuptake inhibitors (SSRIs) for patients with AD or non-anxious depression (NAD). Patients and Methods Four hundred and sixty-five patients with moderate-to-severe depression from the AcuSDep pragmatic trial were included in analysis. Patients were randomly assigned to receive MA+SSRIs, EA+SSRIs, or SSRIs alone (1:1:1) for six weeks. AD was defined by using dimensional criteria. The measurement instruments included 17-items Hamilton Depression Scale (HAMD-17), Self-Rating Depression Scale (SDS), Clinical Global Impression (CGI), Rating Scale for Side Effects (SERS), and WHO Quality of Life-BREF (WHOQOL-BREF). Comparison between AD and NAD subgroups and comparisons between groups within either AD or NAD subgroups were conducted. Results Eighty percent of the patients met the criteria for AD. The AD subgroup had poorer clinical manifestations and treatment outcomes compared to those of the NAD subgroup. For AD patients, the HAMD response rate, remission rate, early onset rate, and the score changes on each scale at most measurement points on the two acupuncture groups were significantly better than the SSRIs group. For NAD patients, the HAMD early onset rates of the two acupuncture groups were significantly better than the SSRIs group. Conclusion For AD subtype patients, either MA or EA add-on SSRIs showed comprehensive improvements, with small-to-medium effect sizes. For NAD subtype patients, both the add-on acupuncture could accelerate the response to SSRIs treatment. The study contributed to the existing literature by providing insights into the potential benefits of acupuncture in combination with SSRIs, especially for patients with AD subtypes. Due to its limited nature as a post hoc subgroup analysis, prospectively designed, high-quality trials are warranted. Clinical Trials Registration ChiCTR-TRC-08000297.
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Affiliation(s)
- Bingcong Zhao
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, People’s Republic of China
- Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, People’s Republic of China
| | - Zhigang Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Chuan Shi
- Psychological Assessment Center, Peking University Sixth Hospital, Beijing, People’s Republic of China
| | - Yan Liu
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Yang Sun
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Bin Li
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, People’s Republic of China
- Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, People’s Republic of China
| | - Jie Zhang
- Department of Psychosomatic Medicine, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, People’s Republic of China
| | - Zhizhong Gong
- Division of Medical Affairs, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, People’s Republic of China
| | - Yuanzheng Wang
- Department of Integrative TCM and Western Medicine, Peking University First Hospital, Beijing, People’s Republic of China
| | - Xuehong Ma
- Department of Acupuncture & Moxibustion, Dongfang Hospital, the Second Clinical Medical College of Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Xinjing Yang
- Department of Traditional Chinese Medicine, South China Hospital of Shenzhen University, Shenzhen, People’s Republic of China
| | - Huili Jiang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Yuanbo Fu
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, People’s Republic of China
- Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, People’s Republic of China
| | - Xin Wang
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, People’s Republic of China
- Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, People’s Republic of China
| | - Yang Li
- Department of Psychosomatic Medicine, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, People’s Republic of China
| | - Hengchia Liu
- Department of Psychosomatic Medicine, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, People’s Republic of China
| | - Tuya Bao
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Yutong Fei
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
- Institute of Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
- Beijing GRADE Centre, Beijing, People’s Republic of China
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Wang X, Luo P, Zhang L, Sun J, Cao J, Lei Z, Yang H, Lv X, Liu J, Yao X, Li S, Fang J. Altered functional brain activity in first-episode major depressive disorder treated with electro-acupuncture: A resting-state functional magnetic resonance imaging study. Heliyon 2024; 10:e29613. [PMID: 38681626 PMCID: PMC11053281 DOI: 10.1016/j.heliyon.2024.e29613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/27/2024] [Accepted: 04/10/2024] [Indexed: 05/01/2024] Open
Abstract
Background Previous studies have found electroacupuncture could improve the clinical symptoms of first-episode major depressive disorder (MDD), but the exact neural mechanism of action needs to be further elucidated. Methods Twenty-eight first-episode MDD patients were randomly divided into 14 electro-acupuncture stimulation (EAS) groups and 14 sham-acupuncture stimulation (SAS) groups, and clinical symptoms were assessed and functional magnetic resonance imaging (fMRI) scans were done in both groups. Amplitude of low-frequency fluctuations (ALFF) was used to observe the changes between the pre-treatment and post-treatment in the two groups, and the altered brain areas were selected as region of interest (ROI) to observe the FC changes. Meanwhile, the correlation between the altered clinical symptoms and the altered ALFF and FC of brain regions in the two groups was analyzed. Results The EAS significantly decreased the HAMD-24 and HAMA-14 scores of MDD than SAS group. The imaging results revealed that both groups were able to increase the ALFF of the left middle temporal gyrus and the left cerebellar posterior lobe. When using the left middle temporal gyrus and the left posterior cerebellar lobe as ROIs, EAS group increased the FC between the left middle temporal gyrus with the left superior frontal gyrus, the left middle frontal gyrus, and the left hippocampus, and decreased the FC between the left posterior cerebellar lobe and the left calcarine gyrus, while SAS group only increased the FC between the left middle temporal gyrus with the left superior frontal gyrus. The alternations in clinical symptoms after EAS treatment were positively correlated with the altered ALFF values in the left middle temporal gyrus and the altered FC values in the left middle temporal gyrus and the left middle frontal gyrus. Conclusion EA demonstrates modulation of functional activity in the default mode network (DMN), sensorimotor network (SMN), cognitive control network (CCN), limbic system, and visual network (VN) for the treatment of the first-episode MDD. Our findings contribute to the neuroimaging evidence for the efficacy of EAS.
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Affiliation(s)
- XiaoLing Wang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ping Luo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ling Zhang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - JiFei Sun
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - JiuDong Cao
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhang Lei
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hong Yang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - XueYu Lv
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jun Liu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - XiaoYan Yao
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - ShanShan Li
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - JiLiang Fang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Li Y, Wang Y, Gao L, Meng X, Deng Q. Effect of nonpharmacological interventions on poststroke depression: a network meta-analysis. Front Neurol 2024; 15:1376336. [PMID: 38645742 PMCID: PMC11027129 DOI: 10.3389/fneur.2024.1376336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/25/2024] [Indexed: 04/23/2024] Open
Abstract
Purpose To investigate the effects of nonpharmacological interventions (NPIs) on poststroke depression (PSD) in stroke patients. Methods Computer searches were conducted on the PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wanfang databases from their establishment to December 2023. The selection was made using the inclusion and exclusion criteria, and 40 articles were included to compare the effects of the 17 NPIs on patients with PSD. Results Forty studies involving seventeen interventions were included. The network findings indicated that compared with conventional therapy (COT), superior PSD improvement was observed for cognitive behavioral therapy (CBT) + acupoint acupuncture (CBTA) (mean difference [MD], -4.25; 95% CI, -5.85 to -2.65), team positive psychotherapy (MD, -4.05; 95% CI, -5.53 to -2.58), music therapy (MT) + positive psychological intervention (MD, -2.25; 95% CI, -3.65 to -0.85), CBT (MD, -1.52; 95% CI, -2.05 to -0.99), mindfulness-based stress reduction (MD, -1.14; 95% CI, -2.14 to -0.14), MT (MD, -0.95; 95% CI, -1.39 to -0.52), acupoint acupuncture + MT (AAMT) (MD, -0.69; 95% CI, -1.25 to -0.14). Furthermore, CBT (MD, -3.87; 95% CI, -4.57 to -3.17), AAMT (MD, -1.02; 95% CI, -1.41 to -0.62), acupressure + MT (MD, -0.91; 95% CI, -1.27 to -0.54), and narrative care + acupressure (MD, -0.74; 95% CI, -1.19 to -0.29) demonstrated superior Pittsburgh Sleep Quality Index (PSQI) improvement compared with COT. Conclusion Evidence from systematic reviews and meta-analyses suggests that CBTA improves depression in patients with PSD. Moreover, CBT improves sleep in these patients. Additional randomized controlled trials are required to further investigate the efficacy and mechanisms of these interventions.
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Affiliation(s)
- Ying Li
- College of Sports Science, Jishou University, Jishou, China
| | - Yuanyuan Wang
- Cardiac Care Unit, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Lei Gao
- School of Nursing, Dalian University, Dalian, China
| | - Xiaohan Meng
- College of Sports Science, Jishou University, Jishou, China
| | - Qidan Deng
- Department of Intensive Care Unit, Affiliated Qingyuan Hospital, Guangzhou Medical University, Qingyuan People’s Hospital, Qingyuan, China
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Chen N, Wu X, Tu M, Xiong S, Jin J, Qu S, Pei S, Fang J, Shao X. Optimizing Treatment for Major Depressive Disorder in Adolescents: The Impact of Intradermal Acupuncture - A Randomized Controlled Trial Protocol. Neuropsychiatr Dis Treat 2023; 19:1819-1832. [PMID: 37641586 PMCID: PMC10460602 DOI: 10.2147/ndt.s420489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/15/2023] [Indexed: 08/31/2023] Open
Abstract
Background Major depressive disorder (MDD) exhibits a pronounced occurrence among adolescents, aligning closely with the lifetime prevalence rate of 16.6% observed in adults. It is difficult to treat and prone to recurrence. Acupuncture has shown potential in enhancing treatment effectiveness. Nonetheless, there is a lack of research on the use of intradermal acupuncture (IA) in treating adolescent MDD. Methods This study is a double-blind, randomized controlled trial. A cohort of 120 participants will be assigned randomly to three distinct groups, namely a Selective Serotonin Reuptake Inhibitors (SSRIs)-only group, a sham intradermal acupuncture combined with SSRIs (SIA) group, and an active intradermal acupuncture combined with SSRIs (AIA) group. Hamilton Depression Rating Scale will serve as the primary outcome, while Patient Health Questionnaire-9, Self-Rating Depression Scale, Pittsburgh Sleep Quality Index, and Short Form 36 Questionnaire will serve as secondary outcomes in assessing the amelioration of depressive symptoms in patients. These data will be analyzed using SPSS26.0 software. Results We will assess the efficacy and safety of IA for MDD using commonly employed clinical psychiatric scales. Conclusion The efficacy of IA in treating adolescent MDD may be demonstrated in this study, suggesting its potential for optimizing MDD treatment schemes. Trial Registration ClinicalTrials.gov Identifier: NCT05832619 (April 27, 2023).
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Affiliation(s)
- Nisang Chen
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Xiaoting Wu
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Mingqi Tu
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Sangsang Xiong
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Junyan Jin
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Siying Qu
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Shuangyi Pei
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
- Key Laboratory for Research of Acupuncture Treatment and Transformation of Emotional Diseases, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Jianqiao Fang
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
- Key Laboratory for Research of Acupuncture Treatment and Transformation of Emotional Diseases, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Xiaomei Shao
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
- Key Laboratory for Research of Acupuncture Treatment and Transformation of Emotional Diseases, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
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LI X, LIU Q, XIA R, LIU J, WANG D, SHI J, KUANG Y, DAI Y, HUANG H, TANG W, CHEN S. Moxibustion modulates working memory in patients with amnestic mild cognitive impairment: a functional magnetic resonance imaging study. J TRADIT CHIN MED 2023; 43:801-808. [PMID: 37454266 PMCID: PMC10320444 DOI: 10.19852/j.cnki.jtcm.20230526.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/19/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE To investigate the correlation between changes in brain activity associated with working memory and assessment scales of memory scores in amnestic mild cognitive impairment (aMCI) before and after moxibustion therapy. METHODS aMCI patients were randomized into the moxibustion treatment (MT) group and the placebo moxibustion (PM) group. Each group received either moxibustion therapy or a placebo moxibustion for eight weeks. Neuropsychological performance and functional brain responses to a working memory task were assessed at baseline and at the end of treatment. Memory function was evaluated individually by the Rivermead behavioral memory test (RBMT), and working memory was assessed by the N-back task. RESULTS Compared with the PM group, RBMT score changes were significant ( < 0.05). In the MT group, the accuracy of the N-back texts increased compared with those before the intervention. After moxibustion intervention, the right insula, postcentral gyrus, precentral gyrus, superior temporal gyrus, thalamus, lingual gyrus, calcarine sulcus, posterior cingulate gyrus, middle frontal gyrus and anterior frontal gyrus were significantly activated (= 0.01, Cluster-level Family-Wise Error = 0.05). Pearson correlation analysis showed that the insula, lingual gyrus and posterior cingulate gyrus were associated with changes in N-back score. Spearman correlation analysis showed that the postcentral gyrus, superior temporal gyrus, thalamus, lingual gyrus, and posterior cingulate gyrus were correlated with RBMT score changes. CONCLUSION Moxibustion treatment improved memory in aMCI patients and was associated with the activation of the brain region of the insula, lingual gyrus, posterior cingulate gyrus, postcentral gyrus, superior temporal gyrus, and thalamus, which may be an important mechanism by which moxibustion improves the memory function.
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Affiliation(s)
- Xingjie LI
- 1 College of Acupuncture and Massage, Anhui University of Chinese Medicine, Hefei 230031, China
- 2 Department of Rehabilitation, The People's Hospital of Baoan Shenzhen, Southern Medical University, and the Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Qiqi LIU
- 1 College of Acupuncture and Massage, Anhui University of Chinese Medicine, Hefei 230031, China
| | - Rui XIA
- 2 Department of Rehabilitation, The People's Hospital of Baoan Shenzhen, Southern Medical University, and the Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Jun LIU
- 1 College of Acupuncture and Massage, Anhui University of Chinese Medicine, Hefei 230031, China
| | - Dan WANG
- 2 Department of Rehabilitation, The People's Hospital of Baoan Shenzhen, Southern Medical University, and the Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Jiao SHI
- 2 Department of Rehabilitation, The People's Hospital of Baoan Shenzhen, Southern Medical University, and the Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Yuxing KUANG
- 2 Department of Rehabilitation, The People's Hospital of Baoan Shenzhen, Southern Medical University, and the Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Yalan DAI
- 2 Department of Rehabilitation, The People's Hospital of Baoan Shenzhen, Southern Medical University, and the Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Haoyu HUANG
- 2 Department of Rehabilitation, The People's Hospital of Baoan Shenzhen, Southern Medical University, and the Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Wei TANG
- 1 College of Acupuncture and Massage, Anhui University of Chinese Medicine, Hefei 230031, China
| | - Shangjie CHEN
- 2 Department of Rehabilitation, The People's Hospital of Baoan Shenzhen, Southern Medical University, and the Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
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Liu Y, Gong Y, Wu XL, Hao XM, Liu JP, Li YY, Yang KZ, Gao XY, Zhang J, Zhang L, Zhang XD, Wang J, Liu QG. Fire acupuncture for anti-LGI1 antibody autoimmune encephalitis: a case report. Front Neurosci 2023; 17:1203915. [PMID: 37539383 PMCID: PMC10395828 DOI: 10.3389/fnins.2023.1203915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/19/2023] [Indexed: 08/05/2023] Open
Abstract
Autoimmune encephalitis, a class of encephalitis, is clinically characterized by multifocal or diffuse brain injury, including aberrant mental behavior, convulsions, and near-event memory impairment. In this article, we describe a female patient with autoimmune encephalitis who tested positive for leucine-rich glioma inactivated 1 (LGI1) antibodies and had hippocampal inflammatory edema in the lesion area. During the first 3 months of her illness, the patient primarily experienced memory loss, the onset of rigid twitching in her extremities that lasted for 1 min while in remission, and incontinence. After gamma globulin administration, methylprednisolone shock, and other symptomatic therapies during hospitalization, the patient's psychiatric symptoms and seizures improved considerably; however, she did not fully recover her memory. After receiving fire acupuncture for 6 months, the patient's understanding, orientation, and calculation skills improved considerably. Her memory and mental state were also improved at the follow-up visit. In this case, the use of fire acupuncture for the treatment of autoimmune encephalitis resulted in favorable outcomes with important benefits for conditions affecting the central nervous system; however, more convincing data are required to support the effectiveness of this treatment method.
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Affiliation(s)
- Yu Liu
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yu Gong
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xiao-li Wu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xiao-min Hao
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Ji-peng Liu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yin-yin Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Ke-zhen Yang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xin-yu Gao
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jing Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Lin Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xu-dong Zhang
- Department of Chinese Medicine, Beijing Jishuitan Hospital, Beijing, China
| | - Jun Wang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Qing-guo Liu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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8
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Wong KKL, Xu J, Chen C, Ghista D, Zhao H. Functional magnetic resonance imaging providing the brain effect mechanism of acupuncture and moxibustion treatment for depression. Front Neurol 2023; 14:1151421. [PMID: 37025199 PMCID: PMC10070747 DOI: 10.3389/fneur.2023.1151421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 02/22/2023] [Indexed: 04/08/2023] Open
Abstract
The efficacy of acupuncture and moxibustion in the treatment of depression has been fully recognized internationally. However, its central mechanism is still not developed into a unified standard, and it is generally believed that the central mechanism is regulation of the cortical striatum thalamic neural pathway of the limbic system. In recent years, some scholars have applied functional magnetic resonance imaging (fMRI) to study the central mechanism and the associated brain effects of acupuncture and moxibustion treatment for depression. This study reviews the acupuncture and moxibustion treatment of depression from two aspects: (1) fMRI study of the brain function related to the acupuncture treatment of depression: different acupuncture and moxibustion methods are summarized, the fMRI technique is elaborately explained, and the results of fMRI study of the effects of acupuncture are analyzed in detail, and (2) fMRI associated "brain functional network" effects of acupuncture and moxibustion on depression, including the effects on the hippocampus, the amygdala, the cingulate gyrus, the frontal lobe, the temporal lobe, and other brain regions. The study of the effects of acupuncture on brain imaging is not adequately developed and still needs further improvement and development. The brain function networks associated with the acupuncture treatment of depression have not yet been adequately developed to provide a scientific and standardized mechanism of the effects of acupuncture. For this purpose, this study analyzes in-depth the clinical studies on the treatment of anxiety and depression by acupuncture and moxibustion, by depicting how the employment of fMRI technology provides significant imaging changes in the brain regions. Therefore, the study also provides a reference for future clinical research on the treatment of anxiety and depression.
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Affiliation(s)
- Kelvin K. L. Wong
- The Research Center for Medical AI, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Jinping Xu
- The Research Center for Medical AI, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Cang Chen
- The Research Center for Medical AI, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Dhanjoo Ghista
- The Research Center for Medical AI, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Hong Zhao
- Acupuncture and Moxibustion Department, Luohu District Hospital of Traditional Chinese Medicine, Shenzhen, China
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Immediate modulatory effects of transcutaneous auricular vagus nerve stimulation on the resting state of major depressive disorder. J Affect Disord 2023; 325:513-521. [PMID: 36642310 DOI: 10.1016/j.jad.2023.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 12/13/2022] [Accepted: 01/08/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND Previous studies have found that transcutaneous auricular vagus nerve stimulation (taVNS) is clinically effective in the treatment of major depressive disorder (MDD), and its efficacy mechanism is related to modulation of the default mode network (DMN) and cognitive control network (CCN). However, the mechanism of the immediate effect of taVNS for MDD remains to be elucidated. METHODS A total of 58 patients with MDD and 54 healthy controls(HCs) were included in this study. The MDD group was treated with taVNS for 30 min (20 Hz, 4-6 mA) immediately, and we observed amplitude of low-frequency fluctuations (ALFF) abnormalities in the MDD group and changes in ALFF and functional connectivity (FC) before and after immediate treatment. The ALFF brain regions altered by taVNS induction were used as regions of interest to analyze whole-brain FC changes in the MDD group. RESULTS After taVNS treatment, ALFF in the right precuneus was decreased in the MDD group. The FC of the right precuneus with the left middle frontal gyrus, the left posterior cingulate gyrus and the left angular gyrus were decreased in the MDD group. Correlation analysis showed that the FC values between the right precuneus and the left posterior cingulate gyrus in the pre-treatment MDD group was negatively correlated with the 17-item Hamilton depression rating scale scores. CONCLUSION TaVNS has an immediate modulatory effect on DMN and CCN. It would be proposed that these functional networks may be effective targets for the long-term treatment of MDD patients with taVNS.
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Yin Z, Zhou J, Xia M, Chen Z, Li Y, Zhang X, Li X, Yan H, Wang L, Sun M, Zhao L, Liang F, Wang Z. Acupuncture on mild cognitive impairment: A systematic review of neuroimaging studies. Front Aging Neurosci 2023; 15:1007436. [PMID: 36875696 PMCID: PMC9975578 DOI: 10.3389/fnagi.2023.1007436] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 01/13/2023] [Indexed: 02/17/2023] Open
Abstract
Mild cognitive impairment (MCI) is a multifactorial and complex central neurodegenerative disease. Acupuncture appears to be an effective method for cognitive function improvement in MCI patients. Neural plasticity remaining in the MCI brain implies that acupuncture-associated benefits may not be limited to the cognitive function. Instead, neurological alternations in the brain play a vital role in corresponding to the cognitive improvement. However, previous studies have mainly focused on the effects of cognitive function, leaving neurological findings relatively unclear. This systematic review summarized existing studies that used various brain imaging techniques to explore the neurological effect regarding acupuncture use for MCI treatment. Potential neuroimaging trials were searched, collected, and identified independently by two researchers. Four Chinese databases, four English databases, and additional sources were searched to identify studies reporting the use of acupuncture for MCI from the inception of databases until 1 June 2022. Methodological quality was appraised using the Cochrane risk-of-bias tool. In addition, general, methodological, and brain neuroimaging information was extracted and summarized to investigate the potential neural mechanisms by which acupuncture affects patients with MCI. In total, 22 studies involving 647 participants were included. The methodological quality of the included studies was moderate to high. The methods used included functional magnetic resonance imaging, diffusion tensor imaging, functional near-infrared spectroscopy, and magnetic resonance spectroscopy. Acupuncture-induced brain alterations observed in those patients with MCI tended to be observable in the cingulate cortex, prefrontal cortex, and hippocampus. The effect of acupuncture on MCI may play a role in regulating the default mode network, central executive network, and salience network. Based on these studies, researchers could extend the recent research focus from the cognitive domain to the neurological level. Future researches should develop additional relevant, well-designed, high-quality, and multimodal neuroimaging researches to detect the effects of acupuncture on the brains of MCI patients.
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Affiliation(s)
- Zihan Yin
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Jun Zhou
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Manze Xia
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Zhenghong Chen
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Yaqin Li
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xinyue Zhang
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Xiang Li
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Hang Yan
- School of Basic Medicine, Zhejiang University of Traditional Chinese Medicine, Hangzhou, China
| | - Lu Wang
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Mingsheng Sun
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Ling Zhao
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Fanrong Liang
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Ziwen Wang
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
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11
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Tu M, Xiong S, Lv S, Wu X, Hu H, Hu R, Fang J, Shao X. Acupuncture for Major Depressive Disorder: A Data Mining-Based Literature Study. Neuropsychiatr Dis Treat 2023; 19:1069-1084. [PMID: 37159675 PMCID: PMC10163884 DOI: 10.2147/ndt.s405728] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/21/2023] [Indexed: 05/11/2023] Open
Abstract
Introduction Acupuncture has a long history of treating major depressive disorder (MDD), yet the acupoint selection of acupuncture for MDD varies greatly. This study aimed to explore the characteristics and principles of acupuncture for MDD by analyzing clinical trials of acupuncture for MDD using data mining techniques. Methods In this study, clinical trials of acupuncture for MDD were retrieved and relevant data were extracted, and then the data were analyzed by data mining techniques. In addition, association rule mining, network analysis and hierarchical cluster analysis were used to determine the correlation between different acupoints. Results The results revealed that GV20, LR3, PC6, SP6 and GV29 were used most frequently; acupoints in the Yang meridian were used more often than those in the Yin meridian, with the most applied acupoints in the Governor Vessel; the percentage of specific acupoints applied was 69.39%, with the most applied being five-shu points; the frequency of acupoints used was highest in the lower limbs, while the head, face, and neck had the most acupoints used; GV29 combined with GV20 were the most used acupoint groups; the core acupoints used for MDD were GV20, PC6 and SP36; there were 5 acupoint groups according to the cluster analysis. The most used acupuncture method was manual acupuncture; the frequency of treatment was mostly 7 times per week and the duration of treatment was mostly 42 days. Discussion We discussed the current character of acupuncture treatment on MDD, including the frequency used of acupoints, the property of used acupoints, the acupoint combination, the acupuncture method, and the frequency and duration of treatment. These findings may provide new ideas for the clinical treatment of MDD. However, further clinical/experimental studies are needed to demonstrate the significance of this concept and approach.
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Affiliation(s)
- Mingqi Tu
- Key Laboratory for Research ofAcupuncture Treatment and Transformation of Emotional Diseases, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Sangsang Xiong
- Key Laboratory for Research ofAcupuncture Treatment and Transformation of Emotional Diseases, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Shengxia Lv
- The School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Xiaoting Wu
- Key Laboratory for Research ofAcupuncture Treatment and Transformation of Emotional Diseases, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Hantong Hu
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Renjie Hu
- The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Jianqiao Fang
- Key Laboratory for Research ofAcupuncture Treatment and Transformation of Emotional Diseases, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Xiaomei Shao
- Key Laboratory for Research ofAcupuncture Treatment and Transformation of Emotional Diseases, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
- Correspondence: Xiaomei Shao, Key Laboratory for Research of Acupuncture Treatment and Transformation of Emotional Diseases, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, The Third Clinical Medical College, Zhejiang Chinese Medical University, No. 548, Binwen Road, Binjiang District, Hangzhou, Zhejiang Province, People’s Republic of China, Tel +86 189 5713 0287, Email
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12
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Long Q, Lv Z, Zhao J, Shi K, Li C, Fan B, Zheng J. Cerebral gray matter volume changes in patients with anti-N-methyl-D-aspartate receptor encephalitis: A voxel-based morphometry study. Front Neurol 2022; 13:892242. [PMID: 35959389 PMCID: PMC9358280 DOI: 10.3389/fneur.2022.892242] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/04/2022] [Indexed: 01/19/2023] Open
Abstract
Background Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disease with typical clinical features. Whether and how cerebral gray matter structural damage inherent to the disorder affects cognitive function in patients is still unclear. Therefore, this study aimed to explore the changes in cerebral gray matter volume and whether these alterations contribute to cognitive impairment and mood disorders. Methods Forty patients with anti-NMDAR encephalitis and forty healthy controls (HCs) matched for gender, age, and education were recruited. All participants underwent attention network tests (ANT), neuropsychological tests and magnetic resonance imaging (MRI). Voxel-based morphological analysis (VBM) and correlation analysis was performed on all participants. Finally, according to the course of disease, patients were divided into two groups: NMDARE_SD (short duration; course ≤ 2 years since diagnosis) and NMDARE_LD (long duration; course >2 years since diagnosis), to evaluate gray matter volume changes that differ as a function of disease course. Results Compared to HCs, patients with anti-NMDAR encephalitis showed decreased executive control ability and lower MoCA score, while increased anxiety and depression as reflected by HAMA and HAMD24 scores (all P < 0.05). In VBM analysis, patients showed decreased gray matter volume in bilateral thalamus, left medial prefrontal cortex (mPFC_L), left superior temporal gyrus (STG_L), and left rectus gyrus. In the analysis stratified by disease course, the NMDARE_LD group exhibited decreased gray matter volume in the left precuneus and right posterior cerebellar lobe compared to the NMDARE_SD group. Conclusions Patients with anti-NMDAR encephalitis have cognitive, executive, and emotional dysfunction, and the sites of gray matter atrophy are concentrated in the thalamus, frontal lobe, and temporal lobe. These abnormalities may be involved in the process of cognitive and affective dysfunction.Patients with different courses of anti-NMDAR encephalitis have different brain atrophy sites. These results may help to clarify the contradiction between clinical and imaging manifestations of anti NMDAR encephalitis, which is worthy of further longitudinal studies.
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Affiliation(s)
| | | | | | | | | | | | - Jinou Zheng
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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13
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Yang S, Qin Z, Yang X, Chan MY, Zhang S, Rong P, Hou X, Jin G, Xu F, Liu Y, Zhang ZJ. Transcutaneous Electrical Cranial-Auricular Acupoint Stimulation vs. Escitalopram for Patients With Mild-to-Moderate Depression (TECAS): Study Design for a Randomized Controlled, Non-inferiority Trial. Front Psychiatry 2022; 13:829932. [PMID: 35619617 PMCID: PMC9127209 DOI: 10.3389/fpsyt.2022.829932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background Previous studies in animals and humans indicated that transcutaneous vagus nerve stimulation (tVNS) and transcutaneous electrical acupoint stimulation (TEAS) on trigeminal nerve-innervated forehead acupoints can relief the symptoms of depression. However, due to the limited investigations on these two interventions, more research are needed to confirm their efficacy in depression. To improve the efficacy of the single treatment, we combined two treatments and created a novel non-invasive stimulation, transcutaneous electrical cranial-auricular acupoint stimulation (TECAS). To assess the efficacy and safety of TECAS, we compare it with a selective serotonin reuptake inhibitor (SSRI), escitalopram, for the treatment of depression. Methods/Design This is a multi-center, non-inferiority, randomized controlled trial that will involve 470 patients with mild to moderate depression. Patients will be randomly assigned to either the TECAS group or the escitalopram group in a 1:1 ratio. The TEAS group will receive two sessions of treatments per day for 8 consecutive weeks, and the escitalopram group will receive 8 weeks of oral escitalopram tablets prescribed by clinical psychiatrists as appropriate for their condition. The primary outcome is the clinical response as determined by Montgomery-Åsberg Depression Rating Scale (MADRS) scores at week 8, with -10% as the non-inferior margin. The secondary outcomes include the response rate determined by 17-item Hamilton Depression Rating Scale (HAMD-17), remission rate, changes from baseline in the scores on the MADRS, the HAMD-17, the Hamilton Anxiety Rating Scale (HAMA), the Pittsburgh Sleep Quality Index (PSQI), and the Short Form 36 Health Survey (SF-36). Discussion This will be the first randomized controlled trial to compare the efficacy of TECAS with escitalopram for depression. If effective, this novel intervention could have significant clinical and research implications for patients with depression. Clinical Trial Registration [ClinicalTrials.gov], identifier [NCT03909217].
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Affiliation(s)
- Sichang Yang
- Department of Chinese Medicine, The University of Hong Kong Shenzhen Hospital (HKU-SZH), Shenzhen, China
- LKS Faculty of Medicine, School of Chinese Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Zongshi Qin
- Department of Chinese Medicine, The University of Hong Kong Shenzhen Hospital (HKU-SZH), Shenzhen, China
- LKS Faculty of Medicine, School of Chinese Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Xinjing Yang
- Department of Chinese Medicine, The University of Hong Kong Shenzhen Hospital (HKU-SZH), Shenzhen, China
- LKS Faculty of Medicine, School of Chinese Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Mei Yan Chan
- Department of Chinese Medicine, The University of Hong Kong Shenzhen Hospital (HKU-SZH), Shenzhen, China
- LKS Faculty of Medicine, School of Chinese Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Shuiyan Zhang
- Department of Chinese Medicine, The University of Hong Kong Shenzhen Hospital (HKU-SZH), Shenzhen, China
| | - Peijing Rong
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences (CACMS), Beijing, China
| | - Xiaobing Hou
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Guixing Jin
- Department of Mood Disorders, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Fengquan Xu
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yong Liu
- Department of Radiology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Zhang-Jin Zhang
- Department of Chinese Medicine, The University of Hong Kong Shenzhen Hospital (HKU-SZH), Shenzhen, China
- LKS Faculty of Medicine, School of Chinese Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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Matsuura Y, Hongo S, Yasuno F, Sakai T. Improvement of prefrontal blood flow in a patient with major depressive disorder after acupuncture evaluated by functional near-infrared spectroscopy: a case report. Acupunct Med 2022; 40:281-283. [DOI: 10.1177/09645284221075355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Yuto Matsuura
- Department of Acupuncture and Moxibustion, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | - Seiji Hongo
- Himorogi Psychiatric Institute, Tokyo, Japan
| | - Fumiko Yasuno
- Department of Acupuncture and Moxibustion, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | - Tomomi Sakai
- Department of Acupuncture and Moxibustion, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
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15
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Suh HW, Seol JH, Bae EJ, Kwak HY, Hong S, Park YS, Lim JH, Chung SY. Effectiveness and Safety of the Korean Medicine Senior Health Promotion Program Using Herbal Medicine and Acupuncture for Mild Cognitive Impairment: A Retrospective Study of 500 Patients in Seoul, Korea. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:8820705. [PMID: 34912467 PMCID: PMC8668316 DOI: 10.1155/2021/8820705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 06/18/2021] [Accepted: 10/25/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The management of mild cognitive impairment (MCI) is becoming increasingly important. The Korean Medicine Senior Health Promotion Program (KSHPP) was developed in 2016, and it has been in use to date. This study aimed to assess the effectiveness of KSHPP using herbal medicine and acupuncture for treating MCI and the safety of herbal medicine using liver and renal function tests. METHODS We retrospectively reviewed the medical records of the participants with MCI. We assessed the Korean version of the Montreal Cognitive Assessment (MoCA-K), the Mini-Mental State Examination-Dementia Screening (MMSE-DS), and the Geriatric Depression Scale Short Form-Korea version (GDSSF-K) scores before and after KSHPP to determine its effectiveness. To evaluate its safety, the liver and renal function tests were conducted before and after herbal treatment. RESULTS We enrolled 1002 participants, and 500 participants satisfied the inclusion criteria. Of 500 patients, 364 (72.8%) were depressed and 136 (27.2%) were not. The mean MoCA-K score significantly increased by 2.77 for the entire sample and 3.22 for the depressed sample (all P < 0.0001). The mean MMSE-DS score significantly increased by 2.19 for the entire sample and 2.51 for the depressed sample (all P < 0.0001); the mean GDSSF-K score significantly decreased by 1.73 for the entire sample and 2.68 for the depressed sample (all P < 0.0001). CONCLUSIONS Our findings suggest that Korean medicine interventions can improve cognitive function and depression symptoms in patients with MCI. In addition, the results of the liver and renal function tests were analyzed as surrogate outcomes to assess the safety of herbal medicine. Based on these results, we expect that Korean medicine interventions can promote the cognitive and mental health of seniors. However, as there were several study limitations, particularly study design, practice effect, and short follow-up, these results must be interpreted with caution. We need a further long-term study with a rigorous design to retain confidence in the effectiveness and safety of KSHPP.
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Affiliation(s)
- Hyo-Weon Suh
- College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jae-Hyun Seol
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Eun-Joo Bae
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Hui-Yong Kwak
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Sunggyu Hong
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Yong-Sin Park
- Seoul Korean Medicine Association, Seoul, Republic of Korea
- Balkeunnun Korean Medicine Clinic, Seoul, Republic of Korea
| | - Jae Hwan Lim
- Seoul Korean Medicine Association, Seoul, Republic of Korea
- Department of Brain Health Center, Jangdeuk Hospital of Korean Medicine, Seoul, Republic of Korea
| | - Sun-Yong Chung
- College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
- Department of Neuropsychiatry, Kyung Hee University Korean Medicine Hospital at Gangdong, Seoul, Republic of Korea
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16
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The Modulation of Working-Memory Performance Using Gamma-Electroacupuncture and Theta-Electroacupuncture in Healthy Adults. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:2062718. [PMID: 34824588 PMCID: PMC8610651 DOI: 10.1155/2021/2062718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 10/07/2021] [Accepted: 10/26/2021] [Indexed: 11/17/2022]
Abstract
Working memory (WM), a central component of general cognition, plays an essential role in human beings' daily lives. WM impairments often occur in psychiatric, neurodegenerative, and neurodevelopmental disorders, mainly presenting as loss of high-load WM. In previous research, electroacupuncture (EA) has been shown to be an effective treatment for cognitive impairments. Frequency parameters are an important factor in therapeutic results, but the optimal frequency parameters of EA have not yet been identified. In this study, we chose theta-EA (θ-EA; 6 Hz) and gamma-EA (γ-EA; 40 Hz), corresponding to the transcranial alternating-current stimulation (tACS) frequency parameters at the Baihui (DU20) and Shenting (DU24) acupoints, in order to compare the effects of different EA frequencies on WM. We evaluated WM performance using visual 1-back, 2-back, and 3-back WM tasks involving digits. Each participant (N = 30) attended three different sessions in accordance with a within-subject crossover design. We performed θ-EA, γ-EA, and sham-EA in a counterbalanced order, conducting the WM task both before and after intervention. The results showed that d-prime (d′) under all three stimulation conditions had no significance in the 1-back and 2-back tasks. However, in the 3-back task, there was a significant improvement in d′ after intervention compared to d′ before intervention under θ-EA (F [1, 29] = 22.64; P < 0.001), while we saw no significant difference in the γ-EA and sham-EA groups. Reaction times for hits (RT-hit) under all three stimulation conditions showed decreasing trends in 1-, 2-, and 3-back tasks but without statistically significant differences. These findings suggest that the application of θ-EA might facilitate high-load WM performance.
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17
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Wen Q, Ma P, Dong X, Sun R, Lan L, Yin T, Qu Y, Liu Y, Xiao Q, Zeng F. Neuroimaging Studies of Acupuncture on Low Back Pain: A Systematic Review. Front Neurosci 2021; 15:730322. [PMID: 34616275 PMCID: PMC8488100 DOI: 10.3389/fnins.2021.730322] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/16/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: This study was conducted in order to investigate the study design and main outcomes of acupuncture neuroimaging studies on low back pain (LBP). Methods: Neuroimaging studies of acupuncture on LBP were collected from three English databases such as PubMed and four Chinese databases such as China National Knowledge Infrastructure (CNKI) from inception to December 31, 2020. Study selection, data extraction, and assessment of risk of bias were performed independently by two investigators. The quality of studies was appraised with the Cochrane's risk of bias tools. Information on basic information, methodology, and brain imaging data were extracted. Results: The literature search returned 310 potentially eligible studies and 19 articles met inclusion criteria; 78.9% of studies chose manual acupuncture as the intervention, 89.5% of studies evaluated functional changes elicited by acupuncture, and 68.4% of studies used resting-state fMRI as imaging condition. The most frequently reported acupuncture-induced brain alterations of LBP patients were in the prefrontal cortex, insula, cerebellum, primary somatosensory cortex, and anterior cingulate cortex. There was a significant correlation between improved clinical outcomes and changes in the brain. Conclusions: The results suggested that improving abnormal structure and functional activities in the brain of the LBP patient is an important mechanism of acupuncture treatment for LBP. The brain regions involved in acupuncture analgesia for LBP were mainly located in the pain matrix, default mode network (DMN), salience network (SN), and descending pain modulatory system (DPMS). However, it was difficult to draw a generalized conclusion due to the heterogeneity of study designs. Further well-designed multimodal neuroimaging studies investigating the mechanism of acupuncture on LBP are warranted.
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Affiliation(s)
- Qiao Wen
- Acupuncture and Tuina School, Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Peihong Ma
- Acupuncture and Tuina School, Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaohui Dong
- Acupuncture and Tuina School, Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ruirui Sun
- Acupuncture and Tuina School, Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lei Lan
- Acupuncture and Tuina School, Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tao Yin
- Acupuncture and Tuina School, Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuzhu Qu
- Acupuncture and Tuina School, Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yalan Liu
- Acupuncture and Tuina School, Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qingqing Xiao
- Acupuncture and Tuina School, Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fang Zeng
- Acupuncture and Tuina School, Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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18
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Duan G, He Q, Pang Y, Chen W, Liao H, Liu H, Tan L, Liu Y, Tao J, Zhang J, Wei X, Sun P, Liu P, Deng D. Altered amygdala resting-state functional connectivity following acupuncture stimulation at BaiHui (GV20) in first-episode drug-Naïve major depressive disorder. Brain Imaging Behav 2021; 14:2269-2280. [PMID: 31432318 DOI: 10.1007/s11682-019-00178-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Amygdala is an important locus of dysfunction implicated in major depressive disorder(MDD). Aberrant amygdala networks(AN) had been reported in resting-state functional magnetic resonance imaging (rs-fMRI) study. The safety and efficacy of acupuncture treatment for MDD have been verified in previous clinical studies. This study is aimed to investigate whether acupuncture at GV20 could modulate the abnormal AN of patients with the first-episode, drug-naïve MDD by using rs-fMRI combined with functional connectivity (FC) method. Thirty MDD patient underwent 6-min rs-fMRI scans respectively before and after 20-min electro-acupuncture stimulate(EAS) at GV20. Twenty-nine healthy subjects underwent only a 6-min rs-fMRI scan. Based on the amygdala as the seed region, FC method was adopted to examine abnormal AN in patients by comparing with healthy subjects and to evaluate the influence of EAS on intrinsic connectivity within the AN in patients with MDD. Compared to healthy subjects, MDD patients had aberrant intrinsic AN which mainly showed increased FC between amygdala and hippocampus, precuneus, precentral gyrus and angular gyrus, as well as decreased FC between amygdala and orbital frontal cortex(OFC). Moreover, our results indicated that EAS at GV20 induced increased/decreased FC between amygdala and certain regions in MDD patients. In addition, the intrinsic amygdala FC within other certain brain regions in MDD patients were regulated by EAS at GV20. The abnormal AN of MDD patients could be modulated by EAS at GV20. Our findings may further provide the potential imaging evidence to support the modulatory mechanisms of acupuncture on MDD.
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Affiliation(s)
- Gaoxiong Duan
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Qianchao He
- Department of Neurology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Yong Pang
- Department of Acupuncture, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Wenfu Chen
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Hai Liao
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Huimei Liu
- Department of Acupuncture, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Lulu Tan
- Department of Neurology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Yanfei Liu
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China
| | - Jien Tao
- Department of Acupuncture, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Jian Zhang
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Xiaomei Wei
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Peiyi Sun
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Peng Liu
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China
| | - Demao Deng
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China.
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Wei XY, Chen H, Guo C, Tan WL, Zhan SH. The Instant and Sustained Effect of Electroacupuncture in Postgraduate Students with Depression: An fMRI Study. Neuropsychiatr Dis Treat 2021; 17:873-883. [PMID: 33776442 PMCID: PMC7989050 DOI: 10.2147/ndt.s307083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 03/08/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTION This study was a primary study to evaluate the instant and sustained effect of electroacupuncture (EA) at GV20 (Baihui) in postgraduate students with mild depression by using a special flexible head coil. METHODS A total of 20 postgraduate students with mild depression underwent EA stimulation at GV20 and 3 phases of resting-state functional magnetic resonance imaging (rs-fMRI) scanning. Phase I: Preparation (before needle insertion); Phase II: during EA; Phase III: 15 minutes after needle removal. The Rs-fMRI data were processed using DPABI and SPSS 25. RESULTS 1) ReHo values showed significantly differences in the right posterior cingulate cortex, right calcarine gyrus, right angular gyrus, right precuneus, right cuneus, and bilateral postcentral gyri among Phase I, Phase II and Phase III; 2) Relative to the Phase I, increased brain activity in the Phase II was observed in the bilateral postcentral gyri, right calcarine gyrus, right cuneus. Compared with the Phase II, decreased brain activity in the Phase III was observed in the right precuneus, right posterior cingulate cortex, right angular gyrus. Relative to the Phase I, Significantly increased brain activity in the Phase III was observed in the right calcarine gyrus, right cuneus, and bilateral postcentral gyri. While decreased ReHo values were found in the right posterior cingulate cortex, right angular gyrus, right precuneus; and 3) Correlation analysis showed that the ReHo values of multiple brain regions in Phase I and Phase III were significantly correlated with the VAS and HRSD-17 scores. CONCLUSION This study focuses on the instant and sustained effect in postgraduate students with depression. Our study showed that instant effect produced by EA stimulation at GV20 firstly induced changes in somatosensory and visual area, and then, sustained effect (Phase III) have a higher intensity and more extensive than instant effects. Meanwhile, we provide a visualization way to study the instant effects of head acupoints by using a flexible head coil.
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Affiliation(s)
- Xiang-Yu Wei
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China
| | - Hui Chen
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China
| | - Cui Guo
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China
| | - Wen-Li Tan
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China
| | - Song-Hua Zhan
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China
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20
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Zhang J, Wu X, Nie D, Zhuo Y, Li J, Hu Q, Xu J, Yu H. Magnetic Resonance Imaging Studies on Acupuncture Therapy in Depression: A Systematic Review. Front Psychiatry 2021; 12:670739. [PMID: 34489749 PMCID: PMC8417590 DOI: 10.3389/fpsyt.2021.670739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/12/2021] [Indexed: 12/12/2022] Open
Abstract
Accumulating studies had been performed using magnetic resonance imaging (MRI) to understand the neural mechanism of acupuncture therapy for depression. However, inconsistencies remain due to differences in research designs and MRI analytical methods. Therefore, we aim to summarize the current MRI research and provide useful information for further research by identifying papers published in English and Chinese about MRI studies on acupuncture for depression up to November 2020. A total of 22 studies met the inclusion criteria, including 810 depression patients and 416 health controls (HCs). The applied designs of these studies are mainly random control trial and pre-post designs. The MRI analytical methods are mainly (fractional) amplitude of low-frequency fluctuation (fALFF/ALFF) and functional connectivity (FC), whereas a small subset of studies used voxel-based morphometry (VBM) and diffusion tensor imaging (DTI). The most consistent functional MRI (fMRI) results showed increased N-acetylaspartate/creatine (NAA/Cr) ratios, increased ALFF in the right precuneus, decreased ALFF in the inferior frontal gyrus (IFG), and increased FC of the anterior cingulate cortex (ACC). In contrast, no significant neurological changes were identified in any of the DTI or VBM studies. However, clear, reliable conclusions cannot be drawn due to the use of different designs, analytical methods, seed points selected, types of depression, acupuncture points, and so on. Improved report specifications, well-designed studies, consistent analytical methods, and larger sample sizes will enable the field to better elucidate the underlying mechanisms of acupuncture in depressed patients.
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Affiliation(s)
- Jinhuan Zhang
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China.,Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Xiaoxiong Wu
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Dehui Nie
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Yuanyuan Zhuo
- Acupuncture Department, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Jiaying Li
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Qingmao Hu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Jinping Xu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Haibo Yu
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China.,Acupuncture Department, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
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21
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Long Z, Du L, Zhao J, Wu S, Zheng Q, Lei X. Prediction on treatment improvement in depression with resting state connectivity: A coordinate-based meta-analysis. J Affect Disord 2020; 276:62-68. [PMID: 32697717 DOI: 10.1016/j.jad.2020.06.072] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/15/2020] [Accepted: 06/23/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Previous neuroimaging studies revealed abnormal resting-state functional connectivity between distributed brain areas in patients with major depressive disorder. Those abnormalities were normalized after treatment. Moreover, the functional connectivity could predict clinical response to those treatments. However, there has currently been no meta-analysis to verify these findings. METHODS The current study aimed to investigate how the resting-state connectivity patterns predict antidepressant response to various treatments across depressive studies by using coordinate-based meta-analysis named activation likelihood estimation. The relevant articles were obtained by searching on PubMed and Web of Science. RESULTS Following exclusion criteria of inappropriate studies, seventeen papers with 392 individual depressive patients were included. Those articles contained repetitive transcranial magnetic stimulation (rTMS) treatment, pharmacotherapy, cognitive behavioral therapy (CBT), electroconvulsive therapy (ECT) and transcutaneous vagus nerve stimulation in patients with depression. Meta-analysis revealed that clinical response to all treatments could be predicted by baseline default mode network connectivity in patients with depression. The rTMS treatment had larger effect size compared to other treatment strategies. Furthermore, subgroup meta-analysis showed that the baseline connectivity of perigenual anterior cingulate cortex (pgACC) and ventral medial prefrontal cortex could predict symptoms improvement of rTMS treatment. LIMITATIONS More resting-state connectivity studies of CBT and ECT treatment are needed. CONCLUSIONS This study highlighted crucial role of DMN, especially the pgACC, in understanding the underlying treatment mechanism of depression.
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Affiliation(s)
- Zhiliang Long
- Sleep and NeuroImaging Center, Faculty of psychology, Southwest University, Chongqing, PR China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, PR China.
| | - Lian Du
- Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Jia Zhao
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, PR China
| | - Shiyang Wu
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, PR China
| | - Qiaoqiao Zheng
- Sleep and NeuroImaging Center, Faculty of psychology, Southwest University, Chongqing, PR China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, PR China
| | - Xu Lei
- Sleep and NeuroImaging Center, Faculty of psychology, Southwest University, Chongqing, PR China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, PR China
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22
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Chung WY, Liu SY, Gao JC, Jiang YJ, Zhang J, Qu SS, Zhang JP, Tan XL, Chen JQ, Wang SX. Modulatory effect of International Standard Scalp Acupuncture on brain activation in the elderly as revealed by resting-state fMRI. Neural Regen Res 2019; 14:2126-2131. [PMID: 31397351 PMCID: PMC6788231 DOI: 10.4103/1673-5374.262590] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The specific mechanisms by which acupuncture affects the central nervous system are unclear. In the International Standard Scalp Acupuncture system, acupuncture needles are applied at the middle line of the vertex, anterior parietal-temporal oblique line, and the posterior parietal-temporal oblique line. We conducted a single-arm prospective clinical trial in which seven healthy elderly volunteers (three men and four women; 50–70 years old) received International Standard Scalp Acupuncture at MS5 (the mid-sagittal line between Baihui (DU20) and Qianding (DU21)), the left MS6 (line joining Sishencong (EX-HN1) and Xuanli (GB6)), and the left MS7 (line joining DU20 and Qubin (GB7)). After acupuncture, resting-state functional magnetic resonance imaging demonstrated changes in the fractional amplitude of low frequency fluctuations and regional homogeneity in various areas, showing remarkable enhancement of regional homogeneity in the bilateral anterior cingulate, left medial frontal gyrus, supramarginal gyrus, right middle frontal gyrus, and inferior frontal gyrus. Functional connectivity based on a seed region at the right middle frontal gyrus (42, 51, 9) decreased at the bilateral medial superior frontal gyrus. Our data preliminarily indicates that the international standard scalp acupuncture in healthy elderly participants specifcally enhances the correlation between the brain regions involved in cognition and implementation of the brain network regulation system and the surrounding adjacent brain regions. The study was approved by the Ethics Committee of the China-Japan Union Hospital at Jilin University, China, on July 18, 2016 (approval No. 2016ks043).
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Affiliation(s)
- Wai-Yeung Chung
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province; School of Chinese Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
| | - Song-Yan Liu
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
| | - Jing-Chun Gao
- Department of Rehabilitation Medicine, Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong Province, China
| | - Yi-Jing Jiang
- Department of Rehabilitation Medicine, Rehabilitation Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian Province, China
| | - Jing Zhang
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
| | - Shan-Shan Qu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Ji-Ping Zhang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Xiao-Long Tan
- Department of Medical Image, Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong Province, China
| | - Jun-Qi Chen
- Department of Rehabilitation Medicine, Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong Province, China
| | - Sheng-Xu Wang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
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23
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Liu CH, Tang LR, Gao Y, Zhang GZ, Li B, Li M, Woelfer M, Martin W, Wang L. Resting-state mapping of neural signatures of vulnerability to depression relapse. J Affect Disord 2019; 250:371-379. [PMID: 30877860 DOI: 10.1016/j.jad.2019.03.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/21/2018] [Accepted: 03/04/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND Patients with major depressive disorder (MDD) can frequently develop new depressive episodes after remission. However, the neural mechanisms underlying the increased risk for depressive relapse remain unclear. Herein, we aimed to explore whether the specific changes to regional and inter-regional spontaneous brain activities within DMN are associated with the course of episodes in pooled MDD patients. METHODS Resting-state functional magnetic resonance imaging was performed on patients with single-episode MDD (SEMDD, n = 30) and multiple-episode MDD (MEMDD, n = 54), and 71 age-, gender-, and educational level-matched healthy controls (HCs). We then accessed the differences in both the fractional amplitude of low-frequency fluctuations (fALFF) and functional connectivity by using the right precuneus as the seed among different groups. RESULTS Compared to the MEMDD and HC groups, the SEMDD group exhibited increased fALFF values in the right subgenual anterior cingulate cortex and right middle temporal gyrus. Decreased fALFF values in the right thalamus in the MEMDD group were also identified relative to the SEMDD and HC group. The peak values of fALFF in the right precuneus showed a negative correlation with the number of depressive episodes across the entire pool of MDD patients. No correlation was identified between functional connectivity using the right precuneus as the seed and the number of depressive episodes for the pooled MDD patients. LIMITATIONS Medication, a relatively small sample size, and hypothesis driven study. CONCLUSIONS Our neuroimaging results identified depression relapse-associated neural signatures and also indicated the role of reduced emotional appraisals in the thalamus. It is now possible to believe that the regional activity not inter-regional connectivity within the DMN may be involved in the pathology of depression relapse.
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Affiliation(s)
- Chun-Hong Liu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, China; Department of Radiology and Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing, China.
| | - Li-Rong Tang
- Department of Radiology and Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yue Gao
- Department of Radiology and Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Guang-Zhong Zhang
- Dermatological Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China
| | - Bin Li
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China
| | - Meng Li
- Clinical Affective Neuroimaging Laboratory (CANLAB), Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Marie Woelfer
- Clinical Affective Neuroimaging Laboratory (CANLAB), Otto-von-Guericke-University Magdeburg, Magdeburg, Germany; Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA
| | - Walter Martin
- Clinical Affective Neuroimaging Laboratory (CANLAB), Otto-von-Guericke-University Magdeburg, Magdeburg, Germany; Department of Psychiatry, University of Tuebingen, Tubeingen, Germany
| | - Lihong Wang
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT 06030, USA
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24
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Nierhaus T, Chang Y, Liu B, Shi X, Yi M, Witt CM, Pach D. Somatosensory Stimulation With XNKQ Acupuncture Modulates Functional Connectivity of Motor Areas. Front Neurosci 2019; 13:147. [PMID: 30914909 PMCID: PMC6421982 DOI: 10.3389/fnins.2019.00147] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 02/08/2019] [Indexed: 01/10/2023] Open
Abstract
Xingnao Kaiqiao (XNKQ) acupuncture is an acupuncture technique used for stroke patients. In 24 healthy volunteers, we applied this complex acupuncture intervention, which consists of a manual needle-stimulation on five acupuncture points (DU26 unilaterally, PC6, and SP6 bilaterally). XNKQ was compared to three control conditions: (1) insertion of needles on the XNKQ acupuncture points without stimulation, (2) manual needle-stimulation on five nearby non-acupuncture points, and (3) insertion of needles on the non-acupuncture points without stimulation. In a within-subject design, we investigated functional connectivity changes in resting-state functional magnetic resonance imaging (fMRI) by means of the data-driven eigenvector centrality (EC) approach. With a 2 × 2 factorial within-subjects design with two-factor stimulation (stimulation vs. non-stimulation) and location (acupuncture points vs. non-acupuncture points), we found decreased EC in the precuneus after needle-stimulation (stimulation<non-stimulation), whereas the factor location showed no statistically significant EC differences. XNKQ acupuncture compared with needle-stimulation on non-acupuncture points showed decreased EC primarily in subcortical structures such as the caudate nucleus, subthalamic nucleus, and red nucleus. Post-hoc seed-based analysis revealed that the decrease in EC was mainly driven by reduced temporal correlation to primary sensorimotor cortices. The comparison of XNKQ acupuncture with the other two (non-stimulation) interventions showed no significant differences in EC. Our findings support the importance of the stimulation component of the acupuncture intervention and hint toward the modulation of functional connectivity by XNKQ acupuncture, especially in areas involved in motor function. As a next step, similar mechanisms should be validated in stroke patients suffering from motor deficits. ClinicalTrials.gov ID: NCT02453906
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Affiliation(s)
- Till Nierhaus
- Neurocomputation and Neuroimaging Unit, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Yinghui Chang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.,Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Bin Liu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xuemin Shi
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Ming Yi
- Neuroscience Research Institute and Department of Neurobiology, School of Basic Medical Sciences, Peking University, Beijing, China.,Key Laboratory for Neuroscience, Ministry of Education/National Health Commission, Peking University, Beijing, China
| | - Claudia M Witt
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany.,Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Daniel Pach
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany.,Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland
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25
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Zhang Y, Zhang H, Nierhaus T, Pach D, Witt CM, Yi M. Default Mode Network as a Neural Substrate of Acupuncture: Evidence, Challenges and Strategy. Front Neurosci 2019; 13:100. [PMID: 30804749 PMCID: PMC6378290 DOI: 10.3389/fnins.2019.00100] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 01/28/2019] [Indexed: 01/22/2023] Open
Abstract
Acupuncture is widely applied all over the world. Although the neurobiological underpinnings of acupuncture still remain unclear, accumulating evidence indicates significant alteration of brain activities in response to acupuncture. In particular, activities of brain regions in the default mode network (DMN) are modulated by acupuncture. DMN is crucial for maintaining physiological homeostasis and its functional architecture becomes disrupted in various disorders. But how acupuncture modulates brain functions and whether such modulation constitutes core mechanisms of acupuncture treatment are far from clear. This Perspective integrates recent literature on interactions between acupuncture and functional networks including the DMN, and proposes a back-translational research strategy to elucidate brain mechanisms of acupuncture treatment.
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Affiliation(s)
- Yuqi Zhang
- Department of Neurobiology, School of Basic Medical Sciences, Neuroscience Research Institute, Peking University, Beijing, China
| | - Haolin Zhang
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Till Nierhaus
- Neurocomputation and Neuroimaging Unit, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Daniel Pach
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Institute for Complementary and Integrative Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Claudia M Witt
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Institute for Complementary and Integrative Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Ming Yi
- Department of Neurobiology, School of Basic Medical Sciences, Neuroscience Research Institute, Peking University, Beijing, China.,Key Laboratory for Neuroscience, Ministry of Education, National Health Commission, Peking University, Beijing, China
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26
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Different Brain Activation after Acupuncture at Combined Acupoints and Single Acupoint in Hypertension Patients: An Rs-fMRI Study Based on ReHo Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:5262896. [PMID: 30719061 PMCID: PMC6335668 DOI: 10.1155/2019/5262896] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/02/2018] [Accepted: 12/17/2018] [Indexed: 12/11/2022]
Abstract
Background Acupuncture is proved to be effective on hypertension by numerous studies and resting-state functional magnetic resonance imaging (Rs-fMRI) is a widely used technique to study its mechanism. Along with lower blood pressure, patients with hypertension receiving acupuncture also presented improvement in function of cognition, emotion, language, sematic sensation, and so on. This study was a primary study to explore the acting path of acupuncture at combined acupoints in stimulated brain areas related to such functions. Methods In this research, regional homogeneity (ReHo) was applied to analyze the Rs-fMRI image data of brain activities after acupuncture at LR3, KI3, and LR3+KI3 and to compare the differences of functional brain activities between stimulating combined acupoints and single acupoint under pathological conditions. A total of thirty hypertension patients underwent Rs-fMRI scanning before acupuncture treatment and then were randomly divided into three groups following random number table, the LR3 group (3 males and 7 females), the KI3 group (3 males and 7 females), and the LR3+ KI3 group (4 males and 6 females) for needling, respectively. When the 30-min treatment finished, they received a further Rs-fMRI scanning. The Rs-fMRI data before and after the acupuncture treatment were analyzed through ReHo. Results Compared with preacupuncture, respectively, ReHo values increased in Brodmann areas (BAs) 3, 18, and 40 and decreased in BAs 7 and 31 in LR3+ KI3 group. However, ReHo values only decreased in BA7 of KI3 group while the results showed no significant difference of brain regions in LR3 group between pre- and postacupuncture. Compared with LR3 group, LR3+KI3 group exhibited decreased ReHo values in BAs 7, 9, and 31. Meanwhile, compared with KI3 group, LR3+KI3 group exhibited increased ReHo values in the BAs 2, 18, 30, and 40 and decreased ReHo values in BA13. Conclusion Combined acupoints of LR3 and KI3 could act on wider brain areas than the sum of single acupoints, whose functions include emotional processing, cognition, somatic sensation, spatial orientation, language production, and vision.
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27
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Jin L, Sun J, Xu Z, Yang X, Liu P, Qin W. Intersubject Synchronisation Analysis of Brain Activity Associated with the Instant Effects of Acupuncture: An Fmri Study. Acupunct Med 2018; 36:14-20. [DOI: 10.1136/acupmed-2016-011327] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2017] [Indexed: 11/03/2022]
Abstract
Objective To use a promising analytical method, namely intersubject synchronisation (ISS), to evaluate the brain activity associated with the instant effects of acupuncture and compare the findings with traditional general linear model (GLM) methods. Methods 30 healthy volunteers were recruited for this study. Block-designed manual acupuncture stimuli were delivered at SP6, and de qi sensations were measured after acupuncture stimulation. All subjects underwent functional MRI (fMRI) scanning during the acupuncture stimuli. The fMRI data were separately analysed by ISS and traditional GLM methods. Results All subjects experienced de qi sensations. ISS analysis showed that the regions activated during acupuncture stimulation at SP6 were mainly divided into five clusters based on the time courses. The time courses of clusters 1 and 2 were in line with the acupuncture stimulation pattern, and the active regions were mainly involved in the sensorimotor system and salience network. Clusters 3, 4 and 5 displayed an almost contrary time course relative to the stimulation pattern. The brain regions activated included the default mode network, descending pain modulation pathway and visual cortices. GLM analysis indicated that the brain responses associated with the instant effects of acupuncture were largely implicated in sensory and motor processing and sensory integration. Conclusion The ISS analysis considered the sustained effect of acupuncture and uncovered additional information not shown by GLM analysis. We suggest that ISS may be a suitable approach to investigate the brain responses associated with the instant effects of acupuncture.
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Affiliation(s)
- Lingmin Jin
- School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Jinbo Sun
- School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Ziliang Xu
- School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Xuejuan Yang
- School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Peng Liu
- School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Wei Qin
- School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi, China
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Role of Acupuncture in the Management of Severe Acquired Brain Injuries (sABIs). EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:8107508. [PMID: 30298094 PMCID: PMC6157173 DOI: 10.1155/2018/8107508] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 07/25/2018] [Accepted: 08/15/2018] [Indexed: 01/05/2023]
Abstract
Acupuncture therapy has been used to treat several disorders in Asian countries and its use is increasing in Western countries as well. Current literature assessed the safety and efficacy of acupuncture in the acute management and rehabilitation of patients with neurologic disorders. In this paper, the role of acupuncture in the treatment of acute severe acquired brain injuries is described, acting on neuroinflammation, intracranial oedema, oxidative stress, and neuronal regeneration. Moreover, beneficial effects of acupuncture on subacute phase and chronic outcomes have been reported in controlling the imbalance of IGF-1 hormone and in decreasing spasticity, pain, and the incidence of neurovegetative crisis. Moreover, acupuncture may have a positive action on the arousal recovery. Further work is needed to understand the effects of specific acupoints on the brain. Allegedly concurrent neurophysiological measurements (e.g., EEG) may help in studying acupuncture-related changes in central nervous system activity and determining its potential as an add-on rehabilitative treatment for patients with consciousness disorders.
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Cai RL, Shen GM, Wang H, Guan YY. Brain functional connectivity network studies of acupuncture: a systematic review on resting-state fMRI. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2017; 16:26-33. [PMID: 29397089 DOI: 10.1016/j.joim.2017.12.002] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 06/23/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND Functional magnetic resonance imaging (fMRI) is a novel method for studying the changes of brain networks due to acupuncture treatment. In recent years, more and more studies have focused on the brain functional connectivity network of acupuncture stimulation. OBJECTIVE To offer an overview of the different influences of acupuncture on the brain functional connectivity network from studies using resting-state fMRI. SEARCH STRATEGY The authors performed a systematic search according to PRISMA guidelines. The database PubMed was searched from January 1, 2006 to December 31, 2016 with restriction to human studies in English language. INCLUSION CRITERIA Electronic searches were conducted in PubMed using the keywords "acupuncture" and "neuroimaging" or "resting-state fMRI" or "functional connectivity". DATA EXTRACTION AND ANALYSIS Selection of included articles, data extraction and methodological quality assessments were respectively conducted by two review authors. RESULTS Forty-four resting-state fMRI studies were included in this systematic review according to inclusion criteria. Thirteen studies applied manual acupuncture vs. sham, four studies applied electro-acupuncture vs. sham, two studies also compared transcutaneous electrical acupoint stimulation vs. sham, and nine applied sham acupoint as control. Nineteen studies with a total number of 574 healthy subjects selected to perform fMRI only considered healthy adult volunteers. The brain functional connectivity of the patients had varying degrees of change. Compared with sham acupuncture, verum acupuncture could increase default mode network and sensorimotor network connectivity with pain-, affective- and memory-related brain areas. It has significantly greater connectivity of genuine acupuncture between the periaqueductal gray, anterior cingulate cortex, left posterior cingulate cortex, right anterior insula, limbic/paralimbic and precuneus compared with sham acupuncture. Some research had also shown that acupuncture could adjust the limbic-paralimbic-neocortical network, brainstem, cerebellum, subcortical and hippocampus brain areas. CONCLUSION It can be presumed that the functional connectivity network is closely related to the mechanism of acupuncture, and central integration plays a critical role in the acupuncture mechanism.
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Affiliation(s)
- Rong-Lin Cai
- Graduate School of Anhui University of Chinese Medicine, Hefei 230012, Anhui Province, China
| | - Guo-Ming Shen
- Graduate School of Anhui University of Chinese Medicine, Hefei 230012, Anhui Province, China.
| | - Hao Wang
- School of Integrated Traditional Chinese & Western Medicine, Anhui University of Chinese Medicine, Hefei 230012, Anhui Province, China
| | - Yuan-Yuan Guan
- Graduate School of Anhui University of Chinese Medicine, Hefei 230012, Anhui Province, China
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30
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Bao C, Wang D, Liu P, Shi Y, Jin X, Wu L, Zeng X, Zhang J, Liu H, Wu H. Effect of Electro-Acupuncture and Moxibustion on Brain Connectivity in Patients with Crohn's Disease: A Resting-State fMRI Study. Front Hum Neurosci 2017; 11:559. [PMID: 29204113 PMCID: PMC5698267 DOI: 10.3389/fnhum.2017.00559] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 11/06/2017] [Indexed: 01/14/2023] Open
Abstract
Acupuncture and moxibustion have been shown to be effective in treating Crohn’s disease (CD), but their therapeutic mechanisms remain unclear. Here we compared brain responses to either electro-acupuncture or moxibustion treatment in CD patients experiencing remission. A total of 65 patients were randomly divided into an electro-acupuncture group (n = 32) or a moxibustion group (n = 33), and treated for 12 weeks. Eighteen patients in the electro-acupuncture group and 20 patients in the moxibustion group underwent resting-state functional magnetic resonance imaging at baseline and after treatment. Seed-based analysis was used to compare the resting-state functional connectivity (rsFC) between bilateral hippocampus and other brain regions before and after the treatments, as well as between the two groups. The CD activity index (CDAI) and inflammatory bowel disease questionnaire (IBDQ) were used to evaluate disease severity and patient quality of life. Electro-acupuncture and moxibustion both significantly reduced CDAI values and increased IBDQ scores. In the electro-acupuncture group, the rsFC values between bilateral hippocampus and anterior middle cingulate cortex (MCC) and insula were significantly increased, and the changes were negatively correlated with the CDAI scores. In the moxibustion group, the rsFC values between bilateral hippocampus and precuneus as well as inferior parietal lobe (IPC) were significantly elevated, and the changes were negatively correlated with the CDAI scores. We conclude that the therapeutic effects of electro-acupuncture and moxibustion on CD may involve the differently modulating brain homeostatic afferent processing network and default mode network (DMN), respectively.
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Affiliation(s)
- Chunhui Bao
- Key Laboratory of Acupuncture and Immunological Effects, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Di Wang
- Key Laboratory of Acupuncture and Immunological Effects, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Peng Liu
- Life Sciences Research Center, School of Life Sciences and Technology, Xidian University, Xi'an, China
| | - Yin Shi
- Outpatient Department, Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaoming Jin
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Luyi Wu
- Key Laboratory of Acupuncture and Immunological Effects, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaoqing Zeng
- Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jianye Zhang
- Department of Radiology, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Huirong Liu
- Outpatient Department, Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Huangan Wu
- Key Laboratory of Acupuncture and Immunological Effects, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Cao J, Tang Y, Li Y, Gao K, Shi X, Li Z. Behavioral Changes and Hippocampus Glucose Metabolism in APP/PS1 Transgenic Mice via Electro-acupuncture at Governor Vessel Acupoints. Front Aging Neurosci 2017; 9:5. [PMID: 28174534 PMCID: PMC5259686 DOI: 10.3389/fnagi.2017.00005] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 01/10/2017] [Indexed: 11/22/2022] Open
Abstract
Objective: Investigating the effects of electro-acupuncture (EA) treatment on mice with Alzheimer’s disease (AD), using Morris water maze (MWM) for spatial learning and memory behavior tests combined with micro-positron emission tomography (micro-PET) imaging for glucose metabolism in hippocampus. Methods: Thirty seven-month-old APP/PS1 mice were randomly divided into AD Model group (AD group), medicine group (M group) and EA group, C57BL/6 mice were used for Normal control group (N group), n = 10 in each group. Mice in M group received donepezil intervention by gavage with dose at 0.92 mg/kg. EA was applied at Baihui (GV20) and Yintang (GV29) acupoints for 20 min then pricked at Shuigou (GV26) acupoint, while mice in N, M and AD groups were received restriction for 20 min, with all treatment administrated once a day for 15 consecutive days. After the treatment, MWM was performed to observe behavioral changes in mice, then hippocampus glucose metabolism level was tested by micro-PET imaging. Results: Compared with that of AD group, the escape latency of M and EA groups declined significantly (P < 0.01), while the proportion of the platform quadrant swimming distance in total swimming distance showed an obvious increase (P < 0.01), and EA group occupied a higher percentage than that in M group. The micro-PET imaging showed that mice in AD group performed a lower glucose metabolic rate in hippocampus compared with N group (P < 0.01). Both M and EA groups presented a significant higher injected dose compared with AD group (P < 0.01), and the uptake rate of EA group was higher than M group. Conclusion: Both donepezil and EA have therapeutic effects on AD mice. To a certain extent, EA shows a better efficacy in treatment of AD by improving the spatial learning and memory ability, while also enhancing glucose metabolism in hippocampus.
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Affiliation(s)
- Jin Cao
- School of Acupuncture Moxibustion and Tuina, Beijing University of Chinese Medicine Beijing, China
| | - Yinshan Tang
- Department of Rehabilitation in Traditional Chinese Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine Hangzhou, China
| | - Yujie Li
- School of Acupuncture Moxibustion and Tuina, Beijing University of Chinese Medicine Beijing, China
| | - Kai Gao
- Institute of Medical Laboratory Animal Science, Chinese Academy of Medical Sciences Beijing, China
| | - Xudong Shi
- Institute of Medical Laboratory Animal Science, Chinese Academy of Medical Sciences Beijing, China
| | - Zhigang Li
- School of Acupuncture Moxibustion and Tuina, Beijing University of Chinese Medicine Beijing, China
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32
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Wang Z, Wang X, Liu J, Chen J, Liu X, Nie G, Jorgenson K, Sohn KC, Huang R, Liu M, Liu B, Kong J. Acupuncture treatment modulates the corticostriatal reward circuitry in major depressive disorder. J Psychiatr Res 2017; 84:18-26. [PMID: 27693978 PMCID: PMC5125902 DOI: 10.1016/j.jpsychires.2016.09.014] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 09/08/2016] [Accepted: 09/15/2016] [Indexed: 01/05/2023]
Abstract
Major depressive disorder (MDD) is a common disorder with a high prevalence and significant social and economic impacts. Nevertheless, the treatment of MDD is far from satisfactory. Acupuncture treatment has emerged as a promising method for treating MDD. However, the neural mechanism by which acupuncture reduces depressive symptoms is not fully understood. Studies have shown that the corticostriatal reward circuitry is associated with the pathophysiology of MDD; thus, we investigated the corticostriatal resting-state functional connectivity (rsFC) before and after real and sham acupuncture treatments combined with the antidepressant fluoxetine. Forty-six female major depressive patients were assigned to either verum acupuncture plus fluoxetine (n = 22) or sham acupuncture plus fluoxetine (n = 24) treatment for 8 weeks, and resting state functional magnetic resonance imaging (fMRI) data were collected before the first and after the last treatment sessions. The results showed that compared with sham acupuncture, the verum acupuncture group showed: (1) significantly increased rsFC between inferior ventral striatum and medial prefrontal cortex, ventral rostral putamen and amygdala/parahippocampus, as well as dorsal caudate and middle temporal gyrus; (2) significantly decreased rsFC between right ventral rostral putamen and right dorsolateral prefrontal cortex, and right dorsal caudate and bilateral cerebellar tonsil. The increased rsFC between the inferior ventral striatum and medial prefrontal cortex, ventral rostral putamen and amygdala/parahippocampus were significantly positively associated with decreased clinical scores (Montgomery-Åsberg Depression Rating Scale and Self-Rating Depression Scale scores) at the end of the eight-week treatment. Our findings suggest that acupuncture may achieve treatment effects by modulating the corticostriatal reward/motivation circuitry in MDD patients.
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Affiliation(s)
- Zengjian Wang
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, South China Normal University, Guangzhou, 510631, China; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Xiaoyun Wang
- The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, 510120, China
| | - Jian Liu
- The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, 510120, China
| | - Jun Chen
- The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, 510120, China
| | - Xian Liu
- The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, 510120, China
| | - Guangning Nie
- The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, 510120, China
| | - Kristen Jorgenson
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Ki Cheul Sohn
- Hospital of Catholic University of Daegu, 3056-6 Daemyeong 4 Nam-gu, Daegu 705-718, South Korea
| | - Ruiwang Huang
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, South China Normal University, Guangzhou, 510631, China
| | - Ming Liu
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, South China Normal University, Guangzhou, 510631, China
| | - Bo Liu
- The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, 510120, China.
| | - Jian Kong
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
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Efficacy and Safety of Electroacupuncture on Treating Depression Related Sleep Disorders: Study Protocol of a Randomized Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:1069597. [PMID: 28119755 PMCID: PMC5227148 DOI: 10.1155/2016/1069597] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 11/29/2016] [Indexed: 12/20/2022]
Abstract
Background. Depression is frequently accompanied by sleep disturbances including insomnia. Insomnia may persist even after mood symptoms have been adequately treated. Acupuncture is considered to be beneficial to adjust the state of body and mind and restore the normal sleep-awake cycle. This trial is aimed at evaluating the efficacy and safety of electroacupuncture on treating insomnia in patients with depression. Methods. We describe a protocol for a randomized, single-blinded, sham controlled trial. Ninety eligible patients will be randomly assigned to one of 3 treatment groups: treatment group (acupuncture), control A group (superficial acupuncture at sham points), and control B group (sham acupuncture). All treatment will be given 3 times per week for 8 weeks. The primary outcome is the Pittsburgh Sleep Quality Index (PSQI). The secondary outcomes are sleep parameters recorded in the Actigraphy, Hamilton Rating Scale for Depression (HAMD), and Self-Rating Depression Scale (SDS). All adverse effects will be accessed by the Treatment Emergent Symptom Scale (TESS). Outcomes will be evaluated at baseline, 4 weeks after treatment, 8 weeks after treatment, and 4 weeks of follow-up. Ethics. This trial has been approved by the Ethics Committee of Shanghai Municipal Hospital of Traditional Chinese Medicine (2015SHL-KY-21) and is registered with ChiCTR-IIR-16008058.
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Long X, Huang W, Napadow V, Liang F, Pleger B, Villringer A, Witt CM, Nierhaus T, Pach D. Sustained Effects of Acupuncture Stimulation Investigated with Centrality Mapping Analysis. Front Hum Neurosci 2016; 10:510. [PMID: 27803655 PMCID: PMC5067410 DOI: 10.3389/fnhum.2016.00510] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 09/27/2016] [Indexed: 01/17/2023] Open
Abstract
Acupuncture can have instant and sustained effects, however, its mechanisms of action are still unclear. Here, we investigated the sustained effect of acupuncture by evaluating centrality changes in resting-state functional magnetic resonance imaging after manually stimulating the acupuncture point ST36 at the lower leg or two control point locations (CP1 same dermatome, CP2 different dermatome). Data from a previously published experiment evaluating instant BOLD effects and S2-seed-based resting state connectivity was re-analyzed using eigenvector centrality mapping and degree centrality mapping. These data-driven methods might add new insights into sustained acupuncture effects on both global and local inter-region connectivity (centrality) by evaluating the summary of connections of every voxel. We found higher centrality in parahippocampal gyrus and middle temporal gyrus after ST36 stimulation in comparison to the two control points. These regions are positively correlated to major hubs of the default mode network, which might be the primary network affected by chronic pain. The stronger integration of both regions within the whole-brain connectome after stimulation of ST36 might be a potential contributor to pain modulation by acupuncture. These findings highlight centrality mapping as a valuable analysis for future imaging studies investigating clinically relevant outcomes associated with physiological response to acupuncture stimulation. CLINICAL TRIAL REGISTRATION NCT01079689, ClinicalTrials.gov.
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Affiliation(s)
- Xiangyu Long
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Germany
| | - Wenjing Huang
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin BerlinBerlin, Germany; Acupuncture and Tuina School, The 3rd Teaching Hospital, Chengdu University of Traditional Chinese MedicineChengdu, China
| | - Vitaly Napadow
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, CharlestownMA, USA; Department of Radiology, Logan University, ChesterfieldMO, USA
| | - Fanrong Liang
- Acupuncture and Tuina School, The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine Chengdu, China
| | - Burkhard Pleger
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Germany
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain SciencesLeipzig, Germany; The Mind-Brain Institute at Berlin School of Mind and Brain, Charité and Humboldt-UniversitätBerlin, Germany
| | - Claudia M Witt
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin BerlinBerlin, Germany; Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital ZurichZurich, Switzerland
| | - Till Nierhaus
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain SciencesLeipzig, Germany; The Mind-Brain Institute at Berlin School of Mind and Brain, Charité and Humboldt-UniversitätBerlin, Germany; Neurocomputation and Neuroimaging Unit, Department of Education and Psychology, Freie Universität BerlinBerlin, Germany
| | - Daniel Pach
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin Berlin, Germany
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35
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Neural correlates of healing prayers, depression and traumatic memories: A preliminary study. Complement Ther Med 2016; 27:123-9. [DOI: 10.1016/j.ctim.2016.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 06/09/2016] [Accepted: 07/05/2016] [Indexed: 11/15/2022] Open
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