Repeated acupuncture treatments modulate amygdala resting state functional connectivity of depressive patients

Abstract

As a widely-applied alternative therapy, acupuncture is gaining popularity in Western society. One challenge that remains, however, is incorporating it into mainstream medicine. One solution is to combine acupuncture with other conventional, mainstream treatments. In this study, we investigated the combination effect of acupuncture and the antidepressant fluoxetine, as well as its underlying mechanism using resting state functional connectivity (rsFC) in patients with major depressive disorders.Forty-six female depressed patients were randomized into a verum acupuncture plus fluoxetine or a sham acupuncture plus fluoxetine group for eight weeks. Resting-state fMRI data was collected before the first and last treatments. Results showed that compared with those in the sham acupuncture treatment, verum acupuncture treatment patients showed 1) greater clinical improvement as indicated by Montgomery–Åsberg Depression Rating Scale (MADRS) and Self-Rating Depression Scale (SDS) scores; 2) increased rsFC between the left amygdala and subgenual anterior cingulate cortex (sgACC)/preguenual anterior cingulate cortex (pgACC); 3) increased rsFC between the right amygdala and left parahippocampus (Para)/putamen (Pu). The strength of the amygdala-sgACC/pgACC rsFC was positively associated with corresponding clinical improvement (as indicated by a negative correlation with MADRS and SDS scores). Our findings demonstrate the additive effect of acupuncture to antidepressant treatment and suggest that this effect may be achieved through the limbic system, especially the amygdala and the ACC.

Acupuncture treatment modulates the corticostriatal reward circuitry in major depressive disorder

“…In our previous study, we reported how acupuncture plus fluoxetine treatment modulates the rsFC of the amygdala related network (Wang et al, 2016). In this manuscript, we focus on how acupuncture modulates the rsFC of the extended corticostriatal network using a seed-to-whole-brain method, which has never been reported before.…”

“…In addition, accumulating evidence has indicated that acupuncture combined with antidepressant medication is more effective than antidepressants alone, and is safe, well-tolerated, and has an early onset of action (Chan et al, 2015; Wang et al, 2016; Zhang, Yang, & Zhong, 2009), which embodies the potential of combining acupuncture and pharmacological treatments for depression.…”

Effectiveness and Safety of Acupuncture for Perimenopausal Depression: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

“…Heterogeneity: chi 2 = 11.20, df = 9 (P = 0.26); I 2 = 20% Test for overall effect: Z = 7.92 (P < 0.00001) Heterogeneity: chi 2 = 20.44, df = 13 (P = 0.08); I 2 = 36% Test for overall effect: Z = 8.21 (P < 0.00001) Test for subgroup differences: chi 2 =5.94, df = 1 (P = 0.01); I 2 = 83.2% Evidence-Based Complementary and Alternative Medicine [49][50][51][52]. It is generally believed that the LPNN is related to sleep and emotions.…”

The Science of Auricular Microsystem Acupuncture: Amygdala Function in Psychiatric, Neuromusculoskeletal, and Functional Disorders

“…These researchers concluded that the additional benefit of acupuncture was achieved via its positive regulatory influence on the limbic system, particularly the amygdala and anterior cingulate cortex. 15 Benefits derived from auricular amygdala acupuncture are consistent, precise, and frequently extraordinary. Patients from the current author's clinical practice are well-informed regarding the clinical significance amygdala function and the rationale for addressing it through the auricular-acupuncture microsystem.…”