Magnetic Resonance Imaging Studies on Acupuncture Therapy in Depression: A Systematic Review

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.

Electroacupuncture as a rapid-onset and safer complementary therapy for depression: A systematic review and meta-analysis

“…One was an update of a meta-analysis of EA for post-stroke depression in 2018 (19 trials) (18), which indicated that in comparison with antidepressants, EA has a similar effect in improving depression symptoms and shows better safety in post-stroke depression patients. Another systematic review focused on the neuroimaging effects of acupuncture (including EA) in depression (10 trials of EA) (65). However, that study did not conduct a meta-analysis of efficacy or neuroimaging data of EA for depression because of the limited number of trials and the fact that most of the trials used pre-post designs.…”

"Application Progress of Traditional Chinese Medicine Therapy in the Treatment of Depression"

“…Copyright © Yajing Hou PPRS.000637. 6(3).2023 and reshape the microstructure of the white matter fiber bundle in the brain area to reduce the depression scale score of patients [9]. Acupuncture and moxibustion can regulate neurotransmitters, neuroinflammatory cytokines, hypothalamus-pituitary-adrenal axis and hypothalamus-pituitary-gonadal axis to treat depression [10].…”

The efficacy and cerebral mechanism of intradermal acupuncture for major depressive disorder: a study protocol for a randomized controlled trial

“…As previously mentioned, fMRI has been used not only to observe activity in specific brain regions in MDD patients, but also to quantify the brain response induced by acupuncture for MDD in an attempt to illuminate the cerebral mechanism ( 47 ). Importantly, the activity in brain regions such as the ACC, hypothalamus, amygdala and dorsolateral PFC, was found to be positively correlated with the efficacy of acupuncture for MDD, suggesting that acupuncture can improve depressive symptoms by modulating brain networks ( 47–49 ). What this evidence focused on, however, was the cerebral mechanism of manual and electroacupuncture for MDD, and not IA.…”