Modulation of the Default Mode Network in First-Episode, Drug-Naïve Major Depressive Disorder via Acupuncture at Baihui (GV20) Acupoint

Abstract

Background: Previous neuroimaging studies have revealed that acupuncture modulates the default mode network (DMN) in healthy subjects and patients with certain disorder. However, few studies have been performed to investigate whether or not acupuncture might modulate the DMN in patients with major depressive disorder (MDD). Thereby, the aim of the present study was to assess alterations of the DMN induced by acupuncture stimulation in patients with first-episode, drug-naïve MDD.Materials and Methods: Twenty nine patients with first-episode, drug-naïve MDD and 29 healthy subjects were enrolled in this study. All the healthy subjects underwent 6-min resting-state functional magnetic resonance imaging (R-fMRI) scan. While patients underwent acupuncture stimulation for 20-min electro-acupuncture stimulation (EAS) at Baihui acupoint (GV20) and two 6-min R-fMRI scans before and after EAS. Based on the precuneus/posterior cingulate cortex (PC/PCC) as the seed region, functional connectivity (FC) method was adopted to examine abnormal DMN in patients by comparing with healthy subjects and to evaluate the influence of EAS on intrinsic connectivity within the DMN in patients with MDD.Results: Compared to healthy subjects, MDD patients had abnormal DMN. Moreover, results showed that EAS at GV20 induced increased FC between the PC/PCC and bilateral anterior cingulate cortex (ACC), and decreased FC between the PC/PCC and left middle prefrontal cortex, left angualr gyrus and bilateral hippocampus/parahippocampus (HIPP/paraHIPP) in patients with MDD, which were the main brain regions showing significant differences between the patients and healthy subjects.Conclusion: Our findings provide imaging evidence to support that GV20-related acupuncture stimulation may modulate the DMN in patients with first-episode, drug-naïve MDD. This study may partly interpret the neural mechanisms of acupuncture at GV20 which is used to treat patients with MDD in clinical.

Acupuncture treatment modulates the corticostriatal reward circuitry in major depressive disorder

“…Recently, rsFC has been used to investigate the underlying mechanism of acupuncture in healthy subjects (Bai, Qin, Tian, Dai, & Yang, 2009; Dhond, Yeh, Park, Kettner, & Napadow, 2008; Hui et al, 2009; Liu et al, 2009; Qin et al, 2008; Zhong et al, 2012), and patient populations, such as patients with MDD (Deng et al, 2016; Yi et al, 2012), knee osteoarthritis (Chen et al, 2015; Egorova, Gollub, & Kong, 2015), migraines (Li et al, 2016) and Alzheimer’s disease (Wang et al, 2014). For instance, investigators found that peripheral nerve stimulation and acupuncture can significantly modulate the rsFC of the default mode network (Deng et al, 2016; Fang et al, 2016), amygdala (Liu et al, 2016), and anterior cingulate cortex (Yi et al, 2012) in MDD patients.…”

“…For instance, investigators found that peripheral nerve stimulation and acupuncture can significantly modulate the rsFC of the default mode network (Deng et al, 2016; Fang et al, 2016), amygdala (Liu et al, 2016), and anterior cingulate cortex (Yi et al, 2012) in MDD patients. Taken together, these results suggest that rsFC can be a useful tool to investigate the mechanism of acupuncture treatment of MDD.…”

Behavioral Changes and Hippocampus Glucose Metabolism in APP/PS1 Transgenic Mice via Electro-acupuncture at Governor Vessel Acupoints

“…Electro-acupuncture (EA), combining traditional acupuncture with modern electrotherapy, is a promising therapy that has been widely used in clinical practice, especially exerting beneficial effects in CNS diseases such as depression, spinal cord injury (SCI), stroke and AD (Guo et al, 2014; Mo et al, 2014; Deng et al, 2016; Lai et al, 2016). The mechanism of AD mainly lies in two aspects of deficiency in origin and enrichment in symptom in accordance with the Traditional Chinese Medicine (TCM) theory.…”

Efficacy and Safety of Electroacupuncture on Treating Depression Related Sleep Disorders: Study Protocol of a Randomized Controlled Trial

“…Combining acupuncture theory with acupuncturists' experience, we regard acupuncture method of regulating the Governor Vessel as the main treatment principle and choose two acupoints (GV20 and GV29) in GV for electroacupuncture to enhance the curative effect for treating insomnia. Imageology study also found that electroacupuncture stimulation at GV20 can modulate the default mode network in patients with depressive disorder, which supports that EA has positive effect on treating comorbid depression and insomnia [31]. The application of the Actigraphy is another flashpoint in the trial.…”