The Role of Medial Prefrontal Cortex in Acupuncture Treatment for Functional Dyspepsia

Abstract

Acupuncture is an effective therapy for functional dyspepsia (FD). However, the efficacy of acupuncture in the treatment of FD varies among individuals in clinical practice. This study aimed to reveal the brain response patterns in acupuncture higher response/lower response FD patients. Firstly, we performed a within-group comparison of brain function activity before and after acupuncture treatment in 115 FD patients and analyzed the correlation between brain function activity changes and clinical improvements. Secondly, 115 subjects were divided into the acupuncture higher response group or the lower response group based on the median clinical improvement values. The changes in functional brain activity after acupuncture treatment were investigated in these two groups, respectively. Finally, the identified brain regions associated with the clinical improvements were set as regions of interest (ROI), and the ROI-to-voxel functional connectivity comparisons were also performed in both groups, respectively. The results demonstrated that the functional activities of the left cerebellum inferior, right middle temporal gyrus, and right medial prefrontal cortex (mPFC) were increased, and the left Heschl and right middle cingulate cortex were decreased in 115 FD patients after acupuncture treatment. The functional connectivity changes of mPFC were correlated with improving the Nepean Dyspepsia Symptom Index. The significant increase in mPFC functional activity was also found in acupuncture higher response FD patients but not in lower response FD patients. The functional connectivity between the mPFC and default mode network (DMN) was significantly diminished in the higher response group but not in the lower response group. In conclusion, this study suggested that modulating the functional activity of the mPFC and its connectivity to the DMN may be one of the important mechanisms of acupuncture for treating FD with a higher response.

A neural circuit for gastric motility disorders driven by gastric dilation in mice

“…Several neuroimaging studies have shown that acupuncture treatment improves not only clinical symptoms (postprandial fullness, epigastric distention, etc.) but also significantly modulates abnormal brain functions such as medial prefrontal cortex, brainstem, thalamus, caudate, and hippocampus in FD patients (Zeng et al, 2015;Teng et al, 2022;Yin et al, 2022). The central neural mechanism of the acupuncture effect is closely related to its modulation of neural circuits or neural networks, our study found after EA intervention, fMRI in GD subjects showed changes in functional connectivity between hypothalamus and brainstem.…”

Clinical‐functional brain connectivity signature predicts longitudinal symptom improvement after acupuncture treatment in patients with functional dyspepsia

“…(Kano et al, 2018 ). As shown in the previous studies, the functional activity and connectivity patterns of the hippocampus, anterior insula, and mPFC were correlated with the disease severity in FD patients (Beckers et al, 2022 ; Zeng et al, 2011 ), and acupuncture treatment could significantly modulate the functional activity and connectivity patterns of the mPFC, ACC, and anterior insula of FD patients (Teng et al, 2022 ; Zeng et al, 2012 ). It suggested that these regions were the critical pathologic aspects of the disease as well as the targets for acupuncture treatment, and therefore could be severed as the predictive features for the prediction of acupuncture efficacy in FD patients.…”

“…Depending on their group assignments, patients received acupuncture stimulation at one or two acupoints. Since these stimulated acupoints were disease‐related and proven to be effective (Dong et al, 2022 ; Kim et al, 2020 ; Teng et al, 2022 ), samples from different intervention groups were aggregated and utilized to develop and evaluate the prediction models. The details of the acupuncture interventions can be found in Supplementary 1 .…”

Symptom effects and central mechanism of acupuncture in patients with functional gastrointestinal disorders: a systematic review based on fMRI studies

“…Studies have confirmed that acupuncture can improve the symptoms of abdominal pain, diarrhea, anxiety, and other symptoms in patients with IBS-D by affecting the functional connection between the hippocampus and the brain regions related to emotion and visceral sensation [ 19 ]. Basolateral amygdala, hippocampus and medial prefrontal cortex (mPFC) may be the target brain regions for the central response to acupuncture treatment of functional dyspepsia [ 20 – 22 ]. In recent years, clinical randomized controlled trials (RCTs) involving acupuncture on brain function changes of FGIDs patients have gradually emerged.…”