Abstract
This study aimed to investigate changes in resting state brain activity in remissive Crohn’s Disease (CD) patients after electro-acupuncture or moxibustion treatment. Fifty-two CD patients and 36 healthy subjects were enrolled, and 36 patients were equally and randomly assigned to receive either electro-acupuncture or moxibustion treatment for twelve weeks. We used resting state functional magnetic resonance imaging to assess Regional Homogeneity (ReHo) levels, and Crohn’s Disease Activity Index (CDAI) and Inflammatory Bowel Disease Questionnaire (IBDQ) scores to evaluate disease severity and quality of life. The results show that (i) The ReHo levels in CD patients were significantly increased in cortical but decreased in subcortical areas, and the coupling between them was declined. (ii) Both treatments decreased CDAI, increased IBDQ scores, and normalized the ReHo values of the cortical and subcortical regions. (iii) ReHo changes in multiple cortical regions were significantly correlated with CDAI score decreases. ReHo changes in several subcortical regions in the electro-acupuncture group, and those of several cortical regions in the moxibustion group, were correlated with reduced CDAI. These findings suggest that both treatments improved cortex-subcortical coupling in remissive CD patients, but electro-acupuncture regulated homeostatic afferent processing network, while moxibustion mainly regulated the default mode network of the brain.
Highlights
Recent researches have indicated that regions of the central nervous system involved in the brain-gut axis dysfunction may play an important role in the development and mechanism of inflammatory bowel disease (IBD), and those abnormal changes in the structure and function of the brain might be directly involved in development of IBD12–17
In comparison with the healthy controls (HCs), the regional homogeneity (ReHo) values of Crohn’s disease (CD) patients were significantly greater in the bilateral ACC, superior frontal medial cortex, middle frontal cortex, superior temporal pole, precuneus, right superior frontal cortex, inferior temporal cortex, angular gyrus, left middle temporal cortex, superior parietal cortex and middle occipital cortex (P < 0.05, corrected) (Table 2, Fig. 2a)
We examined and compared, for the first time, the effects of electro-acupuncture and moxibustion treatments in regulating brain functional activities in CD patients at resting state
Summary
Recent researches have indicated that regions of the central nervous system involved in the brain-gut axis dysfunction may play an important role in the development and mechanism of IBD, and those abnormal changes in the structure and function of the brain might be directly involved in development of IBD12–17. Earlier research showed that electro-acupuncture normalizes brain’s functional activity[21,22], but data on the mechanism of moxibustion is scarce. It remains an open question whether these treatment methods induce different responses in the brain and whether their clinical efficacy is linked to the normalization of the brain’s functional activity. Resting state-functional magnetic resonance imaging (rs-fMRI) reveals brain’s functional activities and organization without external stimulation, which provides a useful tool for studying the mechanisms of acupuncture on the central nervous system. We hypothesized that electro-acupuncture and moxibustion have a regulatory effect on the abnormal brain activities at resting state, evoking similar and different responses from the brain. We compared the resting-state brain activities between CD patients in remission and healthy controls (HCs), and investigated the effects of electro-acupuncture and moxibustion on brain activities of CD patients and potential correlations between brain activity changes and clinical outcomes
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