Effect of Electro-Acupuncture and Moxibustion on Brain Connectivity in Patients with Crohn's Disease: A Resting-State fMRI Study.

Chunhui Bao,Jianye Zhang,Luyi Wu,Di Wang,Xiaoqing Zeng,Peng Liu,Huangan Wu,Huirong Liu,Yin Shi,Xiaoming Jin

doi:10.3389/fnhum.2017.00559

Abstract

Acupuncture and moxibustion have been shown to be effective in treating Crohn’s disease (CD), but their therapeutic mechanisms remain unclear. Here we compared brain responses to either electro-acupuncture or moxibustion treatment in CD patients experiencing remission. A total of 65 patients were randomly divided into an electro-acupuncture group (n = 32) or a moxibustion group (n = 33), and treated for 12 weeks. Eighteen patients in the electro-acupuncture group and 20 patients in the moxibustion group underwent resting-state functional magnetic resonance imaging at baseline and after treatment. Seed-based analysis was used to compare the resting-state functional connectivity (rsFC) between bilateral hippocampus and other brain regions before and after the treatments, as well as between the two groups. The CD activity index (CDAI) and inflammatory bowel disease questionnaire (IBDQ) were used to evaluate disease severity and patient quality of life. Electro-acupuncture and moxibustion both significantly reduced CDAI values and increased IBDQ scores. In the electro-acupuncture group, the rsFC values between bilateral hippocampus and anterior middle cingulate cortex (MCC) and insula were significantly increased, and the changes were negatively correlated with the CDAI scores. In the moxibustion group, the rsFC values between bilateral hippocampus and precuneus as well as inferior parietal lobe (IPC) were significantly elevated, and the changes were negatively correlated with the CDAI scores. We conclude that the therapeutic effects of electro-acupuncture and moxibustion on CD may involve the differently modulating brain homeostatic afferent processing network and default mode network (DMN), respectively.

Highlights

Crohn’s disease (CD) is a chronic inflammatory disease that most commonly affects the terminal ileum and neighboring colon, but can affect the entire digestive tract
This study aimed to investigate the effects of electro-acupuncture or moxibustion treatment on resting-state functional connectivity (rsFC) using bilateral hippocampus as seeds, to compare the differences in brain response between the two approaches, and to further explore the correlation between these changes and clinical outcomes in CD patients experiencing remission
Our results demonstrate that electro-acupuncture and moxibustion treatments resulted in similar improvements in clinical outcomes but different changes in brain connectivity in CD patients in remission

Summary

Introduction

Crohn’s disease (CD) is a chronic inflammatory disease that most commonly affects the terminal ileum and neighboring colon, but can affect the entire digestive tract. Current therapeutic strategies are aimed at inducing and maintaining disease remission, preventing the incidence of complications, and preventing disease progression (Torres et al, 2016). Medications such as mesalazine, glucocorticoids, and immunosuppressants are efficient in controlling the acute activity of disease, the side effects caused by long-term administration of these medications hinder their continuous usage (Clark et al, 2007; Saibeni et al, 2014). For example tumor necrosis factor alpha (TNF-α) inhibitors, bring hope to some patients. The use of these agents places a heavy financial burden on them (Clark et al, 2007)

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