Neural Activation via Acupuncture in Patients With Major Depressive Disorder: A Functional Near-Infrared Spectroscopy Study

Zhong Zheng,Jiaqi Zhang,Tingyu Zhang,Jiaxi Huang,Pu Wang

doi:10.3389/fpsyt.2021.669533

Abstract

Background and Objective: Acupuncture is used as an alternative treatment for patients with major depressive disorder (MDD). The associated therapeutic effect of acupuncture is often attributed to its modulatory effect on the activity of the pre-frontal cortex (PFC), although the mechanism is not well-studied. We employed a repeated measures design to investigate the brain modulatory effect of acupuncture on the PFC in a group of patients with MDD and investigated whether the modulatory effect is influenced by the severity of the disease.Methods: A total of 47 patients diagnosed with MDD were enrolled in this functional near-infrared spectroscopy experiment. The severity of depressive symptoms was measured at baseline using the Hamilton Depression Rating Scale-24 (HAMD). The cortical activation in the bilateral PFC areas during a verbal fluency task (VFT) was measured before and after a single session of acupuncture in the Baihui acupoint. We further explored the potential correlation between the severity of MDD and task-related activation before and after acupuncture.Results: A single session of acupuncture significantly tended to enhance the activation level of the left frontopolar cortex in patients with severe depression during VFT, but a null effect was found in those with mild to moderate depression. Among patients with severe depression, a strong correlation was observed between HAMD scores and the change in VFT-related activation after acupuncture in the left dorsolateral PFC (DLPFC).Conclusion: A single session of acupuncture did not significantly modulate the activation of the left PFC in patients with mild to moderate depression; however, it demonstrated a tendency to enhance the activation of the frontopolar area in patients with severe depression. Among patients with severe depression, there is a correlation between the activation by acupuncture of left DLPFC during executive functioning and the severity of depressive symptoms, suggesting that the brain activity induced by acupuncture is likely to be influenced by the baseline disease severity in patients with MDD.

Highlights

Patients with major depressive disorder (MDD) present with impaired pre-frontal cortex (PFC) functioning, that is, decreased cerebral blood flow [1] and glucose hypometabolism [2] in the PFC during either resting or task conditions
The patients were invited to participate in this experiment if they met all of the following inclusion criteria: [1] aged between 18 and 60 years; [2] right-handed, as assessed by the Edinburgh Handedness Inventory (EDI) [patients whose EDI laterality quotient, that is/(right + left), was >0.4 were considered as right-hand dominant] [14]; [3] severity of depressive symptoms score ≥8 according to the Hamilton Depression Rating Scale (HAMD); and [4] having >6 years of formal education
The changes in the oxy-Hb level during the post-acu verbal fluency task (VFT) significantly increased in the frontopolar area and dorsolateral PFC (DLPFC, channel 28) compared to that in the post-task baseline (FDR-corrected p = 0.017, 0.008, 0.036, and 0.021, respectively)

Summary

Introduction

Patients with major depressive disorder (MDD) present with impaired pre-frontal cortex (PFC) functioning, that is, decreased cerebral blood flow [1] and glucose hypometabolism [2] in the PFC during either resting or task conditions. There is a possibility that the modulatory effect of Baihui acupuncture on the activation of the PFC can, at least partly, contribute to its therapeutic effects on MDD. We first conducted an fNIRS experiment to reveal the modulatory effects of Baihui acupuncture on the PFC among a group of individuals diagnosed with MDD. The associated therapeutic effect of acupuncture is often attributed to its modulatory effect on the activity of the pre-frontal cortex (PFC), the mechanism is not well-studied. We employed a repeated measures design to investigate the brain modulatory effect of acupuncture on the PFC in a group of patients with MDD and investigated whether the modulatory effect is influenced by the severity of the disease

Methods

Results

Discussion

Conclusion