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Abstract
Neuropsychiatric disorders, including depression, anxiety, schizophrenia, and Alzheimer's disease (AD), are diseases that are directly or indirectly associated with cerebral dysfunction and contribute significantly to disability in adult populations worldwide. Important limitations surround the currently available pharmacologic agents for neuropsychiatric disorders and, moreover, many patients fail to respond to these therapies. Acupuncture might be a complementary therapy for neuropsychiatry disorders. In this review, we investigate the current evidence for the treatment efficacy of acupuncture in depression, anxiety, schizophrenia, and AD. Secondly, we review recent advances in understanding of the dysregulated glutamate system underlying the pathophysiology of these disorders. Finally, we discuss the ways in which acupuncture treatment can potentially modulate glutamate receptors and excitatory amino acid transporters. We conclude that the treatment effects of acupuncture may be underpinned by its intervention in the dysregulated glutamate system. Further preclinical and clinical studies are needed to clarify the possible mechanisms of acupuncture in these neuropsychiatric disorders and to establish protocols for treatment guidelines.
Highlights
Neuropsychiatry focuses on illness relating to altered cognition, mood, or behavior caused by cerebral dysfunction with neuronal pathological changes, or abnormal physiological conditions
The results show that as compared with superficial needling, acupuncture with deep needling induces stronger, wider-ranging de qi sensations and enhances nodal centrality, primarily in the abnormal regions of the brain implicated in mild cognitive impairment
Evidence indicates that acupuncture treatment may be of benefit in several neuropsychiatric disorders, including depression, anxiety, schizophrenia, and Alzheimer’s disease (AD)
Summary
Neuropsychiatry focuses on illness relating to altered cognition, mood, or behavior caused by cerebral dysfunction with neuronal pathological changes (e.g., dysregulated neurotransmitter systems or tissue damage), or abnormal physiological conditions (e.g., hyper/hypoglycemia or hypoxia). A recent meta-analysis that included 18 randomized clinical trials (RCTs) involved 1,678 adults given acupuncture for depression-related insomnia and found significant improvements in sleep quality with acupuncture compared with Western medicine [11]. When acupuncture was given as an adjunctive therapy with Western medicine, both depression and insomnia were improved [11] In another RCT involving 150 patients with residual insomnia associated with MDD, traditional acupuncture needling produced only mild treatment effects that were similar to those of minimal acupuncture and placebo acupuncture [33]. In a recent systematic review of data from 26 studies (1,181 participants) reporting limited evidence for the use of adjunctive acupuncture therapy in the treatment of positive, negative and cognitive symptoms, the authors point out the importance of differences between quantitative and qualitative changes [16]. A high proportion of patients in each treatment group remained clinically significantly affected by insomnia after treatment
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