Acupuncture treatment modulates the corticostriatal reward circuitry in major depressive disorder.
Major depressive disorder (MDD) is a common disorder with a high prevalence and significant social and economic impacts. Nevertheless, the treatment of MDD is far from satisfactory. Acupuncture treatment has emerged as a promising method for treating MDD. However, the neural mechanism by which acupuncture reduces depressive symptoms is not fully understood. Studies have shown that the corticostriatal reward circuitry is associated with the pathophysiology of MDD; thus, we investigated the corticostriatal resting-state functional connectivity (rsFC) before and after real and sham acupuncture treatments combined with the antidepressant fluoxetine. Forty-six female major depressive patients were assigned to either verum acupuncture plus fluoxetine (n = 22) or sham acupuncture plus fluoxetine (n = 24) treatment for 8 weeks, and resting state functional magnetic resonance imaging (fMRI) data were collected before the first and after the last treatment sessions. The results showed that compared with sham acupuncture, the verum acupuncture group showed: (1) significantly increased rsFC between inferior ventral striatum and medial prefrontal cortex, ventral rostral putamen and amygdala/parahippocampus, as well as dorsal caudate and middle temporal gyrus; (2) significantly decreased rsFC between right ventral rostral putamen and right dorsolateral prefrontal cortex, and right dorsal caudate and bilateral cerebellar tonsil. The increased rsFC between the inferior ventral striatum and medial prefrontal cortex, ventral rostral putamen and amygdala/parahippocampus were significantly positively associated with decreased clinical scores (Montgomery-Åsberg Depression Rating Scale and Self-Rating Depression Scale scores) at the end of the eight-week treatment. Our findings suggest that acupuncture may achieve treatment effects by modulating the corticostriatal reward/motivation circuitry in MDD patients.
Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, South China Normal University, Guangzhou, 510631, China; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
Zengjian
Z
Wang
The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, 510120, China.
Xiaoyun
X
Wang
The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, 510120, China.
Jian
J
Liu
The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, 510120, China.
Jun
J
Chen
The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, 510120, China.
Xian
X
Liu
The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, 510120, China.
Guangning
G
Nie
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
Kristen
K
Jorgenson
Hospital of Catholic University of Daegu, 3056-6 Daemyeong 4 Nam-gu, Daegu 705-718, South Korea.
Ki Cheul
KC
Sohn
Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, South China Normal University, Guangzhou, 510631, China.
Ruiwang
R
Huang
Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, South China Normal University, Guangzhou, 510631, China.
Ming
M
Liu
The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, 510120, China. Electronic address: lbgdhtcm@163.com.
Bo
B
Liu
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA. Electronic address: kongj@nmr.mgh.harvard.edu.
Jian
J
Kong
D015670:Acupuncture Therapy; D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology*; D003131:Combined Modality Therapy; D003342:Corpus Striatum / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology*; D003865:Major Depressive Disorder / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology; D011569:Psychiatric Status Rating Scales; D012146:Rest; D012201:Reward; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D005473:Fluoxetine
Acupuncture; Depression; Fluoxetine; Resting state functional connectivity; Reward; Striatum
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