Repeated acupuncture treatments modulate amygdala resting state functional connectivity of depressive patients.
As a widely-applied alternative therapy, acupuncture is gaining popularity in Western society. One challenge that remains, however, is incorporating it into mainstream medicine. One solution is to combine acupuncture with other conventional, mainstream treatments. In this study, we investigated the combination effect of acupuncture and the antidepressant fluoxetine, as well as its underlying mechanism using resting state functional connectivity (rsFC) in patients with major depressive disorders. Forty-six female depressed patients were randomized into a verum acupuncture plus fluoxetine or a sham acupuncture plus fluoxetine group for eight weeks. Resting-state fMRI data was collected before the first and last treatments. Results showed that compared with those in the sham acupuncture treatment, verum acupuncture treatment patients showed 1) greater clinical improvement as indicated by Montgomery-Åsberg Depression Rating Scale (MADRS) and Self-Rating Depression Scale (SDS) scores; 2) increased rsFC between the left amygdala and subgenual anterior cingulate cortex (sgACC)/preguenual anterior cingulate cortex (pgACC); 3) increased rsFC between the right amygdala and left parahippocampus (Para)/putamen (Pu). The strength of the amygdala-sgACC/pgACC rsFC was positively associated with corresponding clinical improvement (as indicated by a negative correlation with MADRS and SDS scores). Our findings demonstrate the additive effect of acupuncture to antidepressant treatment and suggest that this effect may be achieved through the limbic system, especially the amygdala and the ACC.
Traditional Chinese Medicine Hospital of Guangdong province, Guangzhou 510120, China.
Xiaoyun
X
Wang
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; Psychiatry Department, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
Zengjian
Z
Wang
Traditional Chinese Medicine Hospital of Guangdong province, Guangzhou 510120, China.
Jian
J
Liu
Traditional Chinese Medicine Hospital of Guangdong province, Guangzhou 510120, China.
Jun
J
Chen
Traditional Chinese Medicine Hospital of Guangdong province, Guangzhou 510120, China.
Xian
X
Liu
Traditional Chinese Medicine Hospital of Guangdong province, Guangzhou 510120, China.
Guangning
G
Nie
Department of Internal Medicine, College of Korean Medicine, Daegu Haany University, 165 Sang-dong, Suseong-gu, Daegu 706-828, Republic of Korea.
Joon-Seok
JS
Byun
Psychiatry Department, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Wellesley College, Wellesley, MA, USA.
Yilin
Y
Liang
Psychiatry Department, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
Joel
J
Park
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
Traditional Chinese Medicine Hospital of Guangdong province, Guangzhou 510120, China.
Bo
B
Liu
Psychiatry Department, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
Jian
J
Kong
D015670:Acupuncture Therapy; D000328:Adult; D000679:Amygdala / Q000503:physiopathology*; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D001921:Brain / Q000503:physiopathology; D001931:Brain Mapping; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009434:Neural Pathways / Q000503:physiopathology; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D005473:Fluoxetine
Acupuncture; Amygdala; Combination effect; Depression; Fluoxetine; Limbic system; Resting-state functional connectivity