Zhang Tingyu, Zhang Jiaqi, Huang Jiaxi, Zheng Zhong, Wang Pu
Department of Rehabilitation Medicine, The Seventh Affiliated Hospital Sun Yat-sen University, Shenzhen, China.
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.
Front Psychiatry. 2021 Nov 12;12:669533. doi: 10.3389/fpsyt.2021.669533. eCollection 2021.
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. 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. 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). 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.
针灸被用作重度抑郁症（MDD）患者的一种替代治疗方法。针灸的相关治疗效果通常归因于其对前额叶皮质（PFC）活动的调节作用，尽管其机制尚未得到充分研究。我们采用重复测量设计来研究针灸对一组MDD患者PFC的脑调节作用，并研究这种调节作用是否受疾病严重程度的影响。共有47名被诊断为MDD的患者参与了这项功能近红外光谱实验。在基线时使用汉密尔顿抑郁量表24项（HAMD）测量抑郁症状的严重程度。在百会穴进行单次针灸前后，测量言语流畅性任务（VFT）期间双侧PFC区域的皮质激活情况。我们进一步探讨了MDD严重程度与针灸前后任务相关激活之间的潜在相关性。单次针灸显著倾向于增强重度抑郁症患者在VFT期间左侧额极皮质的激活水平，但在轻度至中度抑郁症患者中未发现明显效果。在重度抑郁症患者中，观察到HAMD评分与左侧背外侧前额叶皮质（DLPFC）针灸后VFT相关激活变化之间存在强相关性。单次针灸对轻度至中度抑郁症患者左侧PFC的激活没有显著调节作用；然而，它显示出增强重度抑郁症患者额极区域激活的趋势。在重度抑郁症患者中，执行功能期间针灸对左侧DLPFC的激活与抑郁症状的严重程度之间存在相关性，这表明针灸诱导的大脑活动可能受MDD患者基线疾病严重程度的影响。
