Modulating the default mode network: Antidepressant efficacy of transcutaneous electrical cranial-auricular acupoints stimulation targeting the insula

Author: Ma Yue1, Xu Peng2, Guo Chunlei1, Luo Yi1, Gao Shanshan1, Sun Jifei1, Chen Qingyan1, Zhenjun Bai3, Liu Yong4, Zhang Zhangjin5, Rong Peijing6, Fang Jiliang7
Affiliation:
1 Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053, Beijing, China; Graduate School of China Academy of Chinese Medical Sciences, 100700, Beijing, China.
2 Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053, Beijing, China.
3 College of Traditional Chinese Medicine Health Service, Shanxi Datong University, Datong, 037009, Shanxi Province, China.
4 Affiliated Hospital of Traditional Chinese Medicine, Southwest Medical University, 646000, Luzhou, China.
5 Department of Chinese Medicine, the University of Hong Kong-Shenzhen Hospital (HKU-SZH), Shenzhen, China.
6 Graduate School of China Academy of Chinese Medical Sciences, 100700, Beijing, China; Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, 100700, Beijing, China.
7 Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053, Beijing, China; Graduate School of China Academy of Chinese Medical Sciences, 100700, Beijing, China. Electronic address: Fangmgh@163.com.
Conference/Journal: Psychiatry Res Neuroimaging
Date published: 2024 Jan 26
Other: Volume ID: 339 , Pages: 111787 , Special Notes: doi: 10.1016/j.pscychresns.2024.111787. , Word Count: 294


Background:
Transcutaneous electrical cranial-auricular acupoint stimulation (TECAS) is a novel non-invasive therapy for major depressive disorder (MDD) that stimulates acupoints innervated by the trigeminal and auricular vagus nerves. However, there are few neuroimaging studies involving the TECAS for the treatment of MDD. Therefore, this study aimed to investigate the treatment response and neurological effects of TECAS using resting-state functional magnetic resonance imaging (rs-fMRI).

Method:
A total of 34 patients with mild-to-moderate MDD and 34 demographically matched healthy controls (HCs) were recruited. After an eight-week treatment the primary outcome was clinical response, defined as a baseline-to-endpoint ≥ 50 % reduction in the 17-item Hamilton Depression Rating Scale (HAMD-17). The low-frequency fluctuations (ALFF) method were used to investigate the brain abnormalities of MDD patients and HCs, and altered brain networks were analyzed between pre- and post-treatment using seed-based functional connectivity (FC) analysis.

Results:
We found no significant differences in terms of gender, age, and years of education between the two groups. After treatment, the response rate was 58.82 %. Compared to HCs, MDD patients showed lower ALFF values in the left insula(t = -4.298,P < 0.005), the insula-based FC revealed in the right middle frontal gyrus (MFG)/ right superior frontal gyrus, orbital part (ORBsupmed) (t = -5.29,P < 0.005) and the right anterior cingulate gyrus (ACC)were decreased (t = -6.08,P < 0.005). Furthermore, Compared to pre-treatment, abnormal FC values in the ACC /orbital superior frontal gyrus (SFG) (t = 3.42,P < 0.005) and left superior frontal gyrus (SFG)/ supplement motor area (SMA) were enhanced (t = 3.34,P < 0.005).

Conclusion:
TECAS exhibits antidepressant efficacy, particularly influencing the insula-based functional connections within the Default Mode Network (DMN) related to emotion processing in individuals with MDD.

Keywords: Functional connectivity; Low-frequency fluctuations; Major depressive disorder; Non-invasive neuromodulation; Rest-state functional magnetic resonance imaging; Transcutaneous electrical cranial-auricular acupoint stimulation.

PMID: 38295529 DOI: 10.1016/j.pscychresns.2024.111787

BACK