Abdominal Acupuncture Combined Medicine In MRI Study Of Brain Functional Connectivity With Major Depression Disorder

ObjectiveUsing functional connectivity at rest (FC) studied abdominal acupuncture combined medicine on the brain effects of major depressive disorder (MDD), providing imaging basis for revealing the acupuncture treatment in MDD.MethodsThis study collected 36 patients with MDD participaters. The patients were recruited from the outpatients of Department of Guangdong Province Hospital of Traditional Chinese Medicine. We were randomly divided patients into two groups, the abdominal acupuncture group and the control group.Before scan and treatment, all subjects must to fill both self-rating depression scale (SDS) and Montgomery and Asperger Depression Rating Scale (MADRS), after 3 months treatment they filt scales again.Scanning was performed using a 3T Verio scanner (Siemens, Erlangen, Germany) with a 32-channel head coil. Head motion was restricted using foam inserts and earplugs were used to attenuate the scanner noise. High-resolution three-dimensional T1-weighted MRI scans were acquired using a magnetization-prepared rapid acquisition gradient echo (MPRAGE) sequence. Anatomical images were collected using the following parameters:TR/TE/ flip angle 1900ms/2.3ms/9°, thickness 1mm, FOV (field of view) 256×256mm, matrix 256X256, acquisition time 4’26"Whole-brain functional imaging was performed using a gradient-echo Echo Planar Imaging (EPI) sequence. Resting-state images were collected with the following parameters:TR/TE/flip angle 2000m s/30ms/90°, thickness 4mm, spacing lmm, FOV 240×240mm, matrix 64×64,30 layers, acquisition time 8’06 "All images were acquired in the axial plane defined by the anterior and posterior commissures. During the resting-state scan, subjects were instructed to keep their eyes close.Statistical analyses of demographic and clinical data were arried out using the SPSS for Windows (version19.0; SPSS). The analysis of imaging data was done sing the statistical parametric mapping (SPM8), resting-state fMRI data analysis toolkit (REST), resting-state functional MRI data processing assistant (DPARSFA) and other standard data processing software.Respectively, the left araventricular nucleus of the hypothalamus (pa: 2.2,-1.4,-12.3), the left posterior hypothalamic area (ph:3.1,-9.1,-9.7), the left vmhventromedial nucleus of the hypothalamus (vmh:3.6,-3.8,-16.1) as ROIs were defined, we used functional connectivity (FC) method to analyze the differences FC change before and after treatment in both groups.Results1. All of the subjects be aged between 30 and 58 years, the mean age was 44 years old. In addition to the control group kurtosis coefficient p=0.20> 0.10, he remaining groups skewness and kurtosis coefficient p<0.10, so the age groups did not satisfy normality,we utilized rank sum test between the two groups, after analysis, z=0.962> 0.1, it indicated no difference in age between the two groups.2. Before treatment, the SDS and MADRS scales in both groups showed no different. After treatment, the Z value for SDS and MADRS in the abdominal acupuncture group and the control group are 0.657,0.763>0.05 Respectively, it indicated different and significant:About efficacy, the abdominal acupuncture group was better than the control group.3. MDD FC MRI results:(1) In abdominal acupuncture group negative FC with the left pa was evident in the right occipital gyrus, the left occipital gyrus, the left middle frontal gyrus, the left side of the center next to the lobules.(2) In abdominal acupuncture group negative FC with the left ph was evident in the right upper corner of the cerebellum, the left upper corner of the cerebellum.(3) In abdominal acupuncture group negative FC with the left vmh was evident in the left middle temporal gyrus, the left lobe wedge left middle frontal gyrus, the left side of the triangle department places next time, right after the center back.(4) In control group no FC change with the left pa and ph in MDD.(5) In control group negative FC with the left vmh was evident in the right fusiform gyrus, the right side of the orbital frontal gyrus, right middle temporal gyrus, the left corner back to the right angular gyrus.(6) Between-group analysis revealed no significan FC change with the left vmh in MDD.Conclusion1. Both groups scores were falt down, but the abdominal acupuncture group declined more, in conclusion the abdominal acupuncture group rehabilitation better than the other group.2. FC with the left thalamus in abdominal acupuncture group and the control group were negative of this study. However, the former group involved more brain regions than the later group, which explained the abdominal acupuncture group rehabilitation better than the other group. For further reaserch of central mechanism with abdominal acupuncture treat MDD provided imaging basis.