Neuroimaging studies of acupuncture for depressive disorder: a systematic review of published papers from 2014 to 2024

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Background: Several neuroimaging studies have confirmed that acupuncture can elicit alterations in brain networks and regions associated with depressive disorder (DD). This review provides an overview of the methodologies and results of neuroimaging investigations into the efficacy of acupuncture in treating DD, with the intention of guiding future research objectives. Methods: Neuroimaging studies of acupuncture for DD being published between February 2, 2014 and February 2, 2024, were gathered from PubMed, Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure, Chongqing VIP Database, WanFang Database, and Chinese Biomedical Literature Database. The methodological quality of the studies was assessed utilizing the Risk of Bias 2.0 and Risk of Bias in Non-Randomized Studies of Interventions tools. Following a qualitative analysis of the studies, relevant information regarding acupuncture interventions and brain imaging data was extracted. Results: A total of 26 studies met the inclusion criteria. These studies featured a combined sample size of 1138 participants. All studies employed magnetic resonance imaging. Our findings indicate that acupuncture can affect neural activity in the cingulate gyrus, precuneus, insula, prefrontal lobe, etc. The neuroimaging results of most DD patients were correlated with the Hamilton Rating Scale for Depression scores. Conclusions: The results of the current study indicate that acupuncture treatment may have a regulatory effect on the abnormal functioning of neural regions and networks in individuals diagnosed with DD. These networks are predominantly localized within various brain regions, including the default mode network, limbic system, emotion regulation and cognitive network, reward network, central executive network, salience network, and sensorimotor network. It is essential to conduct additional high-quality and multimodal neuroimaging research to expand upon these findings and elucidate the mechanisms by which acupuncture impacts patients with DD. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023400557.

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