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.

中文翻译：

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调节默认模式网络：针对岛叶的经皮颅耳穴位电刺激的抗抑郁功效

背景

经皮颅耳穴位电刺激（TECAS）是一种治疗重度抑郁症（MDD）的新型非侵入性疗法，可刺激三叉神经和耳迷走神经支配的穴位。然而，涉及 TECAS 治疗 MDD 的神经影像学研究很少。因此，本研究旨在利用静息态功能磁共振成像（rs-fMRI）研究 TECAS 的治疗反应和神经学效应。

方法

总共招募了 34 名轻度至中度 MDD 患者和 34 名人口统计学匹配的健康对照 (HC)。八周治疗后，主要结局是临床缓解，定义为 17 项汉密尔顿抑郁评定量表 (HAMD-17) 的基线到终点下降 ≥ 50%。使用低频波动（ALFF）方法来调查 MDD 患者和 HC 的大脑异常，并使用基于种子的功能连接（FC）分析来分析治疗前后的大脑网络变化。

结果

我们发现两组之间的性别、年龄和受教育年限没有显着差异。治疗后有效率58.82%。与HCs相比，MDD患者的左侧岛叶ALFF值较低（t = -4.298，P < 0.005），基于岛叶的FC显示在右侧额中回（MFG）/右侧额上回、眼眶部分（ORBsupmed） ）（t = -5.29，P < 0.005）和右前扣带回（ACC）减少（t = -6.08，P < 0.005）。此外，与治疗前相比，ACC/眶额上回（SFG）（t  =  3.42，P < 0.005）和左额上回（SFG）/补充运动区（SMA）的异常FC值增强（t = 3.42，P < 0.005）。= 3.34，P < 0.005）。  

结论

TECAS 具有抗抑郁功效，特别是影响 MDN 患者与情绪处理相关的默认模式网络 (DMN) 中基于岛叶的功能连接。