Effect of Electro-Acupuncture and Moxibustion on Brain Connectivity in Patients with Crohn's Disease: A Resting-State fMRI Study

Chunhui Bao, Di Wang, Peng Liu, Yin Shi, Xiaoming Jin, Luyi Wu, Xiaoqing Zeng, Jianye Zhang, Huirong Liu, Huangan Wu, Chunhui Bao, Di Wang, Peng Liu, Yin Shi, Xiaoming Jin, Luyi Wu, Xiaoqing Zeng, Jianye Zhang, Huirong Liu, Huangan Wu

Abstract

Acupuncture and moxibustion have been shown to be effective in treating Crohn's disease (CD), but their therapeutic mechanisms remain unclear. Here we compared brain responses to either electro-acupuncture or moxibustion treatment in CD patients experiencing remission. A total of 65 patients were randomly divided into an electro-acupuncture group (n = 32) or a moxibustion group (n = 33), and treated for 12 weeks. Eighteen patients in the electro-acupuncture group and 20 patients in the moxibustion group underwent resting-state functional magnetic resonance imaging at baseline and after treatment. Seed-based analysis was used to compare the resting-state functional connectivity (rsFC) between bilateral hippocampus and other brain regions before and after the treatments, as well as between the two groups. The CD activity index (CDAI) and inflammatory bowel disease questionnaire (IBDQ) were used to evaluate disease severity and patient quality of life. Electro-acupuncture and moxibustion both significantly reduced CDAI values and increased IBDQ scores. In the electro-acupuncture group, the rsFC values between bilateral hippocampus and anterior middle cingulate cortex (MCC) and insula were significantly increased, and the changes were negatively correlated with the CDAI scores. In the moxibustion group, the rsFC values between bilateral hippocampus and precuneus as well as inferior parietal lobe (IPC) were significantly elevated, and the changes were negatively correlated with the CDAI scores. We conclude that the therapeutic effects of electro-acupuncture and moxibustion on CD may involve the differently modulating brain homeostatic afferent processing network and default mode network (DMN), respectively.

Keywords: Crohn’s disease; acupuncture; fMRI; functional connectivity; moxibustion.

Figures

Figure 1
Figure 1
Locations of selected acupoints and schematic diagram of electro-acupuncture and moxibustion treatment. The acupoints were ST25 (stomach, Tianshu, bilateral), CV6 (conception vessel, Qihai) and CV12 (Zhongwan).
Figure 2
Figure 2
Left hippocampal seed locations and brain responses to electro-acupuncture and moxibustion treatment. (A) Seed region in the left hippocampus. (B) Brain regions showing an increase of rsFC with the left hippocampus following moxibustion compared to electro-acupuncture treatment, and the correlation between rsFC and CDAI scores. (C) Brain regions showing less of an increase of rsFC with the left hippocampus after electro-acupuncture compared to moxibustion treatment, and the correlation between rsFC and CDAI score changes. CDAI, Crohn’s disease activity index; HIPP, hippocampus; IPC, inferior parietal cortex; MCC, middle cingulate cortex; PCUN, precuneus; rsFC, resting-state functional connectivity.
Figure 3
Figure 3
Right hippocampal seed locations and brain responses to electro-acupuncture and moxibustion treatment. (A) Seed region in the right hippocampus. (B) Brain regions showing an increase of rsFC with the right hippocampus following moxibustion compared to electro-acupuncture treatment, and the correlation between rsFC and CDAI scores. (C) Brain regions showing less of an increase of rsFC with the right hippocampus after electro-acupuncture compared to moxibustion treatment, and the correlation between rsFC and CDAI score changes. CDAI, Crohn’s disease activity index; HIPP, hippocampus; IPC, inferior parietal cortex; MCC, middle cingulate cortex; PCUN, precuneus; rsFC, resting-state functional connectivity.

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