Different brain responses to electro-acupuncture and moxibustion treatment in patients with Crohn's disease

Abstract

This study aimed to investigate changes in resting state brain activity in remissive Crohn's Disease (CD) patients after electro-acupuncture or moxibustion treatment. Fifty-two CD patients and 36 healthy subjects were enrolled, and 36 patients were equally and randomly assigned to receive either electro-acupuncture or moxibustion treatment for twelve weeks. We used resting state functional magnetic resonance imaging to assess Regional Homogeneity (ReHo) levels, and Crohn's Disease Activity Index (CDAI) and Inflammatory Bowel Disease Questionnaire (IBDQ) scores to evaluate disease severity and quality of life. The results show that (i) The ReHo levels in CD patients were significantly increased in cortical but decreased in subcortical areas, and the coupling between them was declined. (ii) Both treatments decreased CDAI, increased IBDQ scores, and normalized the ReHo values of the cortical and subcortical regions. (iii) ReHo changes in multiple cortical regions were significantly correlated with CDAI score decreases. ReHo changes in several subcortical regions in the electro-acupuncture group, and those of several cortical regions in the moxibustion group, were correlated with reduced CDAI. These findings suggest that both treatments improved cortex-subcortical coupling in remissive CD patients, but electro-acupuncture regulated homeostatic afferent processing network, while moxibustion mainly regulated the default mode network of the brain.

Figure 1. Schematic diagrams show the methods of electro-acupuncture and moxibustion treatments and the locations of acupoints used in this study.

The acupoints were ST25 (Tianshu), RN6 (Qihai) and RN12 (Zhongwan).

Figure 2. Significant differences in ReHo values between CD patients and HCs.

(a) The CD patients exhibited significantly increased ReHo values compared to the HCs. (b) The CD patients exhibited significantly decreased ReHo values compared to the HCs. P < 0.05, false discovery rate was corrected for multiple comparisons with age, gender and weight as covariates. ACC, anterior cingulate cortex; Amyg, amygdala; dmPFC, dorsomedial prefrontal cortex; HIPP, hippocampal cortex; IFC, inferior frontal cortex; ITC, inferior temporal cortex; MCC, middle cingulate cortex; MFC, middle frontal cortex; MTC, middle temporal cortex; OC, occipital cortex; PAG, periaqueductal gray; PCC, posterior cingulate cortex; PCUN, precuneus; PPC, posterior parietal cortex; S1, primary somatosensory cortex; SFC, superior frontal cortex; SMA, supplementary motor area; STC, superior temporal cortex; TP, temporal pole.

Figure 3. Similar and different brain regions that were affected by EA or moxibuston treatment.

(a) Correlation analyses between brain responses and CDAI scores. EA&MOX graphs show correlations between changes in ReHo values of different brain regions with common response in EA and moxibustion groups and decreases in CDAI score. EA graphs show correlations between changes in ReHo values of different brain regions in the EA group and a decrease in CDAI score. MOX graphs show correlations between changes in ReHo values of different brain regions in the moxibustion group and a decrease in CDAI score. (b) Similar brain regions that were affected by EA or moxibustion treatment. (c) Different brain regions that were affected by EA or moxibustion treatment. ACC, anterior cingulate cortex; dlPFC, dorsolateral prefrontal cortex; EA, electro-acupuncture; HIPP, hippocampal cortex; L, left; MCC, middle cingulate cortex; MOX, moxibustion; mPFC, medial prefrontal cortex; PCC, posterior cingulate cortex; PREC, precentral cortex; PSTS, postcentral cortex; SMA, supplementary motor area; TP, temporal pole.