Potential scalp stimulation targets for mental disorders: evidence from neuroimaging studies

Abstract

Mental disorders widely contribute to the modern global disease burden, creating a significant need for improvement of treatments. Scalp stimulation methods (such as scalp acupuncture and transcranial electrical stimulation) have shown promising results in relieving psychiatric symptoms. However, neuroimaging findings haven't been well-integrated into scalp stimulation treatments. Identifying surface brain regions associated with mental disorders would expand target selection and the potential for these interventions as treatments for mental disorders. In this study, we performed large-scale meta-analyses separately on eight common mental disorders: attention deficit hyperactivity disorder, anxiety disorder, autism spectrum disorder, bipolar disorder, compulsive disorder, major depression, post-traumatic stress disorder and schizophrenia; utilizing modern neuroimaging literature to summarize disorder-associated surface brain regions, and proposed neuroimaging-based target protocols. We found that the medial frontal gyrus, the supplementary motor area, and the dorsal lateral prefrontal cortex are commonly involved in the pathophysiology of mental disorders. The target protocols we proposed may provide new brain targets for scalp stimulation in the treatment of mental disorders, and facilitate its clinical application.

Keywords: Mental disorder; Meta-analysis; Neuroimaging; Scalp acupuncture; Scalp stimulation; Transcranial electrical stimulation.

Fig. 1

Brain surface regions for scalp stimulation for mental disorders, identified from meta-analyses of neuroimaging studies. A ADHD-associated surface regions. B Anxiety disorder-associated surface regions. C Autism spectrum-associated surface regions. D Bipolar disorder-associated surface regions. E Compulsive disorder-associated surface regions. F Major depression-associated surface regions. G. PTSD-associated surface regions. H Schizophrenia-associated surface regions

Fig. 2

Neuroimaging-based scalp stimulation protocols for mental disorders. A to H scalp stimulation locations for ADHD, anxiety disorder, autism spectrum disorder, bipolar disorder, compulsive disorder, major depression, PTSD, and schizophrenia, respectively. Upper and lower panels of A to H applied 10–20 EEG system, and international acupoints, respectively, to facilitate identifying the locations. I 10–20 EEG system locations. J acupoint locations. ADHD, Attention deficit hyperactivity disorder; ANX, anxiety disorder; AUT, autism spectrum; BD, bipolar disorder; CD, compulsive disorder; MD, major depression; PTSD, post-traumatic stress disorder; SCH, schizophrenia; GV 17, Naohu; GV 18, Qiangjian; GV 19, Houding; GV 20, Baihui; GV 21, Qianding; GV 22, Xinhui; GV 23, Shangxing; GV 24, Shenting; GV 29, Yintang; GB 4, Hanyan; GB 5, Xuanlu; GB 6, Xuanli; GB 7, Qubin; GB 8, Shuaigu; GB 9, Tianchong; GB 10, Fubai; GB 11, Touqiaoyin; GB 15, Toulinqi; GB 16, Muchuang; GB 17, Zhengying; GB 18, Chengling; GB 19, Naokong; BL 3, Meichong; BL 5, Wuchu; BL 6, Chengguang; BL 7, Tongtian; BL 8, Luoque; BL 9, Yuzhen; ST 8, Touwei; SJ 20, Jiaosun; EX-HN 5, Taiyang

Fig. 3

Overlap surface regions among different mental disorders. A ADHD, PTSD, anxiety, autism spectrum, compulsive disorder, major depression, and schizophrenia overlapping on right SMA/MedFG. B anxiety, autism spectrum, bipolar disorder, major depression, and schizophrenia overlapping on right dlPFC. C ADHD, PTSD, anxiety, autism spectrum, and major depression overlapping on left IFG/lateral OrbPFC. D anxiety, compulsive disorder, major depression, and schizophrenia overlapping on left MTG/STG/ITG//IOG/MOG. E ADHD, anxiety, major depression, and schizophrenia overlapping on left OrbMFG/VenMedFG. F ADHD, autism spectrum, and bipolar disorder overlapping on left IPL/SPL/SMG/AG. G Autism spectrum and major depression overlapping on right PCu. H autism spectrum and bipolar disorder overlapping on right R IPL/SPL/SMG/AG. I Major depression and bipolar disorder overlapped on right ITG/MTG/STG/IOG/MOG