Acupuncture and anxiety: possible neural mechanisms

Authors

DOI:

https://doi.org/10.33448/rsd-v11i6.29309

Keywords:

Acupuncture; Anxiety; Brain plasticity; Brain network.

Abstract

Anxiety disorders are among the most common mental disturbances around the world, and they can negatively impact a patient's quality of life and disrupt important activities of daily living. Recent studies have shown that the psychopathology of anxiety involves altered neural circuits and the normalization of these circuits would be the key factor for therapeutic effects. Acupuncture has an anxiolytic effect recognized in the treatment of anxiety. However, neural mechanism underlying the anxiolytic acupuncture effect is unknown. Some studies have shown that brain circuits related to the control of the autonomic nervous system, emotional, memory and cognitive processing are modulated by acupuncture. These circuits overlap the circuits related to psychopathology of anxiety. Thus, in this paper, we presented a hypothesis about how the acupuncture can reduces anxiety through modulation of brain circuits. In conclusion, the consulted literature showed that acupuncture has the potential to modulate the brain regions implicated in the anxious behaviors. Nonetheless, future studies should be done to elucidate the neuroendocrine mechanisms of acupuncture in the anxiety disorders.

References

Alvarez, R. P. et al. (2011) Phasic and sustained fear in humans elicits distinct patterns of brain activity. Neuroimage, 55(1), 389–400.

Amorim, D. et al. (2018). Acupuncture and electroacupuncture for anxiety disorders: A systematic review of the clinical research. Complement Ther Clin Pract, 31, 31-37.

Apps, M. A. (2018). Stimulating cingulate: distinct behaviours arise from discrete zones. Brain, 141, 2827–2830 .

Arranz, L. et al. (2007). Effect of acupuncture treatment on the immune function impairment found in anxious women, Am J Chin Med, 35(1):35-51.

Balderston, N. L. et al. (2017). Anxiety patients show reduced working memory related dlPFC activation during safety and threat. Depress anxiety, 34(1), 25-36.

Bandelow, B. & Michaelis, S. (2015). Epidemiology of anxiety disorders in the 21st century. Dialogues Clin Neurosci, 17(3), 327-335.

Bandelow, B. et al. (2012). Guidelines for the pharmacological treatment of anxiety disorders, obsessive e compulsive disorder and posttraumatic stress disorderin primary care, Int J Psychiatr Clin Pract, 16 (2):77-84.

Bernardo, W. M. et al (2004). A prática clínica baseada em evidências. Parte II: buscando as evidências em fontes de informação. Rev Assoc Med

Bras, 50(1), 104-108.

Bishop, S. J. (2009). Trait anxiety and impoverished prefrontal control of attention. Nat neurosci, 12(1), 92-98.

Cai, R. L. et al. (2017). Brain functional connectivity network studies of acupuncture: a systematic review on resting-state fMRI. J Integr Med, 16(1):26-33.

Chae Y, et al. (2013). Inserting needles into the body: a meta-analysis of brain activity associated with acupuncture needle stimulation. J Pain, 14(3):215-22.

Corbetta, M. et al. (2000). Voluntary orienting is dissociated from target detection in human posterior parietal cortex. Nat. Neurosci, 3(3), 292–297.

Cornwell, B. R. et al. (2012). Distinct contributions of human hippocampal theta to spatial cognition and anxiety. Hippocampus, 22(9), 1848–1859.

Craske, M. G. et al. (2009). What is an anxiety disorder? Depression and Anxiety, 26(12), 1066-1085.

Downar, J. et al. (2000). A multimodal cortical network for the detection of changes in the sensory environment. Nat Neurosci, 3(3), 277–283.

Etkin, A. et al. (2011). Emotional processing in anterior cingulate and medial prefrontal cortex. Trends cogn sci, 15(2), 85–93.

Goyata, S. et al. (2016). Effects from acupuncture in treating anxiety: integrative review, Rev Bras Enferm, 69(3):564-571.

Hsieh, J. C. et al. (2001). Activation of the hypothalamus characterizes the acupuncture stimulation at the analgesic point in human: a positron emission tomography study. Neurosci Lett, 307(2):105-108.

Hui, K. K. S. et al. (2010). Acupuncture, the limbic system, and the anticorrelated networks of the brain. Auton Neurosci, 157(1-2):81-90.

Hui, K. K. S. et al. (2009). Acupuncture mobilizes the brain's default mode and its anti-correlated network in healthy subjects. Brain Res, 1287, 84-103.

Imperatori, C. et al. (2019). Default mode network alterations in individuals with high-trait-anxiety: An EEG functional connectivity study. J Affect Disord, 246:611-618.

Kavoussi, B. & Ross, B. E. (2007). The neuroimmune basis of anti-inflammatory acupuncture. Integr Cancer Ther, 6(3), 251–257.

Kessler, R.C. et al. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry, 51(1), 8–19.

Kwon, C. Y. & Lee, B. (2018). Acupuncture or Acupressure on Yintang (EX-HN 3) for Anxiety: A Preliminary Review. Med Acupunct, 30(2):73-79.

Li, M. et al. (2019). Acupuncture for treatment of anxiety, an overview of systematic reviews. Complement Ther Med, 43, 247-252.

Marsh, R. (2009). Functional disturbances within frontostriatal circuits across multiple childhood psychopathologies. Am J Psychiatry, 166(6), 664–674.

Mechias, M. L. et al. (2010). A meta-analysis of instructed fear studies: Implications for conscious appraisal of threat. Neuroimage, 49(2), 1760–1768.

Paulus, M. P. & Stein, M. B. (2006). An insular view of anxiety. BiolPsychiatry, 60(4), 383– 387.

Phillips, R. G. & LeDoux, J. E. (1992). Differential contribution of amygdala and hippocampus to cued and contextual fear conditioning. Behav Neurosci, 106(2), 274-285.

Preston, A. R. & Eichenbaum H. (2013). Interplay of hippocampus and prefrontal cortex in memory. Curr Biol, 23(17), R764-773

Robinson, O. J. et al. (2016) Anxiety-potentiated amygdala-medial frontal coupling and attentional control. Transl Psychiatry, 6(6):e833.

Tong, Q. Y. et al. (2021). Can acupuncture therapy reduce preoperative anxiety? A systematic review and meta-analysis. J Integr Med, 19(1), 20-28.

Vytal, K. et al. (2012). Describing the interplay between anxiety and cognition: from impaired performance under low cognitive load to reduced anxiety under high load. Psychophysiology, 49(6), 842–852.

Wittchen, H. U. & Jacobi, F. (2005). Size and burden of mental disorders in Europe — a critical review and appraisal of 27 studies. Eur Neuropsychopharmacol. 15(4), 357–376

Yang, X. Y. Et al. (2021). Effectiveness of acupuncture on anxiety disorder: a systematic review and meta‑analysis of randomised controlled trials. Ann Gen Psychiatry, 20(1), 9.

Yeo, B. T. T. et al. (2011). The organization of the human cerebral cortex estimated by intrinsic functional connectivity. J Neurophysiol, 106(3), 1125–1165.

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Published

02/05/2022

How to Cite

ALMEIDA, M. dos S. de .; CAVALCA, A. M. B. Acupuncture and anxiety: possible neural mechanisms. Research, Society and Development, [S. l.], v. 11, n. 6, p. e42211629309, 2022. DOI: 10.33448/rsd-v11i6.29309. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/29309. Acesso em: 24 apr. 2024.

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Section

Review Article