Exploration Of Brain Magnetic Resonance Imaging Of Acupuncture Anti-depression Based On The Concept Of "treating The Root Cause Of The Disease

OBJECTIVEBased on the clinical findings from our research team analyzed by the personalized functional magnetic resonance imaging(fMRI)technology,the present study aims to investigate the correlation between the changes of brain functional connections and the remssion effect before and after acupuncture treatment on depression patients,and to find the possible biomarkers of fMRI in depression disorder,which might provide a rigorous scientific explanation and clinical evidence to the mechanism of acupuncture on depression disorders.Meanwhile,under the guidance of the basic theory of the concept of wholism and treating disease from the root in traditional Chinese medicine(TCM),the present study also aims to elucidate the logical interpretation of TCM acupuncture theoretical advantages and curative effect characteristics through the results from application and enlightenment of its methodology principles of TCM in treatment for depression,and explore the new promising research approaches via new perspectives and new means to get closer to the reality of the complex disease as depression.CONTENTSExperiment 1.The diffusion tensor imaging study of corpus callosum in patients with depressive disorder or subthreshold depression was conducted through collaboration of the leading research teams in and this field,including State Key Laboratory of Brain Imaging Center of brain and cognitive science Institute at Beijing Normal University to complete the whole brain MRI scans,and with Professor Li-jun Bai team in Ministry of Education Key Laboratory of Biomedical Information Engineering in College of life science and technology at the Xi An Jiaotong University to analysis data results.Brain imaging data of 146 subjects were included.Diffusion tensor imaging(DTI)of fine subdivision of corpus callosum in depressive disorder group,subthreshold depressive patient group and healthy volunteer group were used to study the evolution of depression risk.This study includes applications for fine corpus callosum and the depression of partitions dividing high-risk progress evolution analysis technology and software platform,including technical calculation method,software program,feature extraction and optimization technology,and on the basis of the research and development of depression accelerated aging prediction assessment model),completed subjects MRI of diffusion tensor imaging data quality analysis and processing results.Experiment 2.Exploration of brain magnetic resonance imaging markers based on clinical trials of acupuncture in the treatment of depression.This study was conducted at McGovern Institute for Brain Research at the Massachusetts Institute of technology(MIT),with cooperation between Research Center for Mental Disorders at Beijing University of Chinese Medicine and Individual Brain Difference Lab in Martinos Center for Biomedical Imaging at Massachusetts General Hospital.With the important support from Professor Liu Hesheng from Harvard Medical School we completed antidepression MRI imaging analysis.Liu’s team has keenly captured the core problems and urgent needs in international brain imaging research and pioneered the theory and technology of "Personalized Brain Functional Sector"(pBFS)for accurate individual brain function mapping and algorithm for 34 patients who were diagnosed with depression disorder.In this study,34 patients who were diagnosed with depression disorder were blindly and randomly assigned into three groups for different treatments for 6 weeks.That is 12 patients were treated with electroacupuncture+escitalopram,10 with electroacupuncture+escitalopram placebo,while the other 12 with sham acupuncture+escitalopram.By using the personalized brain functional sector technology and algorithm,first pioneered by Professor Liu Hesheng,and machine learning the correlation between the change of the connection strength and HAMD reduction before and after the treatment were studied.The capability to predict symptom change in patients by functional connection changes was also investigated,and those functional connections that contributed to symptom improvement were considered radiographic markers associated with symptom change in patients.RESULTSExperiment 1:1.FA values of corpus callosum and subdivisions decreased in depression group and high-risk group(Sub threshold depression,St).Moreover,CC1 and CC2 FA values continued to decrease significantly in the process that subthreshold develops to depressive disorder.Combined with HAMD(17/24)data analysis,it was confirmed that the higher the HAMD score was,the more serious the decline of CC1/CC2 FA value was,showing a significant negative correlation between the two.This result has important implications for the clinical prevention and treatment of depressive disorder:That early intervention is needed for those with significant decline in CC1 and CC2 FA values in subthreshold depression in order to resist the progressive process.2.Through the clustering study on the white matter network of the subjects,10 brain networks that were significantly associated with depressive disorder as well as subthreshold depression were obtained.Compared the functional connections of the white matter network in the resting state,the differences of the functional connections of white matter network and white matter network to gray matter network were statistically significant between the depressed group and the healthy control group.Differences in connection strength were notified between the average white matter functional network of the healthy control group.Also notified is the differences in connection strength between the average white matter functional network and the gray matter functional network comparing the depressed group and the healthy control group.3.Following the principle of in touch with clinical practice,this study conducted the correlation analysis between abnormal functional connectivity of brain network and factor cluster HAMD24.The results confirmed that there were five abnormal functional connectivity founded between white matter network:cognitive impairment(2);Feeling of hopelessness(2);Block(1).There are also five abnormal white matter to gray matter functional network connections found:cognitive impairment(3);Hopelessness(1);Block(1).In conclusion,this study fully demonstrates the importance of the white matter(corpus callosum)network in brain mental activities,especially in depressive disorders.Based on DTI method this study on functional connection network of corpus callosum once again shows us that the brain is a d high speed functional connected as a whole compact structure.In depression status the abnormal trend of whole brain connection function is extremely complicated and intertwined with each other.The prevention and treatment system of mental emotion disorders by Chinese medicine remains outstanding advantages.Experiment 2:It was found from the study on 34 patients who were diagnosed with depression disorder,pBFS-based personalized features can better predict HAMD changes before and after treatment and can capture and characterize individual information more accurately.Compared with the changes of functional connections within the brain network,the changes of functional connections between brain networks were more important to the changes of symptomatology in patients with depressive disorder.We found that the functional connections contributing to the prediction of HAMD were mainly distributed among the connections between the default network,the dorsal attention network and the fronto-parietal control network.Finally,it was found that there was an overestimated bias in the connections between the networks of the traditional group level atlas,so that the association between functional connections based on group level atlas and the improvement in HAMD before and after treatment was lower than association between individual based functional connections and the improvement in HAMD.Based on personalized brain functional sector(pBFS)technology,the new algorithm of personalized MRI brain imaging is expected to further establish personalized MRI imaging methods for depression diagnosis as well as subtypes identification and efficacy evaluation of depression disorders.New personalized approaches and clinical strategies could be developed for depression disorders according to the characteristics of brain functional connections.CONCLUSIONThe conclusion from the present study is as follows.Traditional Chinese medicine(TCM)has the advantage of adjusting the neurologic disorders with its unique theory and effective treatment.It is opposed to understand humans’ physical health with isolation from mental health.Despite the domination of separating mind from body in the medical world for hundreds of years,the TCM core value of "body and spirit integration" as well as the principle of syndrome differential treatment has established its solid position with definite curative effect in prevention and treatment for mental disorders.Conclusively,the human and nature integrity and/or the unity of form and spirit is the fundamental theory governing the treatment for emotional diseases in TCM.The etiology and pathogenesis of emotional disease is summarized as caused by the uneasy,due to poor qi and blood,upsetting the internal organs.The core wisdom of TCM of diagnosis and treatment system to identify and prevent mental illness relies on Yin and Yang,as well as viscera,while Yang dominates.The original realm of prevention and treatment of mental illness in Chinese medicine focuses on tune mental status and tune qi for metal peace and spirit sound.And to carry out the holistic view of life in Chinese medicine need to follow the principles of "seeking the root of cure" and "treating the differences and similarities of disease",which are enlightening for the clinical prevention and treatment of depressive disorders and mental diseases.