Electro-acupuncture Intervention On The Changes Of White Matter Microstructure In IAD Patients

Background and ObjectiveInternet addiction disorder(IAD)has attracted the attention of psychologists,educators and psychiatrists around the world since the last century.But the current therapies for IAD were limited and the efficacy was quite poor because of lacking of its pathological mechanism.This study intends to use electro-acupuncture(EA)and psychotherapy interventions(PI)as a control to investigate the effect of EA on the changes of white matter microstructure in IAD patients.Diffusion tensor imaging(DTI),Internet addiction self-rating scale(ISS),the self-rating anxiety scale(SAS),the self-rating depression scale(SDS)and fiber tracing were used to compare the difference of white matter microstructure between patients with IAD and healthy controls(HC)and to evaluate the efficacy of EA and PI on IAD.Apart from fractional anisotropy(FA)values commonly used in previous studies,values of axial diffusivity(AD)and radial diffusivity(RD)were further extracted to investigate the specific neuro-pathological changes of IAD patients,in order to provide more effective means for the treatment of IAD.MethodsThis study was to include 30 patients in the IAD group and were randomly divided into an EA group and a PI group,with 15 patients in each group and 12 sexand age-matched volunteers in the HC group.All of the participants were scanned on one same MRI to acquire the DTI data and related scales assessment.We compared the changes of white matter microstructure and the scores of related scales in patients with intra-and inter-group IAD before and after EA and PI.The group differences in FA,AD and RD were explored by using voxel-based analysis.Meanwhile,the deterministic DTI tractography were used to examine the abnormal brain area.The continuous variable ANOVA analysis was also used to evaluate the correlation between diffusion parameters and the scores of Internet addiction self-rating scale.Results1.The whole-brain analysis showed significantly decreased FA in IAD patients in the right thalamus compared with HC group(AlphaSim Corrected,p<0.05).The decreased FA was related negatively to the scores of Self rating scale for Internet Addiction(p<0.01).2.Compared with HC group,diffusivity analysis showed significantly increased RD in right thalamus and anterior cingulate in IAD patients(AlphaSim Corrected,p<0.05).The increased RD positively correlates with the scores of Self rating scale for Internet Addiction(p<0.01).3.Compared with the HC group,AD values in the right middle frontal gyrus and left superior frontal gyrus in the IAD group were increased(AlphaSim corrected,p <0.05).4.The fiber tracing analysis showed the decreased FA in the anterior thalamic radiations and increased RD in the areas of anterior thalamic radiations and cingulate bundle.5.Within the EA group and PI group before and after treatment,scores of ISS,SAS and SDS all decreased and were significant differences(p<0.05).6.The scores of SAS and SDS showed significant differences(p<0.05)between the EA group and the PI group after treatment,and EA group decreased more significantly.7.The whole brain analysis showed that there were no significant changes in FA,AD and RD values between the groups before and after the EA and the PI.Conclusions1.According to our findings,the decreased FA and the increased RD values may be due to myelin sheath hyperplasia or demyelination.2.The RD value of cingulate gyrus in IAD patients were correlated with the score of Internet addiction self-rating scale,which indicated that the mechanism of Internet addiction may be closely related to the reward pathway of cingulate gyrus formation.3.The effect of EA on improving anxiety and depression may be better than PI.4.The reason that EA and PI both did not significantly change the white matter microstructure of IAD patients may be related to the short course of therapy.