[Effect of Jiannao Anshen acupuncture on insomnia: a functional magnetic resonance imaging study]

To observe the efficacy of Jiannao Anshen acupuncture (acupuncture for brain-invigorating and mind-calming) on insomnia, and the dynamic changes of functional magnetic resonance imaging (fMRI) before and after acupuncture, to provide neuroimaging basis of acupuncture for insomnia.

A total of 58 participants were included. Of them, 29 patients with insomnia were included into an observation group, and 29 healthy participants were included into a control group. The patients in the observation group were treated with Jiannao Anshen acupuncture at Baihui (GV 20), bilateral Sishencong (EX-HN 1), Fengfu (GV 16), Fengchi (GB 20), Qiangjian (GV 18), occipital sideline, Anmian (Extra), Yiming (EX-HN 14) and Dazhui (GV 14); treatment was given once a day, 10 days as a course of treatment, and a total of 2 courses of treatment was given. The resting-state fMRI data was collected in the observation group before and after treatment. The participants in the control group received no treatment, and the resting-state fMRI data was collected only once. The resting-state fMRI data in the observation group before treatment and in the control group, also the observation group before and after treatment were compared. The Pittsburgh sleep quality index (PSQI), insomnia severity index (ISI), daytime insomnia symptom scale (DISS), hyperarousal scale (HAS), Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), digit symbol test, mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA) and the A, B speed of trail making test (NCT) were observed in the observation group before and after treatment. The clinical efficacy of the observation group was evaluated.

The total effective rate was 89.7% (26/29) in the observation group. In the observation group, the scores of PSQI, ISI and DISS, the A, B speed of NCT were all decreased after treatment (P<0.01, P<0.05). Before treatment, compared with the control group, functional connectivity in ventral dorsal prefrontal cortex, dorsal anterior cingulate cortex, inferior parietal lobe, dorsal lateral prefrontal cortex, dorsal anterior cingulate cortex, left ventral anterior cingulate gyrus and right ventral anterior cingulate gyrus was reduced in the observation group; compared before treatment, the functional connectivity in lingual gyrus, cerebellar area 6, frontal lobe, insular lobe and anterior cingulate gyrus, premotor gyrus and posterior cingulate gyrus was increased after treatment in the observation group. After treatment, the functional connection intensity of left ventral caudate nucleus and insular lobe was negatively correlated with HAMD score in the observation group (r =-0.55, P<0.05), and the functional connection intensity of left ventral caudate nucleus and anterior cingulate gyrus was negatively correlated with HAMA score in the observation group (r =-0.47, P<0.05).

The Jiannao Anshen acupuncture could effectively improve the sleep quality in patients with insomnia, and acupuncture could enhance the connection of left dorsal, right ventral and left ventral caudate nucleus with brain area.