Site-Dependent Patterns of Affective Interference Control and Inhibitory Braking Following Auricular Stimulation

Auricular neuromodulation specificity remains debated, particularly for electrical approaches in which current spread may obscure site-specific effects. We tested whether focal mechanical auricular acupressure produces site-by-pathway differences across Hot affective interference control and Cold inhibitory braking. In a single-blind, randomized, active-controlled study, 55 young adults with elevated affective symptoms received 48-h auricular acupressure at Shenmen, Subcortex, Combined (Shenmen + Subcortex), or an active Shoulder control site. Participants completed an Emotional Flanker task indexing Hot control and an Emotional Go/No-Go task indexing Cold control. Standardized change scores were analyzed using linear mixed-effects models, with hierarchical drift diffusion modeling and signal detection theory analyses used to constrain mechanistic interpretation. A significant Group × Pathway interaction was observed (p = 0.002). In the Cold pathway, Subcortex and Combined stimulation showed greater improvement than Shenmen stimulation. In the Hot pathway, Shenmen stimulation showed greater improvement than Subcortex stimulation, whereas Hot-pathway contrasts against the active control were non-significant. Focal auricular acupressure produced pathway-selective, site-dependent profiles across Hot and Cold executive-control tasks. These findings suggest relative site-by-pathway specificity, although further studies with larger samples and optimized control conditions are needed to confirm the robustness and mechanisms of this effect.