Clinical Efficacy and Therapeutic Mechanism of Acupuncture in the Treatment of Adolescent Depression.

BACKGROUND

Pharmacological treatment for adolescent depression is limited in safety and efficacy. Acupuncture treatment for depression has been endorsed by the World Health Organization. This study aimed to analyze the efficacy and mechanisms of acupuncture in treating adolescent depression.

METHODS

An 4-week clinical trial was conducted from February 1, 2022 to June 30, 2024 at three hospitals. Patients aged 12 to 18 years were divided into three treatment groups: Manual acupuncture (MA), antidepressants (ADM), or acupuncture combined with antidepressants (MA+ADM). The 24-item Hamilton Depression scale (HAMD-24) scores, serum neurotransmitters levels, and resting-state functional magnetic resonance imaging (RS-fMRI) data were assessed at baseline (week 0) and after treatment (week 4).

RESULTS

After a 4-week intervention, both the MA and MA+ADM groups showed significant improvement in HAMD-24 scores. The MA+ADM group experienced more improvement, particularly in addressing somatization and sleep disorders. The study revealed that acupuncture increased serum levels of 5-hydroxytryptamine (5-HT), kynurenic acid, dopamine noradrenaline, adrenaline, L-histidine, and picolinic acid in adolescents with depression. Acupuncture was also found to regulate the excitability of depression-related brain regions (frontal lobe, caudate nucleus, anterior cingulate, and paracingulate gyri) and the functional connectivity of depression-related circuits (limbic-cortical-striatal-pallidal-thalamic circuit and hate circuit). Furthermore, significant negative correlations were observed between week 0 and week 4 HAMD-24 scores and up-regulated serum levels of 5-HT and dopamine. Scores were positively associated with increased amplitude of low-frequency fluctuations and regional homogeneity values.

CONCLUSIONS

Acupuncture improves adolescents' depressive mood and sleep quality and alleviates somatic symptoms by modulating neurotransmitters levels and brain activity.

CLINICAL TRIAL REGISTRATION: No: ChiCTR2200056171. https://www.chictr.org.cn/showproj.html?proj=151197.