Electroacupuncture Activated Impaired Brain Areas and Improved Mental Status and Sleep Quality in Primary Insomnia Patients.

OBJECTIVE: This study aimed to investigate the specific neurological mechanisms underlying the effects of electroacupuncture at Shenmen (Heart 7) with Neiguan (Pericardium 6) acupoints in patients with primary insomnia (PI). We sought to understand these mechanisms by comparing changes in areaal homogeneity (ReHo) before and after treatment in PI patients and healthy controls (HC).

METHODS: Between November 2019 and November 2021, we recruited 17 primary insomnia patients (PI group) and 20 matched healthy controls (HC group) as study subjects from Zhaoqing First People's Hospital. Before electroacupuncture treatment, all participants completed the Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Rating Scale (HAMD), and Hamilton Anxiety Rating Scale (HAMA) assessments. Resting-state magnetic resonance imaging (MRI) scans were conducted before and after two sessions of electroacupuncture at Shenmen and Neiguan acupoints.

RESULTS: Before treatment, primary insomnia patients showed higher PSQI (χ2=1.964; P = .017), HAMA (χ2=2.016; P = .027), and HAMD scores (χ2=2.367; P = .013) compared to healthy controls, and increased ReHo values were observed in the left amygdala, bilateral middle temporal gyrus, and left posterior cingulate gyrus in PI patients, while decreased ReHo values were found in the left posterior cingulate gyrus, right middle frontal gyrus, and right precuneus. After treatment, ReHo values increased in the left superior frontal gyrus, right parahippocampal gyrus, and right cingulate gyrus, while they decreased in the left amygdala and right angular gyrus. Primary insomnia disrupts brain areas in the default network, salience network, and parts of the affective cognitive network.

CONCLUSION: Electroacupuncture at Shenmen and Neiguan acupoints partially activated impaired brain areas in patients with primary insomnia, leading to improvements in mental status and sleep quality. This offers a novel perspective for the clinical treatment of primary insomnia.