实用医学杂志 ›› 2025, Vol. 41 ›› Issue (22): 3618-3624.doi: 10.3969/j.issn.1006-5725.2025.22.021

• 综述 • 上一篇    

基于伏隔核神经环路探讨抑郁症的发病机制及针灸治疗的研究进展

孙洪艺1,骆思宏1,张成宇1,孟子杭1,陈卓1,李晓宁2()   

  1. 1.黑龙江中医药大学研究生院 (黑龙江 哈尔滨 150040 )
    2.黑龙江中医药大学附属第二医院针灸四科 ;(黑龙江 哈尔滨 150001 )
  • 收稿日期:2025-06-08 出版日期:2025-11-25 发布日期:2025-11-26
  • 通讯作者: 李晓宁 E-mail:18346038346@163.com
  • 基金资助:
    国家中医药管理局高水平中医药重点学科建设项目(国中医药人教函[2023]85号)

Exploring the neural circuitry mechanisms of acupuncture for depression: Insights centered on the nucleus accumbens

Hongyi SUN1,Sihong LUO1,Chengyu ZHANG1,Zihang MENG1,Zhuo CHEN1,Xiaoning LI2()   

  1. *.Graduate School,Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang,China
  • Received:2025-06-08 Online:2025-11-25 Published:2025-11-26
  • Contact: Xiaoning LI E-mail:18346038346@163.com

摘要:

抑郁症发生发展与大脑奖赏和情绪调节环路功能失调密切相关,伏隔核(nucleus accumben,NAc)作为奖赏系统的核心枢纽,与腹侧被盖区(ventral tegmental area, VTA)、内侧前额叶皮质(medial prefrontal cortex, mPFC)、杏仁核(amygdala, AMY)、海马(hippocampus, HIP)及丘脑室旁核(paraventricular nucleus of the thalamus, PVT)等脑区构成的神经环路异常已被证实与抑郁症状存在显著关联。针刺通过多靶点起效的作用特点,符合抑郁症这一多病因、多系统失调的情感障碍特征。现基于NAc为中心的脑神经环路,系统梳理其在抑郁症发生发展中的功能变化及针刺干预的潜在机制,揭示针刺通过调节VTA-NAc多巴胺能传导、增强mPFC-NAc环路的神经递质平衡、双向调节AMY-NAc环路的情绪稳定、减轻HIP-NAc谷氨酸过度活跃状态及优化丘脑-NAc环路的兴奋性传递,实现对抑郁症的整体性改善。此外,该综述聚焦于环路层面的系统整合,突出了针刺抗抑郁的实用性及其机制研究进展,以期为临床治疗提供更可靠的理论支撑与实践指导。

关键词: 伏隔核, 针刺, 抑郁症, 神经环路, 研究进展

Abstract:

The pathogenesis and progression of depression are closely associated with functional dysregulation in the brain's reward and emotion-modulating circuits. As the central hub of the reward system, the nucleus accumbens (NAc) forms aberrant neural circuits with multiple brain regions?including the ventral tegmental area (VTA), medial prefrontal cortex (mPFC), amygdala (AMY), hippocampus (HIP), and paraventricular nucleus of the thalamus (PVT)?which have been empirically linked to depressive symptomatology. Acupuncture, with its multi-target therapeutic profile, aligns well with the multifactorial and multisystem dysregulation characteristic of depressive disorders.This review systematically examines the functional alterations of the NAc-centered neural circuitry in depression and explores the potential mechanisms of acupuncture intervention. Evidence suggests that acupuncture holistically ameliorates depression by: modulating dopaminergic transmission in the VTA-NAc pathway, enhancing neurotransmitter equilibrium in the mPFC-NAc circuit, bidirectionally regulating emotional stability via the AMY-NAc loop, attenuating HIP-NAc glutamatergic hyperactivity, and optimizing excitatory signaling in the thalamus-NAc circuit. Furthermore, this synthesis emphasizes a systems-level integration of circuit mechanisms, highlighting both the clinical applicability of acupuncture in depression treatment and recent advances in mechanistic research. The findings provide robust theoretical foundations and practical guidance for clinical practice, bridging translational neuroscience with therapeutic innovation.

Key words: nucleus accumbens, acupuncture, depression, neural circuitry, research progress

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