The Journal of Practical Medicine >
Exploring the neural circuitry mechanisms of acupuncture for depression: Insights centered on the nucleus accumbens
Received date: 2025-06-08
Online published: 2025-11-26
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
Hongyi SUN , Sihong LUO , Chengyu ZHANG , Zihang MENG , Zhuo CHEN , Xiaoning LI . Exploring the neural circuitry mechanisms of acupuncture for depression: Insights centered on the nucleus accumbens[J]. The Journal of Practical Medicine, 2025 , 41(22) : 3618 -3624 . DOI: 10.3969/j.issn.1006-5725.2025.22.021
| [1] | WANG X, CHENG S, XU H. Systematic review and meta-analysis of therelationship between sleep disorders and suicidal behaviour in patients with depression[J]. BMC Psychiatry, 2019, 19(1): 303. doi:10.1186/s12888-019-2302-5 |
| [2] | 董晓杰, 王鹏, 马俊华, 等. 青少年抑郁症患者人格特征与非自杀性自伤行为的相关性分析[J]. 实用医学杂志, 2024, 40(20): 2848-2853. |
| [3] | MONROE S M, HARKNESS K L. Major depression and its recurrences: Life course matters[J]. Annu Rev Clin Psychol, 2022, 18: 329-357. doi:10.1146/annurev-clinpsy-072220-021440 |
| [4] | 王慧莹, 周爱南, 吴建威, 等. 不同作用机制临床在研抗抑郁药物研究进展[J]. 中国新药杂志, 2023, 32(7): 676-86. |
| [5] | 陈清, 廖燕. 针药结合与单纯药物治疗抑郁症的临床疗效比较研究[J]. 中国实用医药, 2020, 15(6): 175-177. |
| [6] | PARK Y S, SAMMARTINO F, YOUNG N A, et al. Anatomic Review of the VentralCapsule/Ventral Striatum and the Nucleus Accumbens to Guide Target Selection for DeepBrain Stimulation for Obsessive-Compulsive Disorder[J]. World Neurosurg, 2019, 126: 1-10. doi:10.1016/j.wneu.2019.01.254 |
| [7] | WANG S, LERI F, RIZVI S J. Anhedonia as a central factor in depression: Neural mechanisms revealed from preclinical to clinical evidence[J]. Prog Neuropsychopharmacol Biol Psychiatry, 2021,110: 110289. doi:10.1016/j.pnpbp.2021.110289 |
| [8] | HAN Y R, GEYA T, MING H J, et al. Mechanisms of nucleus accumbens deep brain stimulation in treating mental disorders[J]. Fundam Res, 2024, 5(1): 48-54. doi:10.1016/j.fmre.2024.06.009 |
| [9] | 董戴凤. 抑郁症应激相关脑功能的性别差异性研究[D]. 长沙: 中南大学, 2022. |
| [10] | GIORDANA B, BENOIT M, DARMON N, et al. Acute and Reproducible Mood Improvement Due to Nucleus Accumbens Deep Brain Stimulation[J]. Brain Stimul, 2015, 8(4): 842-843. doi:10.1016/j.brs.2015.05.004 |
| [11] | GEBARA E, ZANOLETTI O, GHOSAL S, et al. Mitofusin-2 in the Nucleus Accumbens Regulates Anxiety and Depression-like Behaviors Through Mitochondrial and Neuronal Actions[J]. Biol Psychiatry, 2021, 89(11): 1033-1044. doi:10.1016/j.biopsych.2020.12.003 |
| [12] | HAN Q X, WEI W, SHAN Q, et al. Effects of electroacupuncture on the ventral tegmental area- nucleus accumbens dopamine pathway in rats with chronic sleep deprivation[J]. Acupunct Med, 2023, 41(6): 336-344. doi:10.1177/09645284221146197 |
| [13] | 潘伟超. “通督调神”电针干预慢性睡眠剥夺小鼠睡眠障碍的VTATH-NAc神经通路机制研究[D]. 南京: 南京中医药大学, 2024. |
| [14] | 李雅清. VTA-NAc通路参与慢性睡眠剥夺导致小鼠抑郁样行为的机制研究[D]. 天津: 天津大学, 2022. |
| [15] | LIU J, MO J W, WANG X, et al. Astrocyte dysfunction drives abnormal resting-state functional connectivity in depression[J]. Sci Adv, 2022, 8(46): eabo2098. doi:10.1126/sciadv.abo2098 |
| [16] | LI Y, ZHANG B, PAN X, et al. Dopamine-Mediated Major Depressive Disorder in the Neural Circuit of Ventral Tegmental Area-Nucleus Accumbens-Medial Prefrontal Cortex: From Biological Evidence to Computational Models[J]. Front Cell Neurosci, 2022, 16: 923039. doi:10.3389/fncel.2022.923039 |
| [17] | CHOI T Y, JEON H, JEONG S, et al. Distinct prefrontal projection activity and transcriptional state conversely orchestrate social competition and hierarchy[J]. Neuron, 2024, 112(4): 611-627. doi:10.1016/j.neuron.2023.11.012 |
| [18] | GARCIA A, ALLER M I, PATERNAIN A V, et al. Central role of regular firing neurons of centrolateral amygdala in affective behaviors[J]. iScience, 2025, 28(6): 112649. doi:10.1016/j.isci.2025.112649 |
| [19] | LI J, LI Z A, TIAN H M, et al. Corticotropin-releasing hormone neurons in the central Amygdala: An integrative hub for pain, emotion, and addiction neurobiology[J]. Brain Res, 2025, 1863: 149753. doi:10.1016/j.brainres.2025.149753 |
| [20] | ZHU Y, WANG K, MA T, et al. Nucleus accumbens D1/D2 circuits control opioid withdrawal symptoms in mice[J]. J Clin Invest, 2023, 133(18): e163266. doi:10.1172/jci163266 |
| [21] | 朱丽君, 李克倩, 李盛楠, 等. 中医药调控海马神经可塑性防治抑郁症的研究进展[J]. 中国中药杂志, 2024, 49(22): 6019-6029. |
| [22] | IBRAHIM K M, MASSALY N, YOON H J, et al. Dorsal hippocampus to nucleus accumbens projections drive reinforcement via activation of accumbal dynorphin neurons[J]. Nat Commun, 2024, 15(1): 750. doi:10.1038/s41467-024-44836-9 |
| [23] | TSAI S F, HSU P L, CHEN Y W, et al. High-fat diet induces depression-like phenotype via astrocyte-mediated hyperactivation of ventral hippocampal glutamatergic afferents to the nucleus accumbens[J]. Mol Psychiatry, 2022, 27(11): 4372-4384. doi:10.1038/s41380-022-01787-1 |
| [24] | MUIR J, TSE Y C, IYER E S, et al.Ventral Hippocampal Afferents to Nucleus Accumbens Encode Both Latent Vulnerability and Stress-Induced Susceptibility[J]. Biol Psychiatry, 2020, 88(11): 843-854. doi:10.1016/j.biopsych.2020.05.021 |
| [25] | LESERRI S, SEGURA-A A, NOWACKI A,et al. Linking connectivity of deep brain stimulation of nucleus accumbens area with clinical depression improvements: A retrospective longitudinal case series[J]. Eur Arch Psychiatry Clin Neurosci, 2024, 274(3): 685-696. doi:10.1007/s00406-023-01683-x |
| [26] | LEONARD B T, KARK S M, GRANGER S J, et al. Anhedonia is associated with higher functional connectivity between the nucleus accumbens and paraventricular nucleus of thalamus[J]. J Affect Disord, 2024, 366: 1-7. doi:10.1016/j.jad.2024.08.113 |
| [27] | DENG Q, ZHANG S Q, YANG P F, et al. A thalamic circuit facilitates stress susceptibility via melanocortin 4 receptor-mediated activation of nucleus accumbens shell[J].CNS Neurosci Ther, 2022, 29 (2): 646-658. doi:10.1111/cns.14046 |
| [28] | BARSON J R, MACK N R, GAO W J. The Paraventricular Nucleus of the Thalamus Is an Important Node in the Emotional Processing Network[J]. Front Behav Neurosci, 2020, 14: 598469. doi:10.3389/fnbeh.2020.598469 |
| [29] | 李瀚, 李政, 黄泳. 黄泳教授基于“督-脑”辨治抑郁症的临床-基础转化研究概述[J]. 上海针灸杂志, 2025, 44(3): 261-266. |
| [30] | WANG Z, WANG X, LIU J, et al. Acupuncture treatment modulates the corticostriatal reward circuitry in major depressive disorder[J]. Psychiatr Res, 2017, 84: 18-26. doi:10.1016/j.jpsychires.2016.12.017 |
| [31] | CAI X, WU M, ZHANG Z, et al. Electroacupuncture alleviated depression-like behaviors in ventromedial prefrontal cortex of chronic unpredictable mild stress-induced rats: Increasing synaptic transmission and phosphorylating dopamine transporter[J]. CNS Neurosci Ther, 2023, 29(9): 2608-2620. doi:10.1111/cns.14200 |
| [32] | DUAN G, HE Q, PANG Y, et al. Altered amygdala resting-state functional connectivity following acupuncture stimulation at BaiHui (GV20) in first-episode drug-Na?ve major depressive disorder[J]. Brain Imaging Behav, 2019, 14 (6): 2269-2280. doi:10.1007/s11682-019-00178-5 |
| [33] | LEONARD B T, KARK S M, GRANGER S J, et al. Anhedonia is associated with higher functional connectivity between the nucleus accumbens and paraventricular nucleus of thalamus[J]. Affect Disord, 2024, 366: 1-7. doi:10.1016/j.jad.2024.08.113 |
| [34] | SHEN Z Q, CHANG W Q, LIANG L F, et al. Electroacupuncture effects on trigeminal neuralgia with comorbid anxiety and depression: The role of frequency and acupoint specificity[J]. FASEB J, 2025, 39(2): e70337. doi:10.1096/fj.202402461rr |
| [35] | YANG Y, WEI X, TIAN J, et al. Scalp electroacupuncture targeting the VTA-DA neurons to relieve negative emotions and promote the alleviation of chronic pain[J]. Front Neurosci, 2023, 17: 1323727. doi:10.3389/fnins.2023.1323727 |
| [36] | LI P, HUANG W, YAN Y N, et al.Acupuncture Can Play an Antidepressant Role by Regulating the Intestinal Microbes and Neurotransmitters in a Rat Model of Depression[J]. Med Sci Monit, 2021, 27: e929027. doi:10.12659/msm.929027 |
| [37] | WANG Q, BI H, HUANG H, et al. Electroacupuncture Prevents the Depression-Like Behavior by Inhibiting the NF-κB/NLRP3 Inflammatory Pathway in Hippocampus of Mice Subjected to Chronic Mild Stress[J]. Neuropsychobiology, 2022, 81(3): 237-245. doi:10.1159/000521185 |
| [38] | YAO J, CHEN C, GUO Y, et al. A Review of Research on the Association between Neuron-Astrocyte Signaling Processes and Depressive Symptoms[J]. Int J Mol Sci, 2023, 24(8): 6985. doi:10.3390/ijms24086985 |
| [39] | LIN S S, ZHOU B, CHEN B J, et al. Electroacupuncture prevents astrocyte atrophy to alleviate depression[J]. Cell Death Dis, 2023, 14(5): 343. doi:10.1038/s41419-023-05839-4 |
| [40] | 徐蕊, 黄兴兵. 难治性抑郁症非药物治疗新进展[J]. 实用医学杂志, 2024, 40(4): 439-446. |
| [41] | LUO T, TIAN H, SONG H,et al. Possible Involvement of Tissue Plasminogen Activator/Brain-Derived Neurotrophic Factor Pathway in Anti-Depressant Effects of Electroacupuncture in Chronic Unpredictable Mild Stress-Induced Depression in Rats[J]. Front Psychiatry, 2020, 20; 11:63. doi:10.3389/fpsyt.2020.00063 |
| [42] | LIU Y, ZHANG G, LI J, et al. Clinical Efficacy of Acupuncture Combined with Escitalopram Oxalate in the Treatment of Mild-to-Moderate Post-Stroke Depression[J]. Neuropsychiatr Dis Treat, 2025, 21: 917-925. doi:10.2147/ndt.s507265 |
| [43] | 张文悦, 何静, 徐颖. 针灸对肝郁气滞型卒中后抑郁患者抑郁情绪及血清NGF、5-HT水平的影响[J]. 现代中西医结合杂志, 2025, 34(6): 779-783. |
/
| 〈 |
|
〉 |