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A coordinate-based meta-analysis published in Medicine (2026) examined how acupuncture affects brain activity in patients with major depressive disorder, drawing on neuroimaging data from seven randomised controlled trials involving 357 participants. The analysis used resting-state functional magnetic resonance imaging measures — specifically regional homogeneity and amplitude of low-frequency fluctuations — to map brain activity changes associated with acupuncture-based interventions, including manual acupuncture, electroacupuncture, and transcutaneous auricular vagus nerve stimulation.
The results revealed that acupuncture produced significant increases in brain activity within the right cingulum and right caudate nucleus — regions associated with emotion regulation and reward processing. By contrast, conventional treatments primarily increased activity in the left hippocampus and right middle occipital gyrus. Further analysis found that clinical improvement in depression symptoms was linked to neuroplastic changes in the left cerebellum, and that a greater number of acupuncture sessions was associated with increased modulation of the left amygdala, suggesting a dose-dependent effect. Across studies, acupuncture produced significantly greater reductions in both depression and anxiety scores compared with control conditions.
The authors acknowledge important limitations, including the small number of included trials, variation in acupuncture protocols, lack of long-term follow-up data, and methodological constraints inherent to coordinate-based meta-analysis approaches.
Conclusion: This meta-analysis provides neuroimaging evidence that acupuncture engages a distinct pattern of brain plasticity in major depressive disorder, targeting emotional and reward circuits in ways that differ from conventional treatments, supporting a plausible neurobiological mechanism for its clinical benefits.
Source: Zhang J, Shi X, Wang W and colleagues. Medicine (2026). View on PubMed (PMID 42601716) · doi:10.1097/MD.0000000000050185