Therapeutic modulation of pain-related affective disorders by acupuncture: Mechanistic review

This review reexamines the mechanism by which acupuncture (especially electroacupuncture) modulates pain-related affective disorders from an integrative functional framework. We propose that the efficacy of acupuncture stems from its regulatory functions that mobilize and coordinate multiple internal physiological systems at the same time. Specifically, it is mainly realized through five functional modules: (1) central network remodeling function: correcting abnormal functional connections and neural circuit activity in brain regions related to pain and emotion; (2) Neuroplasticity and repair function: activate neurotrophic pathways and synaptic regulatory mechanisms to promote neural adaptation; (3) Systematic homeostasis regulation function: balancing the interaction of neurological-endocrine-gut axes; (4) Nociceptive signal gating function: a common signaling pathway that accurately inhibits pain and negative emotions at the molecular and receptor levels; (5) Neuroimmune regulatory function : targeted inhibition of central-specific inflammatory pathways and cytokine storms. This article aims to systematically summarize the evidence from the past 5 years and clarify how these five functions constitute a synergistic treatment network, providing a new perspective for the clinical application and mechanism research of acupuncture.