Potential scalp acupuncture and brain stimulation targets for common neurological disorders: evidence from neuroimaging studies

This innovative study represents a significant milestone in the development of evidence-based scalp acupuncture. Using the Neurosynth Compose platform, researchers conducted a comprehensive meta-analysis of neuroimaging studies to identify specific cortical targets for ten prevalent neurological conditions, establishing a crucial bridge between modern neuroscience and traditional Chinese medicine. The methodology involved the systematic analysis of more than 2,000 studies published through October 2024, encompassing 49,182 brain coordinates from patients with subjective cognitive decline, mild cognitive impairment, Alzheimer's disease, Parkinson's disease, multiple system atrophy, primary progressive aphasia, post-stroke aphasia, dyslexia, chronic pain, and disorders of consciousness. Results revealed specific patterns of brain alterations for each condition, allowing the identification of 3 to 9 distinct therapeutic targets per disorder.

For neurodegenerative conditions such as cognitive decline and Alzheimer's disease, the targets identified include the bilateral angular gyrus, dorsolateral prefrontal cortex, and middle temporal gyrus — regions crucial for memory processing and executive function. In movement disorders such as Parkinson's disease, targets were mapped in the primary motor cortex, prefrontal cortex, and supplementary motor areas. Language-related conditions showed consistent targets in the left inferior frontal gyrus, superior temporal gyrus, and Broca's and Wernicke's areas. The study established specific needling protocols for each target, including direction, depth, and stimulation techniques based on traditional Chinese scalp acupuncture patterns but with localization refined by neuroimaging.

The findings are consistent with existing non-invasive brain stimulation protocols, such as transcranial magnetic stimulation and transcranial electrical stimulation, validating the clinical relevance of the identified targets. Previous studies using these neuromodulation techniques on the same brain targets demonstrated significant improvements in cognitive, motor, and pain symptoms, suggesting that targeted scalp acupuncture may offer similar benefits. The clinical implications are substantial, offering practitioners a neuroimaging-based scalp acupuncture system that can improve treatment precision and efficacy. The identified targets complement existing traditional protocols, such as the Jiao Shunfa system and World Health Organization guidelines, providing more specific, scientifically grounded locations.

However, the study has important limitations that should be considered. The meta-analysis-based approach, although robust, depends on the quality and heterogeneity of the included studies. Some identified targets remain theoretical and require clinical validation through randomized controlled trials. In addition, scalp acupuncture cannot directly reach deep brain structures, being limited to the superficial cortex, although it can influence connected functional networks.

Future studies should focus on the clinical validation of these targets, the development of standardized stimulation protocols, and integration with functional connectivity analyses to optimize the selection of therapeutic points.