Acupuncture effect on brain default mode network connectivity in breast cancer patients with hot flashes: A randomized controlled trial

Objective: To use functional MRI to assess the effect of acupuncture on brain resting-state functional connectivity in breast cancer patients with hot flashes. Methods: A total of 24 breast cancer patients experiencing hot flashes (BC-HF) underwent 5 weeks of acupuncture treatment and follow-up at 4–6 months after therapy. The control groups included 35 patients with breast cancer without hot flashes (BC-NF) and 30 healthy controls respectively. Functional connectivity (FC) within the brain default mode network (DMN) was assessed using resting-state functional MRI at baseline and after treatment. The primary outcome was the change in the hot flash composite score (HFCS), and secondary outcomes included sleep quality and quality of life. Results: Acupuncture significantly improved HFCS (-3.87; 95 % CI, −2.21 to −7.32; p < 0.001) and enhanced FC between the right temporal gyrus and angular area (p = 0.001) as well as the medial prefrontal cortex (p = 0.009). At 4–6 months follow-up, BC-HF group maintained 45.4 % improvement in hot flashes syndrome. No significant changes were observed in the sleep quality or quality of life. A strong correlation was found between increased FC and a reduction in HFCS only in a subgroup of patients who responded positively to acupuncture (r = 0.726, p = 0.001). Conclusions: This study provided the first evidence that acupuncture can enhance brain connectivity within the DMN and significantly alleviate the long-term clinical outcome of HF in breast cancer patients. These findings underscore the potential of acupuncture as a viable nonpharmacological option for managing vasomotor symptoms.