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• Clinical Articles •
Resting-state fMRI on the functional connectivity regulation of the default mode network in chronic subjective tinnitus patients using Zhu's scalp acupuncture
DU Junhui  ZHENG Zhaolong  HUANG Kemeng  ZHU Chongyuan  HUANG Tingting  WANG Yaqi  WU Xiqing  ZHANG Fengying 

Cite this article as DU J H, ZHENG Z L, HUANG K M, et al. Resting-state fMRI on the functional connectivity regulation of the default mode network in chronic subjective tinnitus patients using Zhu's scalp acupuncture[J]. Chin J Magn Reson Imaging, 2026, 17(8): 48-56. DOI:10.12015/issn.1674-8034.2026.08.004.


[Abstract] Objective To explore the regulatory effect of Zhu's scalp acupuncture on the functional connectivity of the default mode network (DMN) in patients with chronic subjective tinnitus (CST) based on resting-state functional magnetic resonance imaging (rs-fMRI) technology, clarify its associated brain functional network changes and verify the clinical efficacy.Materials and Methods A total of 85 CST patients meeting the inclusion criteria from March 2025 to October 2025 were selected and randomly divided into an experimental group (Zhu's scalp acupuncture treatment, 43 cases) and a control group (oral administration of Ginkgo Biloba tablets and mecobalamin, 42 cases) using a random number table method. Additionally, 30 healthy volunteers were included as a healthy control group, which underwent only a single baseline rs-fMRI scan. Patients in both treatment groups received intervention for (60 ± 2) days and underwent rs-fMRI scans before and after treatment. Simultaneously, the Tinnitus Handicap Inventory (THI), Hamilton Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), and Visual Analogue Scale (VAS) were assessed. Sliding window analysis, hidden Markov models, and graph theory analysis were employed to extract functional connectivity parameters of core DMN nodes [posterior cingulate cortex (PCC), medial prefrontal cortex (mPFC), angular gyrus (ANG), etc.) and graph theory metrics (global efficiency, local efficiency, clustering coefficient). Dynamic changes in DMN functional connectivity before and after treatment were compared between the two groups, and the correlation between imaging indicators and clinical scale scores was analyzed.Results Before treatment, the functional connectivity strengths between PCC and ANG, as well as between mPFC and PCC in the DMN of patients in both groups were higher than those of healthy people (t = 5.342, P < 0.001; t = 6.115, P < 0.001), and were positively correlated with THI scores (r = 0.583, 0.612, P < 0.01). After treatment, the functional connectivity strengths of PCC-right ANG and mPFC-PCC in the experimental group were lower than those before treatment (t = 8.756, P < 0.001; t = 9.234, P < 0.001), and the global efficiency, local efficiency and clustering coefficient of DMN were improved (t = 7.562, 7.236, 6.982, P < 0.001); the improvement amplitude of the above imaging indicators in the experimental group was better than that in the control group (t = 3.878, 3.652, 3.423, P < 0.05). In terms of clinical efficacy, the total effective rate of the experimental group (86.05%) was significantly higher than that of the control group (64.29%) (χ2 = 6.327, P = 0.012). Correlation analysis showed that the change in PCC-right ANG functional connectivity strength was positively correlated with the change in THI score (r = 0.623, P < 0.001).Conclusions Zhu's scalp acupuncture can improve clinical symptoms by down-regulating the abnormally enhanced functional connectivity in the DMN of CST patients and optimizing the network topological properties. Its mechanism may be related to regulating DMN functional connectivity and network topological properties, which provides imaging evidence for the precise treatment of CST.
[Keywords] chronic subjective tinnitus；Zhu's scalp acupuncture；resting-state functional magnetic resonance imaging；magnetic resonance imaging；default mode network；functional connectivity；efficacy verification

DU Junhui1   ZHENG Zhaolong2   HUANG Kemeng3   ZHU Chongyuan1   HUANG Tingting1   WANG Yaqi1   WU Xiqing2   ZHANG Fengying3*  

1 Department of Otorhinolaryngology, Weifang Hospital of Traditional Chinese Medicine, Weifang 261041, China

2 Department of Radiology, Weifang Hospital of Traditional Chinese Medicine, Weifang 261041, China

3 The First Clinical Medical College of Shandong University of Traditional Chinese Medicine, Jinan 250014, China

Corresponding author: ZHANG F Y, E-mail: zhangfengying1979@163.com

Conflicts of interest   None.

Received  2026-01-30
Accepted  2026-07-11
DOI: 10.12015/issn.1674-8034.2026.08.004
Cite this article as DU J H, ZHENG Z L, HUANG K M, et al. Resting-state fMRI on the functional connectivity regulation of the default mode network in chronic subjective tinnitus patients using Zhu's scalp acupuncture[J]. Chin J Magn Reson Imaging, 2026, 17(8): 48-56. DOI:10.12015/issn.1674-8034.2026.08.004.

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