Research progress on mechanisms of acupuncture regulating limbic system to improve pain-related emotion

Chronic pain is often accompanied by negative emotions such as anxiety, depression, and aversion, with structural and functional abnormalities in the limbic system serving as the key pathological basis for this comorbidity. Acupuncture can improve pain-related emotions by modulating multilevel neural centers within the limbic system. At the cortical level, acupuncture can restore the regulatory mechanism of the cortex over pain-related emotions by modulating the neural plasticity of the anterior cingulate cortex, medial cingulate cortex, prefrontal cortex, and insular cortex; at the subcortical level, acupuncture can act on the amygdala and hippocampus to block negative emotions induced by nociceptive information; at the diencephalic level, acupuncture can inhibit the generation of pain-related emotions by down-regulating the abnormal excitability of thalamic paraventricular nucleus neurons, thereby blocking the transmission of pain signals to the limbic system. From a hierarchical perspective of the limbic system, this review elucidated the mechanisms of acupuncture intervention in pain-related emotions, providing a theoretical foundation and reference for clinical research on acupuncture treatment of pain-related emotions.