Abstract:Objective To explore the neuromechanisms of auricular concha electroacupuncture (ACEA) treatment in enhancing the treatment of late-onset depression using resting-state functional magnetic resonance imaging (fMRI). Methods A total of 64 patients with late-onset depression admitted to the Affiliated Brain Hospital of Guangzhou Medical University from January 2021 to January 2023 were randomly divided into observation group (n=32) and control group (n=32) using a random number table method. Both groups were routinely treated with antidepressants, and the observation group received ACEA treatment,while the control group received a therapeutic device ear clips clamped on the auricle, but no electrical stimulation was performed. Both groups received treatment for 30 minutes each time, twice a day, five days a week, for 8 consecutive weeks. The therapeutic effects of both groups were compared. The scores of the following scales were compared between the two groups before and after treatment, including Hamilton Depression Rating Scale (HDRS-17), Patient Health Questionnaire-15 (PHQ-15), Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) scale, and Pittsburgh Sleep Quality Index (PSQI) scale. After 8 weeks of treatment, MRI scans were performed to collect resting fMRI data. The changes in fractional anisotropy (FA) values of different brain regions before and after treatment were calculated and compared between two groups. Results The overall effective rate of the observation group was slightly higher than that of the control group (90.63% vs 71.88%), but the difference was not statistically significant (χ²=3.692, P=0.055). After treatment, the HDRS-17, PHQ and PSQI scores of both groups were lower than those before treatment (P<0.05), the RBANS delayed memory, attention, speech, visual breadth, and immediate memory scores of both groups were higher than those before treatment (P<0.05), and the FA values of bilateral frontal lobes, thalamus, hippocampus, and amygdala were higher than those before treatment (P<0.05). The improvements of above indicators in the observation group were better compared to the control group (P<0.05). Conclusion For late-onset depression, the combination of ACEA on the basis of conventional antidepressant treatment is expected to improve the efficacy of treatment,and its mechanism may be related to its regulation of patients neurological mechanisms.