Research trends and hotspots of electroacupuncture for depression: a bibliometric and visual analysis (2005-2025).

Background: Depression is one of the most prevalent mental illnesses worldwide, significantly impairing patients' quality of life. As a modernized form of acupuncture, electroacupuncture (EA) has been widely applied as an adjunctive therapy for depression. In recent years, both clinical and mechanistic studies on EA have grown rapidly; however, the evidence remains fragmented, and there is still a lack of comprehensive bibliometric and visual analyses summarizing the research hotspots and developmental trends in this field. Therefore, this study aimed to systematically summarize the international research trends, thematic hotspots, and major mechanism-related research themes of electroacupuncture for depression from 2005 to 2025. Methods: This study was based on the Web of Science Core Collection (WoSCC), which was used to retrieve publications on electroacupuncture for depression from 2005 to 2025. Bibliometric analyses were performed using SCImago Graphica, CiteSpace, and VOSviewer, covering publication trends, countries/regions, institutions, authors, journals, references, and keywords. In addition, PubMed was included as a supplementary database for comparative analysis, primarily to examine keyword distributions and research themes across databases. Results: A total of 317 studies were included. The annual number of publications increased significantly after 2017. China emerged as the leading contributor and occupied a central position in the international collaboration network. Shanghai University of Traditional Chinese Medicine and author Lao Lixing were identified as major contributors. High-frequency keywords included "acupuncture, " "depression, " "anxiety, " and "electroacupuncture." The research focus has shifted from clinical outcomes such as "randomized controlled trial, " "efficacy, " and "quality of life" to mechanistic aspects, including "neurogenesis, " "synaptic plasticity, " "prefrontal cortex, " "inflammation, " and "fMRI." Co-citation and burst analyses revealed that the BDNF/TrkB signaling pathway, NLRP3 inflammasome, prefrontal cortex-amygdala circuit, and HPA axis were major mechanism-related research themes in this field. Conclusions: This study presents the first systematic bibliometric and visual analysis of publications on electroacupuncture for depression from 2005 to 2025, providing an overview of research trends and thematic developments, and using PubMed as a complementary database. The results indicate that research in this field is shifting from clinically oriented studies toward increasing attention to neurobiological mechanisms, with a growing trend of interdisciplinary integration. Future studies should emphasize high-quality randomized controlled trials, objective biomarker application, and international multicenter collaboration to enhance the research quality and international influence of electroacupuncture in the management of depressive disorders.