Article

Commonality and Specificity of Acupuncture Action at Three Acupoints as Evidenced by fMRI

Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, USA.
The American Journal of Chinese Medicine (Impact Factor: 2.63). 01/2012; 40(4):695-712. DOI: 10.1142/S0192415X12500528
Source: PubMed

ABSTRACT Previous work from our team and others has shown that manual acupuncture at LI4 (hegu), ST36 (zusanli), and LV3 (taichong) deactivates a limbic-paralimbic-neocortical brain network, and at the same time activates somatosensory regions of the brain. The objective of the present study was to explore the specificity and commonality of the brain response to manual acupuncture at LI4, ST36, and LV3, acupoints that are located on different meridians and are used to treat pain disorders. We used functional magnetic resonance imaging (fMRI) to monitor the brain responses to acupuncture at three different acupoints; we examined 46 healthy subjects who, according to their psychophysical responses, experienced deqi sensation during acupuncture. Brain responses to stimulation at each of the acupoints were displayed in conjunction with one another to show the spatial distribution. We found clusters of deactivation in the medial prefrontal, medial parietal and medial temporal lobes showing significant convergence of two or all three of the acupoints. The largest regions showing common responses to all three acupoints were the right subgenual BA25, right subgenual cingulate, right isthmus of the cingulum bundle, and right BA31. We also noted differences in major sections of the medial prefrontal and medial temporal lobes, with LI4 predominating in the pregenual cingulate and hippocampal formation, ST36 predominating in the subgenual cingulate, and LV3 predominating in the posterior hippocampus and posterior cingulate. The results suggest that although these acupoints are commonly used for anti-pain and modulatory effects, they may mobilize the same intrinsic global networks, with substantial overlap of common brain regions to mediate their actions. Our findings showing preferential response of certain limbic-paralimbic structures suggests acupoints may also exhibit relative specificity.

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    • "Different cerebral areas were activated during Deqi and non-Deqi at the same point. Claunch et al. 2012 [30] LI4, ST36, LR3 fMRI AWD at all three points deactivated the right subgenual, the right subgenual cingulate, the right isthmus of the cingulum bundle, and the right BA31. Asghar et al. 2010 [31] LI4 fMRI Marked deactivation of the brain area was observed during Deqi in contrast to the occurrence of a mixture of activations and deactivations in the acute pain group. "
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    • "That seemed quite not sufficient for the explanation of acupuncture Deqi mechanism, for the potential involvement of the subcortical gray structures and cerebellum. The structural basis of the CNS in response to acupuncture Deqi is commonly accepted as the limbic-paralimbic-neocortical network to date [19] [22] [36] [43]. Deactivated brain regions above involving the limbic systems are in agreement with Hui's finding on Deqi for the same acupoints. "
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