fMRI review on brain responses to acupuncture: The limitations and possibilities in traditional Korean acupuncture

Acupuncture and Meridian Science Research Center, Kyung Hee University, Seoul 130-701, Korea.
Neurological Research (Impact Factor: 1.44). 02/2007; 29 Suppl 1(Supplement-1):S42-8. DOI: 10.1179/016164107X172284
Source: PubMed


Since the late 1990s, imaging studies have allowed the visualization of brain response to acupuncture stimulation with alteration in blood flow. In 1998, the first functional magnetic resonance imaging (fMRI) study for the Korean acupuncture was published and thereafter, many subsequent neuroimaging studies with acupuncture have been published and revealed that acupuncture modulates central nervous system in human being. The purpose of this review is to summarize and evaluate the acupuncture studies using fMRI.
A survey of computerized literature searches for experimental studies of acupuncture studies using fMRI revealed that a total of 19 studies were published from 1998 to 2005.
These studies have mainly focused on the correlation between acupoints and corresponding brain cortices, acupoint-specific patterns of brain activity. The analgesic effect of acupuncture implied that the pain network, including the hypothalamus and limbic system, was induced by different kinds of acupuncture stimulation. There are still several limitations in these experimental designs.
We reviewed studies that contributed to an understanding of the neurophysiologic mechanisms of acupuncture with the hope that this review will be of benefit to the future traditional Korean acupunctural fMRI studies.

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    • "Although several studies have shown that acupuncture stimulation on acupoints traditionally used for the treatment of vision and hearing disorders are correlated with the activation of corresponding visual and auditory cortex, respectively [113–115], methodological heterogeneity and poor replication have raised the criticism that the response is caused by methodological flaws, rather than a direct result of specific effects of acupuncture [116, 117]. In fact, apart from the somatotopic representation of acupoints in the primary somatosensory cortex, no well-defined correlations between distinct brain regional response patterns and a given acupoint or acupuncture stimulation mode have been identified. "
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    ABSTRACT: When an acupuncture needle is inserted into a designated point on the body and mechanical or electrical stimulation is delivered, various neural and neuroactive components are activated. The collection of the activated neural and neuroactive components distributed in the skin, muscle, and connective tissues surrounding the inserted needle is defined as a neural acupuncture unit (NAU). The traditionally defined acupoints represent an anatomical landmark system that indicates local sites where NAUs may contain relatively dense and concentrated neural and neuroactive components, upon which acupuncture stimulation would elicit a more efficient therapeutic response. The NAU-based local mechanisms of biochemical and biophysical reactions play an important role in acupuncture-induced analgesia. Different properties of NAUs are associated with different components of needling sensation. There exist several central pathways to convey NAU-induced acupuncture signals, Electroacupuncture (EA) frequency-specific neurochemical effects are related to different peripheral and central pathways transmitting afferent signals from different frequency of NAU stimulation. More widespread and intense neuroimaging responses of brain regions to acupuncture may be a consequence of more efficient NAU stimulation modes. The introduction of the conception of NAU provides a new theoretical approach to interpreting effects and mechanisms of acupuncture in modern biomedical knowledge framework.
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    ABSTRACT: According to clinical data, a lot of patients suffering from chronic pain like to be pressed on the tenderness point, and after Tuina they feel apparently better. Some patients even come back frequently to receive further Tuina treatment afer their pain has relieved. So to research on the intervention of the therapy of pressing and kneading on the tenderness point in chronic pain and the mechanism of Tuina analgesia by using functional magnetic resonance imaging. Five patients with one-sided fits of lumbar disc herniation (LDH) were selected according to single-blind randomized experimental method. FMRI was applied to observe the activation and inhibition of brain-functioning area in five cases of patients with lumbar disc herniation after pressing and kneading on their Weizhong (B40 )point. Every patient must finish 11 trials in the experiment. Functional MRI data were obtained from scanning the whole brain, but focusing on ACG, hypothalamus, NAC, amygdaloid body GOB etc. T-test was performed to analyze the data in SPSS software package. The data sets from 5 subjects were all used in the study. Signal increases and signal decreases elicited by Tuina stimulation were demonstrated in multiple brain regions. After pressing and kneading on the patient’s Weizhong (B40 ) acupoint, the patient’s hypothalamus, left nucleus accumbens and left amygdaloid body were excited (P<0.05) and his left anterior cingulated gyrus was inhibited (P<0.05). By pressing and kneading on the pain point (B40), both the pain circuity and the reward circuity are affected which indicates that there might be a close correlation between the effects of analgesia and pleasure through Tuina. And this might also be one of the reasons why clinical Tuina patients with chronic pain like to be pressed on their pain points.
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