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. "
[Show abstract][Hide abstract] 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.
Full-text · Article · Mar 2012 · Evidence-based Complementary and Alternative Medicine
[Show abstract][Hide abstract] ABSTRACT: BackgroundBecause of the limitation of technique, there are few researches on regulating function of central hypothalamus by metabolism, especially the researches on real-time function.ObjectiveTo evaluate the response of hypothalamus to oral glucose tolerance test (OGTT) in different body-weighted subjects by using functional magnetic resonance imaging (fMRI) so as to investigate the relationship between the sensitivity of hypothalamus in glycoregulation and disturbance of carbohydrate metabolism.DesignPaired design.SettingDepartment of Radiology and Beijing Geriatrics Institute, Beijing Hospital, National Public Health Bureau.ParticipantsA total of twenty healthy volunteers were selected from Beijing Geriatrics Institute, National Public Health Bureau, including 10 subjects with obesity (5 males and 5 females; body mass > 28.0 kg/m2) and 10 subjects with normal body mass (5 males and 5 females; body mass from 18.5 to 23.9 kg/m2). All subjects gave written informed consent before participating in the study.MethodsfMRI study was performed on GE 1.5 T Signa Twinspeed Infinity with Excite. Each volunteer was ingested of glucose during the fMRI scan. T2* images were acquired using a single-shot gradient echo (EPI) technique. The parameters of EPI included: TR 3 000 ms, TE 40 ms, Flip angle 90°, field of view (FOV) 24 cm × 24 cm, thickness 5 mm, gap 0 mm, matrix 64 × 64, number of excitation 1. All 10 subjects with normal body mass underwent a repeat fMRI scan after consuming an equivalent amount of water without glucose on a separate day. The procedure for the fMRI scan with water intake was the same as for glucose ingestion. fMRI data were processed with Intensity Averaging Method.Main outcome measuresThe central response of hypothalamus and feedback orientation during OGTT in different body-weighted subjects.ResultsAn acute transient decrease of fMRI intensity in posterior inferior and anterior inferior of hypothalamus was observed in all subjects within 2 minutes after oral glucose intake. This decrease was followed by a recovery to the baseline. However, obese subjects had a delayed intensity decrease [(1.96±1.06) minutes vs. (1.04±0.71) minutes, t =2.14, P < 0.05] and longer recovery time [(26.62±7.35) minutes vs. (16.29±6.42) minutes, t =3.67, P < 0.01] as compared with normal body-weight subjects. Furthermore, decreased fMRI intensity was significant different from baseline intensity [(5.7±2.5)% vs. (14.3±5.5)%, t =2.56, P < 0.05] in obese subjects, but not in normal body-weight subjects. The area of hypothalamus in normal body-weight volunteers demonstrated no significant signal change before and after oral water ingestion (P > 0.05).ConclusionHypothalamus response to glucose loading is different in normal body-weighted and obese subjects. This suggests that fMRI is a useful tool to evaluate the central regulation of glucose metabolism.
No preview · Article · Sep 2007 · Neural Regeneration Research
[Show abstract][Hide abstract] 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.