Neuronal Specificity of Acupuncture Response: A fMRI Study with Electroacupuncture

doi:10.1006/nimg.2002.1145

NeuroImage

Volume 16, Issue 4, August 2002, Pages 1028-1037

https://doi.org/10.1006/nimg.2002.1145 Get rights and content

Abstract

Recently, neuronal correlates of acupuncture stimulation in human brain have been investigated by functional neuroimaging. The preliminary findings suggest that acupuncture at analgesic points involves the pain-related neuromatrix and may have acupoint–brain correlation. Although multiple models of control stimulations have been applied to address the specificity of the needling effect clinically, their impacts have not been evaluated by functional neuroimaging. With the advantage of objective parameter setting, electroacupuncture (EA) was used in this study to devise three distinct controls for real EA, i.e., mock EA (no stimulation), minimal EA (superficial and light stimulation), and sham EA (same stimulation as real EA) applied at nonmeridian points. Fifteen healthy volunteers received real EA at analgesic point Gallbladder 34 (Yanglinquan), sham EA, and one of either mock EA or minimal EA over the left leg in counter-balanced orders. Multisubject analysis showed that sham EA and real EA both activated the reported distributed pain neuromatrix. However, real EA elicited significantly higher activation than sham EA over the hypothalamus and primary somatosensory–motor cortex and deactivation over the rostral segment of anterior cingulate cortex. In the comparison of minimal EA versus mock EA, minimal EA elicited significantly higher activation over the medial occipital cortex. Single-subject analysis showed that superior temporal gyrus (encompassing the auditory cortex) and medial occipital cortex (encompassing the visual cortex) frequently respond to minimal EA, sham EA, or real EA. We concluded that the hypothalamus–limbic system was significantly modulated by EA at acupoints rather than at nonmeridian points, while visual and auditory cortical activation was not a specific effect of treatment-relevant acupoints and required further investigation of the underlying neurophysiological mechanisms.

References (29)

G. Biella et al.
Acupuncture produces central activations in pain regions
NeuroImage
(2001)
J. Hsieh et al.
Activation of the hypothalamus characterizes the acupuncture stimulation at the analgesic point in humans: A positron emission tomography study
Neurosci. Lett.
(2001)
P.H. Richardson et al.
Acupuncture for the treatment of pain: A review of evaluative research
Pain
(1986)
C.A. Vincent et al.
The significance of needle placement site in acupuncture
J. Psychosom. Res.
(1989)
J. Ashburner et al.
Nonlinear spatial normalization using basis functions
Hum. Brain Mapp.
(1999)
M. Baciu et al.
Central processing of rectal pain: A functional MR imaging study
Am. J. Neuroradiol.
(1999)
Essentials of Chinese Acupuncture
(1993)
S. Birch et al.
A brief report on the 1996 U.S. Toyohari workshop, with reflections on the development of Keiraku chiryo (Japanese meridian therapy) in America
Amer. J. Acu.
(1997)
Z.-H. Cho et al.
New findings of the correlation between acupoints and corresponding brain cortices using functional MRI
Proc. Natl. Acad. Sci. USA
(1998)
Z.-H. Cho et al.
Functional magnetic resonance imaging of the brain in the investigation of acupuncture

A. Craig et al.

Functional imaging of an illusion of pain

Nature

(1996)

E. Ernst et al.

A review of problems in clinical acupuncture research

Am. J. Clin. Med.

(1997)

K.J. Friston et al.

Statistical parametric maps in functional imaging: A general linear approach

Hum Brain Mapp.

(1995)

J.-S. Han

Neurochemical basis of acupuncture

Annu. Rev. Pharmacol. Toxicol.

(1982)

Cited by (253)

Biopotential changes of acupuncture points by acupuncture stimulation
2022, Integrative Medicine Research
Citation Excerpt :
In molecular biological studies, biomolecule changes are investigated after acupuncture treatment,12-15 but these studies have limitations that cannot be applied to humans. In bio-imaging studies, the changes of bio-indices such as fMRI16,17 and EEG18,19 are assessed after acupuncture stimulation. As such, many have tried to elucidate the mechanism of acupuncture treatment in various areas, but these are limited in that they focus only on signal transmission by acupuncture stimulation and cannot explain the energy transmission.
The energy flow at acupuncture point is important for understanding the mechanism of acupuncture treatment. However, there are few studies on energy at acupuncture point, and related studies have limitation in explaining the energy flow in all meridians. Thus, we aimed to understand the properties of electrical energy at acupuncture point in twelve meridians by measuring the biopotential at acupuncture and non-acupuncture points.
For each meridian, twenty subjects were participated, and biopotential was measured at five transport points and their adjacent non-acupuncture points. In each subject, both ‘non-stimulation’ and ‘stimulation’ experiments were conducted in random order. The data were analyzed in two parts: biopotential variability and biopotential difference between acupuncture and non-acupuncture points.
The biopotential variability at acupuncture point was increased by acupuncture stimulation, and it was related to the activation of Qi flow by acupuncture stimulation. The biopotential difference between acupuncture and non-acupuncture points was formed in the direction related to the Qi flow theory, and this biopotential difference tended to decrease by acupuncture stimulation.
The study on biopotential can provide a foundation for research on energy flow mechanism of acupuncture stimulation, and it is expected to overcome limitation of qualitative explanation in traditional medicine.
Acute and long-term effects of electroacupuncture alter frontal and insular cortex activity and functional connectivity during resting state
2020, Psychiatry Research - Neuroimaging
Electroacupuncture (EA) is a safe method for treating obesity; however, its underlying neural mechanisms remain unclear. We employed resting-state-functional-magnetic-resonance-imaging (RS-fMRI) and amplitude-of-low-frequency-fluctuation (ALFF) to investigate acute/long-term effects of EA on brain activity and resting-state-functional-connectivity (RSFC) in overweight/obesity subjects who received real/Sham stimulation. For acute effects, 26 and 19 overweight/obesity subjects were included in EA and Sham groups respectively. There were significant time effects on ALFF in the right insula (INS) and left dorsolateral-prefrontal-cortex (DLPFC) due to decreases/increases in INS/DLPFC in both groups. There were weaker positive RSFC between INS and supplementary-motor-area (SMA)/right DLPFC and weaker negative RSFC between INS and precuneus (PCUN); stronger negative RSFC between DLPFC and dorsomedial-prefrontal-cortex (DMPFC) in both groups. For long-term study, body-mass-index (BMI) had significant reduction in EA (n = 17) and Sham (15) groups; EA had higher BMI reduction than in Sham. There were significant time effects on ALFF in right ventrolateral-prefrontal-cortex (VLPFC) due to significant increases in EA group, and stronger positive RSFC between VLPFC and orbitofrontal-cortex and negative RSFC between VLPFC and left thalamus (THA) in both groups after long-term treatment. These findings suggest that changes in resting-activity and RSFC implicated in inhibitory-control, gastric-motility and satiety-control are associated with EA-induced weight-loss.
Integrative Medicine in Rehabilitation
2020, Braddom's Physical Medicine and Rehabilitation
Complementary and integrative healthcare (CIH) is becoming part of musculoskeletal and rehabilitation medicine. In the past, providers or patients would use complementary modalities after conventional Western medicine failed, whereas now individuals are incorporating these approaches into treatment plans from the start. As such, it is important for providers to have an understanding of CIH, so as to provide the patient with a good understanding of how these approaches will be incorporated into their care plan. If providers fail to glean an understanding of these practices, then they may limit their patients with treatment strategies or may be unable to build strong rapport with patients who focus on these modalities.
Anxiety related to De Qi psychophysical responses as measured by MASS: A sub-study embedded in a multisite randomised clinical trial
2018, Complementary Therapies in Medicine
Acupuncture has been broadly applied in the management of many diseases and conditions; however, its mechanism of action has been partially elucidated. Additionally, assessment of psychophysical responses in the acupuncture therapy is not common regarding anxiety disorder studies. Taken together, the therapeutic effect of acupuncture appears when De Qi psychophysical response is experienced following stimulation of the afferent sensory nerves.
The present study investigates the level of anxiety perceived at different occasions in acupuncture and mock laser group. Furthermore, it examines the relationship between perceived De Qi psychophysical response and the level of anxiety experienced during administration of each intervention.
The study was embedded in a two-arm parallel design multi-center, randomized clinical trial, the Tennis Elbow Acupuncture-International Study-China, Hong Kong, Australia, Italy. Participants’ level of anxiety was measured using a validated instrument, the Massachusetts General Hospital Acupuncture Sensation Mood Scale. Ninety-six participants with Lateral Elbow Pain were randomly allocated into two groups; the acupuncture treatment group (n = 47) and the inactive mock laser control group (n = 49). Data were collected immediately following the interventions at the first and the ninth session within the clinical trial.
Acupuncture with De Qi did not induce higher level of anxiety compared to prior administration of acupuncture. In fact, participants were more relaxed after receiving acupuncture than those who received mock laser. There was also a weak association between participants’ perception of anxiety during acupuncture and the MASS De Qi Index in session nine only (p < 0.01). Further investigation of the result revealed weak positive correlation between anxiety perceived during administration of acupuncture and the following De Qi characteristics; ‘soreness’ (p < 0.01), ‘Deep pressure’ (p < 0.05), ‘Heaviness’ (p < 0.05), and ‘Fullness/distension’ (p < 0.05).
Acupuncture can be regarded as a potential therapy for preoperative anxiety through its possible regulatory function of emotion. While culture may not alter the expectation of the individual regarding anxiety, symptomology associated with anxiety should be understood within the context of the cultural background.
Integrative Medicine in Rehabilitation
2018, Braddom's Rehabilitation Care: A Clinical Handbook
Investigation of the Phenomenon of Propagated Sensation along the Channels in the Upper Limb Following Administration of Acupuncture and Mock Laser
2017, JAMS Journal of Acupuncture and Meridian Studies
Similar to De Qi psychophysical responses, propagated sensation along the channels (PSC) is considered an important phenomenon in traditional Chinese acupuncture. In acupuncture clinical trials, different acupuncture manipulation techniques are used to enhance the propagation of sensation along the channels to facilitate an optimum therapeutic result.
To examine and compare the PSC reported by participants in a clinical trial following the administration of acupuncture and inactive mock laser.
The study was embedded in a two-arm parallel design multicenter, randomized clinical trial, the Tennis Elbow Acupuncture—International Study—China, Hong Kong, Australia, Italy (TEA IS CHAI). Needle sensations were measured using a validated instrument, the Massachusetts General Hospital Acupuncture Sensation Spreading Scale. Ninety-six participants with lateral elbow pain were randomly allocated into two groups in a 1:1 ratio; the acupuncture treatment group (n = 47) and the mock laser control group (n = 49). Participants in both groups received the intervention at two acupoints, LI10 and LI11, consisting of 2 minutes of either standardized needle manipulation or mock laser at each acupoint with a rest period between each intervention period. Data were collected immediately following the interventions at the first and the ninth session within the clinical trial.
Although participants in both groups perceived PSC radiating to similar sites along the upper limb, the frequency of the reported radiation sites among the two intervention groups for both radiation up the limb (p < 0.05) and radiation down the limb (p < 0.001) were statistically significantly different. Among the radiating sensation sites recorded within the two study groups, the sensations were reported as radiating a greater distance down the forearm to the wrist compared to up the arm. Evaluation of PSC across the four study sites revealed a statistically significant difference in frequency of the reported radiation down the limb sites in each study group and radiation up the limb sites only in control group only (p < 0.001).
The findings of the study demonstrated that the PSC phenomenon is not just associated with needling but can be perceived when using a mock laser.
Australian and New Zealand Clinical Trial Registry reference: ACTRN12613001138774 on 11th of October 2013.

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Regular ArticleNeuronal Specificity of Acupuncture Response: A fMRI Study with Electroacupuncture

Abstract

NeuroImage

Neurosci. Lett.

Pain

J. Psychosom. Res.

Nonlinear spatial normalization using basis functions

Hum. Brain Mapp.

Central processing of rectal pain: A functional MR imaging study

Am. J. Neuroradiol.

Essentials of Chinese Acupuncture

A brief report on the 1996 U.S. Toyohari workshop, with reflections on the development of Keiraku chiryo (Japanese meridian therapy) in America

Amer. J. Acu.

New findings of the correlation between acupoints and corresponding brain cortices using functional MRI

Proc. Natl. Acad. Sci. USA

Functional magnetic resonance imaging of the brain in the investigation of acupuncture