ACUPUNCTURE PROOF: MRI STUDIES


Am J Chin Med. 2005;33(5):723-8.
Differences in electrical conduction properties between meridians and non-meridians.
Lee MS, Jeong SY, Lee YH,  Jeong DM, Eo YG, Ko SB. Center for Integrative Medicine, Institute of Medical Science, Wonkwang University, Iksan 570-749, Republic of Korea.

Therapy using the acupuncture meridian system is an important part of traditional Chinese medicine. The purpose of this study was to investigate the electrical conduction properties of the meridians. The current conduction and potential profiles were compared after switching the current direction in the Hegu (LI-4) and Quchi (LI- 11) meridians and over a non-acupuncture point 1 cm from Quchi (LI-11) in 20 healthy subjects. Both meridians demonstrated significantly higher conductivity between Hegu (LI-4) and Quchi (LI-11) than between Hegu (LI-4) and the non-acupuncture point. The direction of current, peak frequency and absolute potential values in the direction Hegu (LI-4) to Quchi (LI-11) differed significantly from those in the direction Quchi (LI-11) to Hegu (LI-4). These results suggest that the conducting pathways are stronger in the meridians than in the non-meridians and that preferential conduction directions exist between two acupuncture points. These results are consistent with the theories of Qi-circulation and traditional Chinese medicine.

PMID: 16265984 [PubMed - indexed for MEDLINE]


Pain. 2007 Jan 18; [Epub ahead of print]
Hypothalamus and amygdala response to acupuncture stimuli in carpal tunnel syndrome. Napadow V, Kettner N, Liu J, Li M, Kwong KK, Vangel M, Makris N, Audette J, Hui KK.
Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United States; Department of Radiology, Logan College of Chiropractic, Chesterfield, MO, United States.

Brain processing of acupuncture stimuli in chronic neuropathic pain patients may underlie its beneficial effects. We used fMRI to evaluate verum and sham acupuncture stimulation at acupoint LI-4 in Carpal Tunnel Syndrome (CTS) patients and healthy controls (HC). CTS patients were retested after 5 weeks of acupuncture therapy. Thus, we investigated both the short-term brain response to acupuncture stimulation, as well as the influence of longer-term acupuncture therapy effects on this short-term response. CTS patients responded to verum acupuncture with greater activation in the hypothalamus and deactivation in the amygdala as compared to HC, controlling for the non-specific effects of sham acupuncture. A similar difference was found between CTS patients at baseline and after acupuncture therapy. For baseline CTS patients responding to verum acupuncture, functional connectivity was found between the hypothalamus and amygdala - the less deactivation in the amygdala, the greater the activation in the hypothalamus, and vice versa. Furthermore, hypothalamic response correlated positively with the degree of maladaptive cortical plasticity in CTS patients (inter-digit separation distance). This is the first evidence suggesting that chronic pain patients respond to acupuncture differently than HC, through a coordinated limbic network including the hypothalamus and amygdala.

PMID: 17240066 [PubMed - as supplied by publisher]


Neuroimage. 2005 Sep;27(3):479-96.
The integrated response of the human cerebro-cerebellar and limbic systems to acupuncture stimulation at ST 36 as evidenced by fMRI.
Hui KK, Liu J, Marina O, Napadow V, Haselgrove C, Kwong KK, Kennedy DN,
Makris N.
Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Building 149, 13th Street, Room 2301, Charlestown, MA 02129, USA. hui@nmr.mgh.harvard.edu

Clinical and experimental data indicate that most acupuncture clinical results are mediated by the central nervous system, but the specific effects of acupuncture on the human brain remain unclear. Even less is known about its effects on the cerebellum. This fMRI study demonstrated that manual acupuncture at ST 36 (Stomach 36, Zusanli), a main acupoint on the leg, modulated neural activity at multiple levels of the cerebro-cerebellar and limbic systems. The pattern of hemodynamic response depended on the psychophysical response to needle manipulation. Acupuncture stimulation typically elicited a composite of sensations termed deqi that is related to clinical efficacy according to traditional Chinese medicine. The limbic and paralimbic structures of cortical and subcortical regions in the telencephalon, diencephalon, brainstem and cerebellum demonstrated a concerted attenuation of signal intensity when the subjects experienced deqi. When deqi was mixed with sharp pain, the hemodynamic response was mixed, showing a predominance of signal increases instead. Tactile stimulation as control also elicited a predominance of signal increase in a subset of these regions. The study provides preliminary evidence for an integrated response of the human cerebro-cerebellar and limbic systems to acupuncture stimulation at ST 36 that correlates with the psychophysical response.

PMID: 16046146 [PubMed - indexed for MEDLINE]


Neurosci Lett. 2005 Aug 5;383(3):236-40.
Acupoint-specific fMRI patterns in human brain.
Yan B, Li K, Xu J, Wang W, Li K, Liu H, Shan B, Tang X.
Key Laboratory of Nuclear Analysis Techniques, Institute of High Energy Physics, Chinese Academy of Sciences, 19 Yu Quan Road, Beijing 100049, China.

Specific central nervous system (CNS) responses to acupuncture have recently attracted attention. It is important to understand the differences in fMRI images of the brain evoked by acupuncture at an acupoint and at a nearby "sham" point. Here, we report analyses of fMRI images of the brains of 37 healthy volunteers in response to acupuncture at Liv3 (Taichong) and LI4 (Hegu) versus their sham points. We found common activation areas in response to Liv3 or LI4 acupuncture in the middle temporal gyrus and cerebellum, along with deactivation areas in the middle frontal gyrus and inferior parietal lobule, compared with the effects of acupuncture at sham points. Acupuncture at Liv3 evoked specific activation at the postcentral gyrus, posterior cingulate, parahippocampal gyrus, BA 7, 19 and 41, but deactivation at the inferior frontal gyrus, anterior cingulate, BA 17 and 18, compared with acupuncture at its sham point. Acupuncture at LI4 evoked specific activation at the temporal pole, but deactivation at the precentral gyrus, superior temporal gyrus, pulvinar and BA 8, 9 and 45, compared with acupuncture at its sham point. These observations reveal that acupuncture at acupoints induces specific patterns of brain activity, and these patterns may relate to the therapeutic effects of acupuncture.

PMID: 15876491 [PubMed - indexed for MEDLINE]


Neuroimage. 2004 Jun;22(2):932-40.
Modulation of cerebellar activities by acupuncture stimulation: evidence from fMRI study.
Yoo SS, Teh EK, Blinder RA, Jolesz FA.
Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. yoo@bwh.harvard.edu

Recent neuroimaging studies have revealed that acupuncture stimulation modulates human central nervous system including cerebral limbic/paralimbic and subcortical structures. Due to the wide and intricate connections with cerebrum, we hypothesized that anatomically specific areas in human cerebellum are also modulated by acupuncture stimulation beyond classical involvement of cerebellum in motor coordination. Functional MRI (fMRI) was used to investigate neural substrates responding to the acupuncture stimulation of Pericardium 6 (PC6, Neiguan), an acupoint relevant for the management of nausea including vestibular-related motion sickness. Sham stimulation near the acupoint and tactile stimulation on the skin of the acupoint were given as separate conditions. Psychophysical scores as well as the heart and respiratory rates were measured during each condition. Acupuncture manipulation on PC6, in comparison to the sham acupuncture and tactile stimulation conditions, selectively activated left superior frontal gyrus, anterior cingulate gyrus, and dorsomedial nucleus of thalamus. Acupuncture-specific neural substrates in cerebellum were also evident in declive, nodulus, and uvula of vermis, quadrangular lobule, cerebellar tonsil, and superior semilunar lobule. Negative MR signal changes, often seen during the acupuncture of analgesic points, were not observed in the present study. Our data suggest that cerebellum serves as important activation loci during the acupuncture stimulation of PC6, and clinical efficacy of PC6 may be mediated by the cerebellar vestibular neuromatrix.

PMID: 15193624 [PubMed - indexed for MEDLINE]


Neurosci Lett. 2004 Jan 2;354(1):50-3.
Evidence from brain imaging with fMRI supporting functional specificity of acupoints in humans.
Zhang WT, Jin Z, Luo F, Zhang L, Zeng YW, Han JS.
Neuroscience Research Institute, Peking University, 38 Xue Yuan Rd, Beijing 100083, China.

We tested whether the stimulation of acupoints in the same spinal segments could induce different central responses with functional magnetic resonance imaging (fMRI) study. Stimulation of acupoints ST36/SP6 (Zusanli/Sanyinjiao) or GB34/BL57 (Yanglingquan/Chengshan) both activated primary and secondary somatosensory area, insula, ventral thalamus, parietal Brodmann Area 40, temporal lobe, putamen, and cerebellum, while de-activated amygdala. Nevertheless, ST36/SP6 stimulation specifically activated orbital frontal cortex and de-activated hippocampus. Alternatively, stimulation of GB34/BL57 activated dorsal thalamus and inhibited those of primary motor area and premotor cortex. Thus, stimulation of acupoints in the same spinal segments induced distinct though overlapped cerebral response patterns, which indicated the existence of acupoint specificity.

PMID: 14698480 [PubMed - indexed for MEDLINE]


Neuroreport. 2003 Apr 15;14(5):669-73.
Visual cortical activations on fMRI upon stimulation of the vision-implicated acupoints.
Li G, Cheung RT, Ma QY, Yang ES.
The Jockey Club MRI Engineering Centre, Department of Electrical and Electronic Engineering, The University of Hong Kong, Pokfulam, Hong Kong.

We used fMRI to reveal the visual cortical activations during conventional or electro-acupuncture over four vision-implicated acupoints in 18 healthy volunteers and compared the results with those obtained during direct visual stimulation. Positive activations were seen over the visual cortex during visual stimulation in all subjects, and similar activations were observed in 10 subjects during conventional acupuncture as well as in eight and seven subjects during electro-acupuncture at 2 and 20 Hz, respectively. Negative activations were also seen over the occipital lobes, temporal gyri and frontal gyri bilaterally in 13 subjects during conventional acupuncture. Thus, acupuncture may modulate the activity of relevant brain sites. Our results also suggest that electro-acupuncture is useful in future studies.

PMID: 12692460 [PubMed - indexed for MEDLINE]


Am J Chin Med. 2002;30(2-3):379-85.
Acupuncture stimulation of the vision-related acupoint (Bl-67) increases c-Fos expression in the visual cortex of binocularly deprived rat pups.
Lee H, Park HJ, Kim SA, Lee HJ, Kim MJ, Kim CJ, Chung JH, Lee H.
Department of Oriental Medical Science, Graduate School of East-West Medical Science, Kyung Hee University, Yongin, Korea.

Our previous study with functional magnetic resonance imaging (MRI) demonstrated that acupuncture stimulation of the vision-related acupoint, B1-67, activates the visual cortex of the human brain. As a further study on the effect of B1-67 acupuncture stimulation on the visual cortex, we examined c-Fos expression in binocularly deprived rat pups. Binocular deprivation significantly reduced the number of c-Fos-positive cells in the primary visual cortex, compared with that of normal control rat pups. Interestingly, acupuncture stimulation of B1-67 resulted in a significant increase in the number of c-Fos-positive cells in the primary visual cortex, while acupuncture stimulation of other acupoints less important for visual function had no significant effect on c-Fos expression in the primary visual cortex. The results suggest the possibility of vision-related acupoint (B1-67) having an influence over the activity of the primary visual cortex.

PMID: 12230026 [PubMed - indexed for MEDLINE]


Hum Brain Mapp. 2000;9(1):13-25.
Acupuncture modulates the limbic system and subcortical gray structures of the human brain: evidence from fMRI studies in normal subjects.
Hui KK, Liu J, Makris N, Gollub RL, Chen AJ, Moore CI, Kennedy DN, Rosen BR, Kwong KK.
MGH-NMR Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston 02129, USA. hui@nmr.mgh.harvard.edu

Acupuncture, an ancient therapeutic technique, is emerging as an important modality of complementary medicine in the United States. The use and efficacy of acupuncture treatment are not yet widely accepted in Western scientific and medical communities. Demonstration of regionally specific, quantifiable acupuncture effects on relevant structures of the human brain would facilitate acceptance and integration of this therapeutic modality into the practice of modern medicine. Research with animal models of acupuncture indicates that many of the beneficial effects may be mediated at the subcortical level in the brain. We used functional magnetic resonance imaging (fMRI) to investigate the effects of acupuncture in normal subjects and to provide a foundation for future studies on mechanisms of acupuncture action in therapeutic interventions. Acupuncture needle manipulation was performed at Large Intestine 4 (LI 4, Hegu) on the hand in 13 subjects [Stux, 1997]. Needle manipulation on either hand produced prominent decreases of fMRI signals in the nucleus accumbens, amygdala, hippocampus, parahippocampus, hypothalamus, ventral tegmental area, anterior cingulate gyrus (BA 24), caudate, putamen, temporal pole, and insula in all 11 subjects who experienced acupuncture sensation. In marked contrast, signal increases were observed primarily in the somatosensory cortex. The two subjects who experienced pain instead of acupuncture sensation exhibited signal increases instead of decreases in the anterior cingulate gyrus (BA 24), caudate, putamen, anterior thalamus, and posterior insula. Superficial tactile stimulation to the same area elicited signal increases in the somatosensory cortex as expected, but no signal decreases in the deep structures. These preliminary results suggest that acupuncture needle manipulation modulates the activity of the limbic system and subcortical structures. We hypothesize that modulation of subcortical structures may be an important mechanism by which acupuncture exerts its complex multisystem effects.

PMID: 10643726 [PubMed - indexed for MEDLIN



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