捻针时真、假穴不同中枢激活效应的脑功能MRI

Different central effects of needle rotation in false and real acupoints on functional MRI

目的 利用功能磁共振 (fMRI)观察捻针针刺方法对大脑的作用。方法 用盲法随机分别针刺 13例正常人左侧太冲、丘墟和假穴 ,手法采用捻针和不捻针 ,利用 1 5TMR仪行全脑功能成像 ,用SPM99b分析图像。结果 发现只在真穴捻针针刺时有更强的激活效应 ,有显著性意义的Brodmann激活区域为 :针刺太冲穴激活了左右顶叶BA4 0区 ,右额叶BA4 7和 10区 ,右丘脑 ,左小脑 ;针刺丘墟穴激活了左右顶叶BA4 0区 ,右顶叶BA2区 ,左额叶BA9、10、4 4区 ,左岛叶BA13区 ,左颞叶BA2 2区 ,右颞叶BA4 2区 ,右壳核 ,左小脑。两真穴激活部位部分相同 ,部分不同。在假穴捻针对不捻针的研究中 ,未见到有显著性意义的激活区。结论 真穴捻针时可能对皮层神经活动有较特异的作用 ,而假穴未观察到此种现象 ,推测这可能是针刺治疗作用的机制之一。

Objective To observed the cerebral activation patterns under different acupuncture stimuli by using functional magnetic resonance imaging (fMRI) Methods The cortical activation patterns on fMRI during stimulation of two real (LIV3 and GB40) and one sham acupoints were investigated in 13 healthy subjects, they were punctured in a randomized fashion and for the subjects blinded order employing a) rotating and b) non rotating methods using a blocked paradigm on a 1 5 T scanner Results Only during stimulation of the real acupoints, differential effects were observed, namely on LIV3 an increase of activation within both parietal cortices Brodmann′s area (BA) 40, right frontal cortices BA47 and BA10, right thalamus, and left cerebellum; on GB40 an increase of activation within both parietal BA40, right parietal BA2, left frontal BA9,10,44, left insula cortices BA13, left temporal cortices BA22, right temporal BA42, right putamen, and left cerebellum When doing the same contrast in the sham point, there were no suprathreshold voxels The rotating needle strengthened the effects of acupuncture (the so called De Qi) only in real acupoints Conclusion Acupuncture seems to result in specific cerebral activation patterns which might explain its therapeutic effects in specific subjects