脑成像针刺研究的现况及未来

Brain imaging study on acupuncture: where we are and where we are headed

近20年来,脑成像技术已经推进了对针刺的研究,对针刺疗效机理产生了新的认识。在此文中,作者对此研究领域的几个关键热点问题作一简要综述,如穴位特异性,针刺与安慰剂治疗关系,和利用f MRI作为针刺治疗中的生物标记或预测指标的潜在价值。脑影像技术如MRI和PET的发展明显促进了对针刺的理解。MRI的技术进步,如更高的磁场,更好的成像硬件,新扫描方法,如ASL,DTI,新试验范式,如事件相关,静息态f MRI,以及新的分析方法的引入,能同时研究脑形态及功能的变化。PET成像技术进步不仅可研究脑代谢,血流变化,和其他非选择性的神经活动标记,而且可以探测特异性受体在全脑的分布。这些进展可以间接评估与安慰剂止痛效应相关的脑神经递质变化,例如,可以检测内啡肽的释放情况。更令人惊喜的是,新技术可以使我们同时采集f MRI及PET数据,对脑活动和神经递质进行深入研究。另外,其他脑成像技术如高分辨EEG,MEG能提供高时间分辨率的功能信息。脑成像针刺研究的文献很多,作者将集中讨论几个关键问题,如穴位特异性,针刺与安慰剂效应的区别,使用成像作为针刺治疗的生物标记或预测方法。

Over the course of the past few decades, brain imaging tools have advanced the investigation of acupuncture and shed new light on our understanding of acupuncture treatment. In this manuscript, we will focus on several key questions regarding f MRI brain imaging studies, including acupoint specifi city, the relationship between acupuncture and placebo treatments, and the potential for using f MRI as a biomarker or predictor in acupuncture treatment. The development of brain imaging techniques such as magnetic resonance imaging（MRI） and positron emission tomography（PET） has greatly enhanced our understanding of acupuncture. Technical improvements in MRI resulting from more powerful magnets, increasingly sophisticated imaging hardware, development of new scan methods（Arterial Spin Labeling, ASL, diffusion tensor imaging, DTI）, the application of new experimental paradigms（event related and resting state f MRI） and analysis methods allow us to investigate functional and anatomical changes in the brain.