Activated and deactivated functional brain areas in the Deqi state: A functional MRI study

We compared the activities of functional regions of the brain in the Deqi versus non-Deqi state, as reported by physicians and subjects cludng acupuncture, Twelve healthy volunteers received sham and true needling at the Waiguan （TE5） acupoint. Real-time cerebral functional MRI showed that compared with non-sensation after sham needling, true needling activated Brodmann areas 3, 6, 8, 9, 10, 11, 13, 20, 21, 37, 39, 40, 43, and 47, the head of the caudate nucleus, the parahippocampal gyrus, thalamus and red nucleus. True needling also deactivated Brodmann areas 1,2, 3, 4, 5, 6, 7, 9. 10. 18.24.31.40 and 46.

Specific cerebral activation following true and sham Waiguan(SJ 5) needling Functional magnetic resonance imaging evidence

Positive activation and negative activation of glucose metabolism can be detected in different brain regions under acupuncture conditions using functional magnetic resonance imaging （fMRI） which reveals acupoint function and location-acupoint specificity. This study observed the regional cerebral activation of the Waiguan （SJ 5） acupoint following true needling at the true Waiguan acupoint, sham needling at the true Waiguan acupoint and true needling at a sham point using fMRI. The fMRI results demonstrated that compared with sham needling, true needling at Waiguan activated the BA8 area and left cerebellum. Compared with needling at the sham point, needling at Waiguan activated the BA2 area, the left cerebellum and the right inferior semilunar lobule. Thus the activated brain areas caused by needling Waiguan may be the basis for treatment of certain diseases.

Needling at the Waiguan (SJ5) in healthy limbs deactivated functional brain areas in ischemic stroke patients A functional magnetic resonance imaging study

Deactivation is common in cerebral functional imaging. However, the physiological mechanisms responsible for this phenomenon remain poorly understood. The present study analyzed 12 ischemic stroke patients, who were randomly assigned to two groups： one group underwent sham needling and true needling at the Waiguan （SJ 5） in the healthy upper limb and the other group underwent sham and true needling at a sham point. Functional magnetic resonance imaging results showed no activation points in brain tissues following needling at SJ 5. However, compared with sham needling at SJ 5, true needling at SJ 5 deactivated Broadmann 4, 6, 24, and 32 areas. In addition, compared to needling at the sham point, true needling at SJ 5 deactivated bilateral hypothalamus. Results demonstrated that SJ 5 needling in the healthy upper limb resulted in specific directional brain action, as manifested by deactivation of cerebral areas related to motor （Broadmann 4 and 6）, emotion （hypothalamus）, and cognition （Broadmann 24, 32）.

Cerebral functional imaging of Waiguan (SJ 5) acupoint specificity using single-photon emission computed tomography

The action of needling in acupoint therapy has to first be regulated and integrated by the brain, and then it affects the target organ and manifests its therapeutic effects, which is dependent on the specificity of the acupoints. The authors put forward the hypothesis of the ＂acupoint-related brain＂. Single-photon emission computed tomography was used to explore the activation of brain regions following true needling in true acupoint Waiguan （SJ 5）, sham needling in true acupoint Waiguan, true needling in a sham point, and sham needling in a sham point. The relative specificity of Waiguan in normal persons was analyzed by observing changes in regional cerebral blood flow. Compared with the sham needling in true acupoint group and sham needling in the sham point group, acupuncture at Waiguan can activate brain regions controlling movement. Compared with true needling in the sham point group, acupuncture at Waiguan can also activate brain regions controlling movement. The results suggest that the specificity of needling at an acupoint is related to certain activated cerebral functional regions, which are associated with the clinical application of the acupoint.

Differences in functional magnetic resonance imaging following cutaneous and routine acupuncture at different acupoints

Few studies have examined the effects of different stimuli at a single acupoint using functional magnetic resonance imaging.The present study applied acupuncture at the Neiguan（PC 6）,Waiguan（SJ 5）,Zhigou（SJ 6） and Yanglingquan（GB 34） acupoints in healthy volunteers.fMRI was used to examine the activation of brain areas in response to different types of acupuncture（cutaneous or routine acupuncture） at each acupoint.There were no significant differences in the distribution of activation in the regions of interest between cutaneous and routine acupuncture at the Neiguan,Waiguan,and Zhigou acupoints,but some differences were observed between the two methods of acupuncture at the Yanglingquan acupoint.There were no significant differences in the intensity of induced activation between cutaneous and routine acupuncture at the Neiguan,Zhigou and Yanglingquan acupoints,but the activation intensity in the right cerebellum induced by routine acupuncture at the Waiguan acupoint was greater than that induced by cutaneous acupuncture.Results confirmed that cutaneous and routine acupuncture at the Neiguan,Waiguan,Zhigou and Yanglingquan acupoints activated different functional brain areas,and caused activation of different intensities in some areas.

Positron emission tomography study of the specificity of Waiguan (SJ 5) acupoint

Functional brain imaging studies of the specificity of acupoint stimulation have revealed that needling at particular acupoints can induce activation of corresponding brain areas, examined in physiological and pathological states. The present study examined Waiguan （SJ 5） as the acupoint of interest. We tested five conditions： a true needling at true acupoint group, a sham needling at true acupoint group, a true needling at sham acupoint group, a sham needling at sham acupoint group, and a healthy control group. We examined changes in glucose metabolism in different functional cortical regions to determine the specific brain activation elicited by acupuncture at Waiguan. The results revealed that true and sham acupuncture at the same acupoint activated different brain regions. In addition, applying acupuncture at a genuine acupoint and a neighboring sham acupoint activated different brain regions. These findings suggest that acupuncture at Waiguan causes activation in some brain regions.

Acupoints combination correlates with activation of cerebral areas A functional MRI study

Acupoint combination is a method used for acupoint treatment of patients. Traditionally, acupoints are matched along the meridian distribution, which is a common rule in clinical practice, but the underlying mechanism remains unclear. Cerebral scans with functional magnetic resonance imaging （fMRI） have been used in the study of acupuncture and acupoint specifically. In this study, fMRI was used to detect the activation of the brain areas under different acupoints, matched along different meridians, to elucidate the acupoint combination via a modern medical approach. Forty healthy volunteers were randomly divided into the following groups： Waiguan point （SJ 5）, Waiguan （SJ 5） ＋ Zhigou （SJ 6） （2 acupoints come from the same meridian）, Waiguan （SJ 5） ＋ Neiguan （PC 6） （2 acupoints come from 2 meridians with the relationship of interior-exterior）, Waiguan （SJ 5） ＋ Yanglingquan （GB 34） （2 acupoints come from 2 meridians with the same name-Shaoyang Meridian）, and sham point groups （needling in different points on the right hand）. A real-time cerebral fMRI scan was simultaneously performed. The cerebral activation rate, and the number and strength of different regions of interest were compared among the groups. The fMRI cerebral imaging confirmed that there were some differences in the activation of cerebral areas by the needlings in SJ 5, and in combination with other acupoints. Needling at SJ 5 alone greatly activated the right cerebellum, while needling at both SJ 5 and different co-needling points activated different cerebral functional areas.