Acupuncture at Waiguan(SJ5) and sham points influences activation of functional brain areas of ischemic stroke patients: a functional magnetic resonance imaging study

Most studies addressing the specificity of meridians and acupuncture points have focused mainly on the different neural effects of acupuncture at different points in healthy individuals. This study examined the effects of acupuncture on brain function in a pathological context. Sixteen patients with ischemic stroke were randomly assigned to true point group （true acupuncture at right Waiguan （SJ5）） and sham point group （sham acupuncture）. Results of functional magnetic resonance imaging revealed activation in right parietal lobe （Brodmann areas 7 and 19）, the right temporal lobe （Brodmann area 39）, the right limbic lobe （Brodmann area 23） and bilateral oc-cipital lobes （Brodmann area 18）. Furthermore, inhibition of bilateral frontal lobes （Brodmann area 4, 6, and 45）, right parietal lobe （Brodmann areas 1 and 5） and left temporal lobe （Brodmann area 21 ） were observed in the true point group. Activation in the precuneus of right parietal lobe （Brodmann area 7） and inhibition of the left superior frontal gyrus （Brodmann area 10） was observed in the sham group. Compared with sham acupuncture, acupuncture at Waiguan in stroke patients inhibited Brodmann area 5 on the healthy side. Results indicated that the altered specificity of sensation-associated cortex （Brodmann area 5） is possibly associated with a central mechanism of acupuncture at Waiguan for stroke patients.

Functional magnetic resonance imaging evidence for activated functional brain areas following acupoint needling in the extremities

Totally three articles focusing on functional magnetic resonance imaging features of brain function in the activated brain regions of stroke patients undergoing acupuncture on the healthy limbs and healthy controls undergoing acupuncture on the lower extremities are published in three issues. We hope that our readers find these papers useful to their research.

Research on resting spontaneous brain activity and functional connectivity of acupuncture at uterine acupoints

Objective The resting-state functional magnetic resonance imaging(rs-f MRI)method was used to observe brain activity and its functional connection upon electroacupuncture stimulation at bilateral uterine acupoints(EX-CA1),as well as to investigate the mechanism of acupuncture in the treatment of gynecological diseases.Methods Twenty-two healthy female subjects were stimulated by electroacupuncture at bilateral uterine acupoints;rs-f MRI data of the brain were acquired and standardized.Degree centrality(DC),amplitude of low-frequency fluctuation(ALFF),and regional homogeneity(ReHo)were used to analyze local spontaneous brain activity via acupuncture.An independent component analysis was used to evaluate the functional connectivity of the resting brain networks after acupuncture.Results Analytical results showed that the neural activity intensity of the precuneus lobe,orbitofrontal cortex,lingual gyrus,amygdala,and posterior central gyrus decreased after acupuncture(voxel P<0.001,cluster P<0.05).Functional connectivity analysis revealed weakened auditory and right frontal-parietal networks(voxel P<0.001,cluster P<0.05),enhanced visual network(voxel P<0.001,cluster P<0.05),and synergistic auditory network and hypothalamic-pituitary system.Conclusion Significant differences in neural activity and functional connectivity in specific brain regions were observed after acupuncture intervention at uterine acupoints;the hypothalamic-pituitary system also showed various active states in different brain regions.It is speculated that the effective mechanism of acupuncture at uterine acupoints is related to the regulation of reproductive hormones,emotional changes,and somatic sensations.Therefore,the methods used in this study could clarify the neural mechanism of uterine-point acupuncture in the treatment of gynecological diseases and may serve as a reference for other studies pertaining to acupuncture.

Activation of various brain areas during acupuncture at Taixi (KI 3) and Qiuxu (GB 40) acupoints

A number of previous studies of acupuncture acupoint specificity have used sham acupoints, sham acupuncture or meridian acupoints at a great distance from each other as controls in functional MRI （fMRI） experiments. However, few studies have compared different meridian acupoints within the same segment, which are associated with similarly intense needle sensations. We performed fMRI on 12 healthy young volunteers and observed differences in brain activation elicited by acupuncture of the Taixi （KI 3） and Qiuxu （GB 40） acupoints. Acupuncture was applied at the Taixi and Qiuxu acupoints, using a multiple-block fMRI design with three blocks, involving three altemations of resting and task phases. After scanning, needle sensation was assessed. The behavioral results revealed that the subjective needle sensation was similar between the Taixiand Qiuxu acupoints. The fMRI results revealed that acupuncture at the right Taixi acupoint activated the right superior temporal gyrus （BA 22）, left middle frontal gyrus （BA 46） and inferior frontal gyrus （BA 45）, bilateral parietal lobe postcentral gyrus （BA 2）, right parietal lobe （BA 3）, and left parietal lobe （BA 40）. Acupuncture at the right Qiuxu acupoint activated the left superior temporal gyrus （BA 42）, right parietal lobe postcentral gyrus （BA 40, BA 43）, right inferior frontal gyrus （BA 47）, bilateral superior temporal gyrus （BA 22）, and right insula BA13. These results suggest that the right Taixiand Qiuxu acupoints activated different brain areas.

Modulatory effect of International standard Scalp Acupuncture on brain activation in the elderly as revealed by resting-state fMRI

The specific mechanisms by which acupuncture affects the central nervous system are unclear. In the International Standard Scalp Acupuncture system, acupuncture needles are applied at the middle line of the vertex, anterior parietal-temporal oblique line, and the posterior parietal-temporal oblique line. We conducted a single-arm prospective clinical trial in which seven healthy elderly volunteers (three men and four women;50–70 years old) received International Standard Scalp Acupuncture at MS5 (the mid-sagittal line between Baihui (DU20) and Qianding (DU21)), the left MS6 (line joining Sishencong (EX-HN1) and Xuanli (GB6)), and the left MS7 (line joining DU20 and Qubin (GB7)). After acupuncture, resting-state functional magnetic resonance imaging demonstrated changes in the fractional amplitude of low frequency fluctuations and regional homogeneity in various areas, showing remarkable enhancement of regional homogeneity in the bilateral anterior cingulate, left medial frontal gyrus, supramarginal gyrus, right middle frontal gyrus, and inferior frontal gyrus. Functional connectivity based on a seed region at the right middle frontal gyrus (42, 51, 9) decreased at the bilateral medial superior frontal gyrus. Our data preliminarily indicates that the international standard scalp acupuncture in healthy elderly participants specifcally enhances the correlation between the brain regions involved in cognition and implementation of the brain network regulation system and the surrounding adjacent brain regions. The study was approved by the Ethics Committee of the China-Japan Union Hospital at Jilin University, China, on July 18, 2016 (approval No. 2016ks043).

Modulatory effects of acupuncture on brain networks in mild cognitive impairment patients

Functional magnetic resonance imaging has been widely used to investigate the effects of acupuncture on neural activity. However, most functional magnetic resonance imaging studies have focused on acute changes in brain activation induced by acupuncture. Thus, the time course of the therapeutic effects of acupuncture remains unclear. In this study, 32 patients with amnestic mild cognitive impairment were randomly divided into two groups, where they received either Tiaoshen Yizhi acupuncture or sham acupoint acupuncture. The needles were either twirled at Tiaoshen Yizhi acupoints, including Sishencong（EX-HN1）, Yintang（EX-HN3）, Neiguan（PC6）, Taixi（KI3）, Fenglong（ST40）, and Taichong（LR3）, or at related sham acupoints at a depth of approximately 15 mm, an angle of ± 60°, and a rate of approximately 120 times per minute. Acupuncture was conducted for 4 consecutive weeks, five times per week, on weekdays. Resting-state functional magnetic resonance imaging indicated that connections between cognition-related regions such as the insula, dorsolateral prefrontal cortex, hippocampus, thalamus, inferior parietal lobule, and anterior cingulate cortex increased after acupuncture at Tiaoshen Yizhi acupoints. The insula, dorsolateral prefrontal cortex, and hippocampus acted as central brain hubs. Patients in the Tiaoshen Yizhi group exhibited improved cognitive performance after acupuncture. In the sham acupoint acupuncture group, connections between brain regions were dispersed, and we found no differences in cognitive function following the treatment. These results indicate that acupuncture at Tiaoshen Yizhi acupoints can regulate brain networks by increasing connectivity between cognition-related regions, thereby improving cognitive function in patients with mild cognitive impairment.

Study on the Regulatory Effect of Electro-acupuncture on Hegu Point (LI4) in Cerebral Response with Functional Magnetic Resonance Imaging

Objective： To study, through blood oxygen level dependent functional magnetic resonance imaging （BOLD fMRI）, the cerebral activated areas evoked by electro-acupuncturing （EA） the right Hegu point （LI4） or non-acupoint points on the face, and through comparing their similarities and differences, to speculate on the specific cerebral areas activated by stimulating LI4, for exploring the mechanism of its effect in potential clinical application. Methods： EA was applied at volunteers＇ right LI4 （of 9 subjects in the LI4 group） and facial non-acupoint points （of 5 subjects in the control group）, and whole brain 3-dimensional T1 anatomical imaging of high resolution 1 × 1 × 1 mm^3 used was performed with clustered stimulatory mode adopted by BOLD fMRI. Pretreatment and statistical t-test were conducted on the data by SPM2 software, then the statistical parameters were superimposed to the 3-dimensional anatomical imaging. Results： Data from 3 testees of the 9 subjects in the LI4 group were given up eventually because they were unfit to the demand due to different causes such as movement of patients＇ location or machinery factors. Statistical analysis showed that signal activation or deactivation was found in multiple cerebral areas in 6 subjects of LI4 group and 5 subjects of the control group （P〈0.01）. In the LI4 group, the areas which showed signal activation were： midline nuclear group of thalamus, left supra marginal gyrus, left supra temporal gyrus, right precuneous lobe, bilateral temporal pole, left precentral gyrus and left cerebellum; those which showed signal deactivation were： bilateral hippocampus, parahippocampal gyrus, amygdala body area, rostral side/audal side of cingulate gyrus, prefrontal lobe and occipital lobe as well as left infratemporal gyrus. In the control group, areas which showed signal activation were： bilateral frontal lobe, postcentral gyrus, Reil＇s island lobe, primary somato-sensory cortex, cingulate gyrus, superior temporal gyrus, occipital cuneiform gyrus and/or precuneus gyrus and right brainstem; and the area that showed deactivation was left median frontal lobe. Conclusion： The effects of EA LI4 in regulating cerebral activities could be displayed and recorded through BOLD fMRI, the distribution of signally deactivated area evoked by EA LI4 was similar to the known distribution of anatomical orientation of pain in brain, and closely related to the anatomic structure of limbic system, which areas are possibly the acupuncture analgesic effect＇s cerebral regulating area. Furthermore, activated portion of left central anterior gyrus, which represent the movement of oral facial muscles, and the activated portion of cerebellum are possibly related with the effect of using EA LI4 in treating facial palsy and facial muscle spasm. As for the mechanism of signal deactivation of cerebral activities exhibited in the present study that is unable to be elucidated, it awaits for further research.

Cerebral mechanism of puncturing at He-Mu point combination for functional dyspepsia: study protocol for a randomized controlled parallel trial

Acupuncture is widely used to treat functional dyspepsia with satisfactory outcomes. Combination of the He and Mu acupoints is commonly used and has a synergistic effect on functional dyspepsia; however, its underlying mechanisms remain unclear. Therefore, a randomized controlled parallel clinical trial is currently underway at Chengdu University of Traditional Chinese Medicine, China. This trial is designed to explore the efficacy of and central responses to the He-Mu point combination in patients with functional dyspepsia using functional magnetic resonance imaging. A total of 105 patients with functional dyspepsia will be allocated into 3 groups： the low-He point group（puncturing at Zusanli（ST36））, Mu point group（puncturing at Zhongwan（CV12））, and He-Mu point combination group（puncturing at ST36 and CV12）. Every participant will receive 20 sessions of manual acupuncture for 4 weeks. The needles will be inserted perpendicularly to a depth of 1 to 2 cun. The angle of rotation and twisting will range from 90 to 180 degrees, while lifting and thrusting will range from 0.3 to 0.5 cm. The various manipulations will be performed 60 to 90 times per minute. The needles will remain in place for 30 minutes, during which manipulation will be applied every 10 minutes. Magnetic resonance imaging will be performed before and after 20 sessions of acupuncture. The primary outcome is symptom improvement according to the Chinese version of the Nepean Dyspepsia Index. Secondary outcomes include the Leeds dyspepsia questionnaire, Self-Rating Anxiety Scale, Self-Rating Depression Scale, Beck Anxiety Inventory, Beck Depression Inventory, and visual analogue scale scores before and after 10 and 20 sessions of acupuncture. Needle sensation and adverse events will be used to assess the therapeutic effects. This study will promote more widespread awareness of the benefits of acupoint combination in the clinical setting and provide a further explanation of the neuromechanism by which acupuncture at the He-Mu point combination for functional dyspepsia. Registration： Chinese Clinical Trial Registry, Chi CTR-IOR-15006402.

Functional organization of complex brain networks modulated by acupuncture at different acupoints belonging to the same anatomic segment

Background Noninvasive functional magnetic resonance imaging （fMRI） techniques have opened a ＂window＂ into the brain, allowing us to investigate the anatomical and physiological function involving acupuncture needling. Imaging its sustained effect rather than acute effect on the brain networks may further help elucidate the mechanisms by which acupuncture achieves its therapeutic effects. In this study, we aimed to investigate the functional brain networks during the post-resting state following acupuncture at KI3 in comparison with acupuncture at GB40. Methods Needling at acupoints GB40 and KI3 was performed in twelve subjects. Six minutes of scanning at rest were adopted before and after acupuncture at different acupoints. Then we divided the whole brain into 39 regions and constructed functional brain networks during the post-acupuncture resting states （PARS）. Results For direct comparisons, increased correlations during post-resting state following acupuncture at KI3 compared to resting state （RS） were primarily located between the dorsolateral prefrontal cortex （DLPFC） and post temporal cortex, ventromedial prefrontal cortex （vmPFC） and post temporal cortex. These brain regions were all cognitive-related functions. In contrast, the increased connections between the anterior insula and temporal cortex mainly emerged following acupuncture at GB40 compared with the RS. Conclusions The present study demonstrates that acupuncture at different acupoints belonging to the same anatomic segment can exert different modulatory effects on the reorganizations of post-acupuncture RS networks. The heterogeneous modulation patterns between twoconditions may relate to the functional specific modulatory effects of acupuncture.

Two Sets of Acupoint Combination of Similar Functions Engage Shared Neural Representation:A Functional Magnetic Resonance Imaging Study

Objective： To investigate whether the neural representations underlying alternating two acupoint combinations （ACs） are the same or not. Methods： In this functional magnetic resonance imaging study, two sets of analgesia ACs were utilized, including Waiguan （TE5） and Qiuxu （GB40） for Group A, and Neiguan （PC6） and Taichong （LR3） for Group B, which are the most commonly adopted in clinical treatment. Each group had 20 healthy subjects. An experinlental design was proposed, which consisted of a pre-needling resting phase, a needling phase and a post-needling resting phase. This paradigm optimally mimics the clinical protocol as well as focuses on both the stimulation and the resting periods. The results were subjected to general linear model analysis, conjunction analysis and the functional connectivity analysis. Results： The rostral anterior cingulated cortex was engaged in the initiative period of the acupuncture effect in both groups, and it was chosen as the seed region for the functional connectivity analysis for the following resting period. The results showed that several shared brain regions were involved in both groups, in particular the insula, amygdala and hypothalamus. Moreover, significant differences were located at the posterior cingulated cortex as revealed by a two sample t-test （P〈0.05, corrected）. Other regions showed no significant differences. This finding was further supported by the spatial correlation analysis that the two groups were significantly correlated （r=0.51, P〈0.01）. Conclusion： This preliminary research helps us understand the neurophysiological mechanisms of acupuncture when following clinical guidelines on ACs, as well as provides an important opportunity to develop better treatment strategies for reducing, or even preventing pain.

针刺阳陵泉对中风偏瘫患者脑网络功能连接的即刻效应

目的 基于功能磁共振成像(fMRI)技术,对比针刺阳陵泉真穴/假穴对中风偏瘫患者感觉运动网络(SMN)、背侧注意网络(DAN)功能连接的即刻效应,探讨针刺对中风偏瘫患者中枢调节机制及经穴特异性。方法 纳入中风偏瘫患者20例,间隔2周分别进行1次针刺阳陵泉真穴与假穴的fMRI扫描,应用独立成分分析提取运动相关的SMN、DAN,比较功能连接差异。结果 在SMN内,针刺阳陵泉真穴后较针刺前功能连接增强,增强的脑区有右侧中央前回、颞上回、额下回、楔叶、楔前叶,左侧颞中回、枕中回、颞上回、海马旁回、额下回、颞上回;针刺阳陵泉假穴后较针刺前功能连接增强,增强的脑区有右侧中央前回、额上回、额中回、扣带回,左侧额内侧回、前扣带回、豆状核、尾状核。在DAN中,针刺阳陵泉真穴后较针刺前功能连接增强,增强的脑区包括右侧大脑楔前叶、颞上回、颞中回、枕中回,左侧扣带回、后扣带回、楔前叶;针刺阳陵泉假穴后较针刺前功能连接增强,增强的脑区包括右侧前扣带回,左侧前扣带回、额内侧回。结论 针刺阳陵泉能激活中风偏瘫患者SMN、DAN双侧相关脑区,可能通过调节运动的启动及执行促进患者运动功能的恢复,且相较假穴更具经穴特异性。

基于功能性磁共振成像的针刺治疗脑卒中后功能障碍的研究进展

近年来,先进的技术手段已被广泛用于阐明针刺治疗脑卒中后功能障碍的机制,特别是大脑功能的成像技术。在功能性磁共振成像技术的指导下,针刺治疗中枢疾病的研究日益增多。以脑卒中后不同功能障碍为切入点,结合功能性磁共振成像脑成像技术,探讨针刺治疗脑卒中后不同功能障碍的中枢机制,以动态、视觉和客观的方式为针刺治疗脑卒中后功能障碍的潜在机制提供新的证据。

基于被试间相关性探究针刺治疗丘脑卒中后麻木患者的群体脑效应

目的探究针刺对脑卒中后肢体麻木患者的疗效及群体脑效应。方法招募24例脑卒中后肢体麻木患者(患者组)及年龄、性别匹配的健康受试者(对照组)23名,对2组受试者进行每周3次、持续4周的形神共调针刺治疗,观察针刺前后麻木VAS量表评分变化。对2组受试者进行功能核磁共振扫描,并在扫描时进行针刺干预,分别采集静息态、针刺任务态和留针态3种状态下的血氧依赖水平数据,运用fMRIPrep、BrainIAK等软件进行数据处理,计算被试间相关性(ISC),分别比较不同条件下2组受试者各脑区的ISC值。结果针刺治疗显著降低麻木VAS量表评分。静息状态下,2组受试者ISC值均未出现显著变化。针刺条件下,患者组左侧中央前回、左侧中央旁小叶、左侧中央后回、左侧岛叶、左侧前扣带回、右侧额中回、右侧前扣带回脑区ISC值显著升高。留针条件下,对照组两侧中央前回部分脑区出现轻微负激活。患者组针刺态较静息态左侧额上回、左侧中央前回、左侧中央旁小叶、左侧楔前叶、左侧中央后回、左侧岛叶、左侧前扣带回、左侧丘脑、右侧额上回、右侧额中回、右侧中央前回、右侧前扣带回ISC值显著升高。结论针刺能改善卒中后肢体麻木症状,并能在患者中引起一种特异性的群体激活模式,该模式涉及中央前回、中央后回、丘脑、岛叶、前额叶、扣带回等区域。针刺可能通过激活感觉运动网络和皮质-丘脑-皮质环路增强对感觉信息的处理能力,同时调节中央执行网络和下行疼痛控制通路促进疼痛症状的缓解。

针刺脑效应静息态功能磁共振研究探析

静息态功能磁共振成像(rs-fMRI)作为目前研究针刺中枢功能整合机制的重要切入点,本研究基于近10年国内外相关研究进展,分析总结rs-fMRI在针刺脑效应机理研究领域现状,归纳提炼出针刺脑效应的相对特异性、动态性和条件性特征,重新审视基于rs-fMRI的针刺中枢机制研究的前景与局限,并展望未来研究方向。

基于fMRI研究经筋疗法对健康人脑网络拓扑结构的影响

目的:使用静息态BOLD-fMRI结合图论方法,分析健康志愿者经筋治疗前后功能脑网络的拓扑结构,以揭示经筋疗法对脑神经网络的调控机制。方法:招募41例健康志愿者,随机分为理筋伴针刺组21例和单纯理筋组20例,采集治疗前后简单反应时间测试、舒尔特方格测试、颅脑MRI3D-T_1WI及BOLD数据。使用GRETNA软件构建功能脑网络、计算拓扑参数,并行治疗前后组内及组间比较。结果:治疗后2组反应力和注意力均显著提高;理筋伴针刺组的全局效率(E_(glob))和小世界属性(σ)提高,聚类系数(Cp)和特征路径长度(Lp)降低,而理筋组仅E_(glob)提高和Lp降低;理筋伴针刺组发现一神经回路连接强度减弱,包括86条连边和73个节点。相关性分析示E_(glob)、标准化聚类系数(γ)和σ分别与舒尔特方格时间呈负相关,而Lp与舒尔特方格时间呈正相关。结论:经筋治疗能重塑功能脑网络、优化其信息处理模式,进而增强志愿者的反应力和注意力,这种重塑作用可能是其治未病疗效的作用基础。而针刺松解筋结点作为经筋疗法的重要组成部分,对功能网络的重塑有重要作用。

基于脑功能磁共振成像系统评价针灸治疗抑郁症疗效

目的基于脑功能磁共振成像(Functional magnetic resonance imaging,fMRI),采用Meta分析系统评价针灸治疗抑郁症(Major depressive disorder,MDD)的有效性。方法检索CNKI、CBM、Wan fang、VIP、PubMed、Web of Science、Embase、Cochrane Library从建库以来至2023年10月31日针灸治疗MDD的随机对照研究(RCT),纳入研究质量评估采用Cochrane偏倚风险评估工具,利用RevMan 5.3软件行Meta分析,并采用Cochrane工具自带的GRADE系统进行证据质量评价。结果纳入文章9篇,包括7篇国内文章,2篇国外文章,总样本量636例(试验组325例,对照组311例)。9项研究均以fMRI为主要观察指标,结果显示针灸可调节差异脑区低频振幅(Amplitude of low frequency fluctuation,ALFF)、低频振幅比率(Fractional of amplitude low-frequency fluctuation,f ALFF)及局部一致性(Region homogeneity,ReHo)值,改变脑功能连接。次要结局指标分析结果显示针灸治疗可明显改善MDD患者的症状,提高临床疗效[OR=1.98,95%CI(1.30,2.99),P=0.001],减轻抗抑郁药物带来的副反应,并有效降低患者的汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分[MD=-3.08,95%CI(-4.46,-1.70),P<0.0001]、Zung抑郁自评量表(Self-rating depression scale,SDS)评分[MD=-4.67,95%CI(-6.93,-2.40),P<0.0001]、抗抑郁药副反应量表(Side-effect rating scale for antidepressant,SERS)总分,降低血浆促肾上腺皮质激素[MD=-3.22,95%CI(-5.00,-1.43),P=0.0004]水平及血清皮质醇激素水平。结论针灸治疗MDD效果显著,可激活边缘系统脑区,重组MDD发病的认知、情感加工及默认网络结构,并对额叶进行调节,从而改善抑郁。

联合针刺梁丘穴和足三里穴与足三里穴和上巨虚穴的fMRI-BOLD对比研究

目的:探讨同一经络内2个相邻穴位针刺的联合效应,为针刺的中枢机制和经络学说提供一定证据。方法:50例健康志愿者随机分为2组,分别行右侧梁丘穴+足三里穴和足三里穴+上巨虚穴脉冲电针治疗仪针刺。采用区块设计模式行fMRI,分析针刺过程中的脑活动模式,并比较2组的差异。记录2组针刺感觉类型和强度,评估针刺感觉与脑活动的关系。结果:梁丘穴+足三里组和足三里穴+上巨虚穴组共同激活区集中在右侧额上回眶缘、左侧额下回盖部、左侧前扣带回和左侧眶前回,2组共同负激活区则集中在右侧缘上回、右侧尾状核、右侧壳核和左侧岛叶。梁丘穴+足三里穴组在左侧额下回盖部、左侧前扣带回等区域更活跃,而足三里穴+上巨虚穴组在右侧缘上回、左侧岛叶和左侧壳核等区域更活跃。结论:同一经络内2个相邻穴位的针刺刺激可产生协同效应,不同穴位组合对大脑活动的影响也有差异。这些结果可为针刺的中枢机制和经络学说提供一定证据,为针刺方案的设计提供参考。

用功能磁共振成像探讨经穴和大脑皮层的关系

目的:利用功能磁共振成像研究针刺人体穴位时引起大脑皮层神经兴奋的现象,探讨经穴、经络和大脑皮层的联系。方法:分别针刺足少阳胆经的穴位光明6例、阳陵泉6例和足阳明胃经穴位伏兔6例、足三里6例,均为健康人。用功能磁共振技术观察针刺时大脑的功能状态。结果:针刺足少阳胆经光明穴和阳陵泉穴,对侧枕叶视皮层均有明显兴奋,其中5例受试者(光明穴3例、阳陵泉穴2例)双侧枕叶视皮层都有明显的兴奋区;针刺后枕叶视皮层的平均BOLD信号强度增加的水平为(3.31±1.2)%。针刺足阳明胃经的足三里穴和伏兔穴可以引起下丘脑、海马回、额回的神经兴奋,平均BOLD信号强度增加(4.28±1.5)%。结论:功能磁共振成像显示针刺特定的穴位可以引起大脑相应区域的神经兴奋,同一条经脉上的穴位引起大脑兴奋的区域相同。提示经穴、经络和大脑皮层之间存在某种特定的联系。

针刺正常老年人“四关穴”的脑功能MRI研究

目的采用脑功能磁共振成像(fMRI)探讨针刺正常老年人“四关穴”(双侧太冲穴和合谷穴)的中枢神经机制。方法针刺13例正常老年人“四关穴”,同时进行全脑fMRI扫描。为避免针刺后效应的影响,实验采用单组块设计。数据采用SPM99进行分析。图像中每个体素的t值形成统计参数图,以P<0.05(经比较修正后)的体素作为激活体素。结果针刺正常老年人“四关穴”激活双侧小脑半球、小脑蚓部、左侧额中回、双侧额下回、双侧中央旁小叶、双侧丘脑、后扣带回和前扣带回。针刺“四关穴”所激活的脑区,并非是单独针刺太冲穴和合谷穴所激活脑区的简单叠加。结论针刺正常老年人“四关穴”激活后扣带回和额叶,这可能是该组合穴治疗精神类疾病的中枢神经机制。fMRI是一种客观显示针刺治疗脑改变的方法。

手法针灸足三里穴脑内效应磁共振功能成像研究

目的观察手法(补法)针灸足三里穴脑内效应的功能成像特点,探讨经络的本质和针灸治疗疾病的机理。方法选择26例健康志愿者,按双盲法随机分为穴位组(16例)与非穴位组(10例),使用GESigna1.5T超导MRI成像系统,采用Gradient echo-EPI序列进行功能成像,GE Signa工作站的Functool软件进行图像后处理,获得正相关系数(CC)脑功能图,统计学分析采用SPSS13.0软件。结果穴位组15例,13个脑功能区激活;非穴位组10例,10个脑功能区激活。其中穴位组颞叶激活区有特异性(精确概率法,P=0.022)。穴位组颞叶左右半球激活反应率差异有统计学意义(McNemer检验,P=0.020)。结论(1)针灸穴位在脑内有特定的功能区激活,穴位的治疗作用可能是通过脑作为中介治疗器官疾病和调治器官功能紊乱。(2)经络独特传感道的存在。