acupuncture at acupoint ST36: a magnetoencephalography study. Cheng H, Zhang XT, Yan H, Bai LJ, Ai L, Wang FB, You YB, Chen P, Wang BG. Source Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Chin Med J (Engl). 2011 Apr;124(8):1229-34. Differential temporal neural responses of pain-related regions by





The Brain Effects of Laser Acupuncture in Healthy Individuals: An fMRI Investigation



Variations of Brain Activities of Acupuncture to TE5 of Left Hand in Normal Subjects.




Differences in cortical response to acupressure and electroacupuncture stimuli Thomas Witzel1, Vitaly Napadow1,2, Norman W Kettner2, Mark G Vangel1, Matti S Hämäläinen1 and Rupali P Dhond1*




fMRI Neurophysiological Evidence Of Acupuncture Mechanisms Zang-Hee Cho, PhD; Young-Don Son, MSc; Jae-Yong Han, MSc; Edward K. Wong, MD; Chang-Ki Kang, MSc; Kyung-Yo Kim, PhD; Hyung-Kyoon Kim, PhD; Byung-Yeol Lee, PhD; Yoon-Kyung Yim, PhD; Ki-Hyon Kim, PhD




Central Nervous Pathway for Acupuncture Stimulation: Localization of Processing with Functional MR Imaging of the Brain–Preliminary Experience1 Ming-Ting Wu, MD, Jen-Chuen Hsieh, MD, PhD, Jing Xiong, MD, Chien-Fang Yang, MD, Huay-Ban Pan, MD, Yin-Ching Iris Chen, PhD, Guochuan Tsai, MD, PhD, Bruce R. Rosen, MD, PhD and Kenneth K. Kwong, PhD




Time-Variant fMRI Activity in the Brainstem and Higher Structures in Response to Acupuncture Vitaly Napadow,1,2 Rupali Dhond,1,2 Kyungmo Park,3 Jieun Kim,3 Nikos Makris,4 Kenneth K Kwong,1 Richard E. Harris,5 Norman Kettner,2 and Kathleen KS Hui1




Acupuncture of LI-4 in Anesthetized Healthy Humans Decreases Cerebral Blood Flow in the Putamen Measured with Positron Emission Tomography Lise Schlünzen, MD*, Manouchehr S. Vafaee, MSc, PhD† and Georg E. Cold, MD, DMSc*




Expectancy and treatment interactions: A dissociation between acupuncture analgesia and expectancy evoked placebo analgesia Jian Kong,1,2 Ted J Kaptchuk,3 Ginger Polich,1 Irving Kirsch,4 Mark Vangel,2,5 Carolyn Zyloney,1 Bruce Rosen,2 and Randy Gollub1,2,3




Traditional Chinese Acupuncture and Placebo (Sham) Acupuncture Are Differentiated by Their Effects on μ-Opioid Receptors (MORs) Richard E. Harris,1 Jon-Kar Zubieta,2,3 David J. Scott,4 Vitaly Napadow,5 Richard H. Gracely,6 and Daniel J. Clauw1




Acupuncture of LI-4 in Anesthetized Healthy Humans Decreases Cerebral Blood Flow in the Putamen Measured with Positron Emission Tomography Lise Schlünzen, MD*, Manouchehr S. Vafaee, MSc, PhD† and Georg E. Cold, MD, DMSc*



Central Nervous Pathway for Acupuncture Stimulation: Localization of Processing with Functional MR Imaging of the Brain–Preliminary Experience1 Ming-Ting Wu, MD, Jen-Chuen Hsieh, MD, PhD, Jing Xiong, MD, Chien-Fang Yang, MD, Huay-Ban Pan, MD, Yin-Ching Iris Chen, PhD, Guochuan Tsai, MD, PhD, Bruce R. Rosen, MD, PhD and Kenneth K. Kwong, PhD




Acupuncture Modulates the Limbic System and Subcortical Gray Structures of the Human Brain: Evidence From fMRI Studies in Normal Subjects Kathleen K.S. Hui,1,2* Jing Liu,2 Nikos Makris,3 Randy L. Gollub,1,4 Anthony J.W. Chen,1 Christopher I. Moore,1 David N. Kennedy,3 Bruce R. Rosen,1 and Kenneth K. Kwong1




Modulatory effects of acupuncture on resting-state networks: A functional MRI study combining independent component analysis and multivariate granger causality analysis. Zhong C, Bai L, Dai R, Xue T, Wang H, Feng Y, Liu Z, You Y, Chen S, Tian J.




J Vis Exp. 2010; (38): 1190. Published online 2010 April 8. doi: 10.3791/1190 PMCID: PMC3149981 Monitoring Acupuncture Effects on Human Brain by fMRI




Acupunct Med. 2012 Dec;30(4):316-23. doi: 10.1136/acupmed-2012-010169. Epub 2012 Sep 29.


Brain areas involved in acupuncture needling sensation of de qi: a single-photon emission computed tomography (SPECT) study. Chen JR, Li GL, Zhang GF, Huang Y, Wang SX, Lu N. Source First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China.





Magn Reson Imaging. 2013 May 15. pii: S0730-725X(13)00033-7. doi: 10.1016/j.mri.2013.01.006. [Epub ahead of print]
Long-duration transcutaneous electric acupoint stimulation alters small-world brain functional networks.




2013 Aug 6. doi: 10.1136/acupmed-2012-010297. [Epub ahead of print]
Differential brain effects of laser and needle acupuncture at LR8 using functional MRI.




Acupunct Med.
. 2013 Sep;31(3):282-9. doi: 10.1136/acupmed-2012-010297. Epub 2013 Aug 6.
Differential brain effects of laser and needle acupuncture at LR8 using functional MRI.
Quah-Smith I, Williams MA, Lundeberg T, Suo C, Sachdev P.





Forsch Komplementmed. 2014;21(2):99-104. doi: 10.1159/000360804. Epub 2014 Mar 24.
Different Cerebral Responses to Puncturing at ST36 among Patients with Functional Dyspepsia and Healthy Subjects.
Li Z1, Zeng F, Yang Y, Chen Y, Zhang D, Sun J, Qin W, Yang J, Liang F.
Author information




Acupunct Med
2014 May;35 Suppl 1:189-93. doi: 10.1007/s10072-014-1768-7.
Ear acupuncture and fMRI: a pilot study for assessing the specificity of auricular points.
Romoli M1, Allais G, Airola G, Benedetto C, Mana O, Giacobbe M, Pugliese AM, Battistella G, Fornari E.
Author information




Neurol Sci.
2014 Jun 3. pii: S0304-3940(14)00448-0. doi: 10.1016/j.neulet.2014.05.050. [Epub ahead of print]
Acupuncture at HT7 suppresses morphine self-administration at high dose through GABA system.
Lee BH1, Ku JY2, Zhao RJ3, Kim HY4, Yang CH4, Gwak YS4, Chang SC4, Kim NJ2, Kim JS2, Lee YK2, Lee HJ2, Lim SC5.





Evidence-Based Complementary and Alternative MedicineVolume 2013 (2013), Article ID 175278, 14 pageshttp://dx.doi.org/10.1155/2013/175278
Research Article
Brain Responses to Acupuncture Are Probably Dependent on the Brain Functional Status




Neurosci Lett.
2014 Oct;8(5):417-28. doi: 10.1007/s11571-014-9297-x. Epub 2014 Jun 3.
WLPVG approach to the analysis of EEG-based functional brain network under manual acupuncture.
Pei X, Wang J, Deng B, Wei X, Yu H.
Cogn Neurodyn.



2015;2015:183074. doi: 10.1155/2015/183074. Epub 2015 Jan 1.
Gender differences in cerebral regional homogeneity of adult healthy volunteers: a resting-state FMRI study.

Biomed Res Int.
2014;2014:103491. doi: 10.1155/2014/103491. Epub 2014 Nov 26.
An FMRI study of neuronal specificity in acupuncture: the multiacupoint siguan and its sham point.
Shan Y1, Wang ZQ1, Zhao ZL1, Zhang M1, Hao SL2, Xu JY2, Shan BC3, Lu J1, Li KC1.



Evid Based Complement Alternat Med.
2015 Jun;45(6):669-71. doi: 10.1111/imj.12767.
Using functional magnetic resonance imaging to explore the possible mechanism of the action of acupuncture at Dazhong (KI 4) on the functional cerebral regions of healthy volunteers.
Zhang Q1,2, Li A3, Yue J4,2, Zhang F5, Sun Z4, Li X5.
Intern Med J.



2015 Oct 14;15(1):361. doi: 10.1186/s12906-015-0881-3.
Acupuncture at KI3 in healthy volunteers induces specific cortical functional activity: an fMRI study.
Zhu B1, Wang Y2, Zhang G3, Ouyang H4, Zhang J5, Zheng Y6, Zhang S7, Wu C8, Qu S9, Chen J10, Huang Y11, Tang C12.




BMC Complement Altern Med.
2015 Oct 29;11(1):67. doi: 10.1186/s12990-015-0071-9.
The modulation effect of longitudinal acupuncture on resting state functional connectivity in knee osteoarthritis patients.
Chen X1, Spaeth RB2, Freeman SG3, Scarborough DM4, Hashmi JA5, Wey HY6, Egorova N7, Vangel M8,9, Mao J10, Wasan AD11, Edwards RR12, Gollub RL13,14, Kong J15,16.


Mol Pain.
2016 Feb;9(1):22-5. doi: 10.1016/j.jams.2015.11.035. Epub 2015 Nov 27.
Waiguan Stimulation May Kindle Anticorrelated Brain Networks: Functional Magnetic Resonance Imaging Data Revisited.
Wik G1, Huang Y2, Zeng T3, Qu S2, Zheng Y2, Zhang J2, Lai X4, Tang C5, Shan B6.


J Acupunct Meridian Stud.
2016 Feb;9(1):4-10. doi: 10.1016/j.jams.2015.05.007. Epub 2015 Jun 4.
Hypothalamic Norepinephrine Mediates Acupunctural Effects on Hypothalamic-Pituitary-Adrenal Axis During Ethanol Withdrawal.
Zhao ZL1, Kim SC2, Zhang J1, Liu HF1, Lee BH2, Jang EY2, Lee CW2, Cho IJ2, An WG3, Yang CH2, Kim YW2, Zhao RJ4, Wu YY5.
Author information


J Acupunct Meridian Stud.
2016 Jul 20. [Epub ahead of print]
Changes in Regional Brain Homogeneity Induced by Electro-Acupuncture Stimulation at the Baihui Acupoint in Healthy Subjects: A Functional Magnetic Resonance Imaging Study.
Deng D1, Duan G1, Liao H1, Liu Y2, Wang G2, Liu H3, Tang L3, Pang Y3, Tao J3, He X1, Yuan W1, Liu P2.



J Altern Complement Med.
2016 Aug 22. [Epub ahead of print]
Evidence of a Synergistic Effect of Acupoint Combination: A Resting-State Functional Magnetic Resonance Imaging Study.
Zhang J1, Zheng Y1, Wang Y1, Qu S1, Zhang S1, Wu C1, Chen J2, Ouyang H3, Tang C4, Huang Y1.


J Altern Complement Med.
2016 Nov 18;6:36636. doi: 10.1038/srep36636.
Different brain responses to electro-acupuncture and moxibustion treatment in patients with Crohn's disease.
Bao C1, Liu P2, Liu H3, Jin X4, Calhoun VD5,6, Wu L1, Shi Y3, Zhang J7, Zeng X8, Ma L9, Qin W2, Zhang J1, Liu X2, Tian J2, Wu H1.
Sci Rep.



Acupunct Med. 2012 Dec;30(4):307-15. doi: 10.1136/acupmed-2011-010123. Epub 2012 Sep 15.
Post-stimulation effect of electroacupuncture at Yintang (EX-HN3) and GV20 on cerebral functional regions in healthy volunteers: a resting functional MRI study.
Zheng Y, Qu S, Wang N, Liu L, Zhang G, Jiang X, Chen J, Huang Y, Zhang Z.
Source
School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province, China.
Abstract
Objective The aim of the present work was to observe the activation/deactivation of cerebral functional regions after electroacupuncture (EA) at Yintang (EX-HN3) and GV20 by functional MRI (fMRI). Design A total of 12 healthy volunteers were stimulated by EA at Yintang and GV20 for 30 min. Resting-state fMRI scans were performed before EA, and at 5 and 15 min after needle removal. Statistical parametric mapping was used to preprocess initial data, and regional homogeneity (ReHo) and amplitude of low-frequency fluctuation (ALFF) were analysed. Results ReHo at 5 min post stimulation showed increases in the left temporal lobe and cerebellum and decreases in the left parietal lobe, occipital lobe and right precuneus. At 15 min post stimulation, ReHo showed increases in the left fusiform gyrus; lingual gyrus; middle temporal gyrus; postcentral gyrus; limbic lobe; cingulate gyrus; paracentral lobule; cerebellum, posterior lobe, declive; right cuneus and cerebellum, anterior lobe, culmen. It also showed decreases in the left frontal lobe, parietal lobe, right temporal lobe, frontal lobe, parietal lobe and right cingulate gyrus. ALFF at 5 min post stimulation showed increases in the right temporal lobe, but decreases in the right limbic lobe and posterior cingulate gyrus. At 15 min post stimulation ALFF showed increases in the left frontal lobe, parietal lobe, occipital lobe, right temporal lobe, parietal lobe, occipital lobe and cerebellum, but decreases in the left frontal lobe, anterior cingulate gyrus, right frontal lobe and posterior cingulate gyrus. Conclusions After EA stimulation at Yintang and GV20, which are associated with psychiatric disorder treatments, changes were localised in the frontal lobe, cingulate gyrus and cerebellum. Changes were higher in number and intensity at 15 min than at 5 min after needle removal, demonstrating lasting and strong after-effects of EA on cerebral functional regions.




Chin J Integr Med. 2007 Mar;13(1):10-6.
Study on the regulatory effect of electro-acupuncture on hegu point (LI4) in cerebral response with functional magnetic resonance imaging.
Wang W, Liu L, Zhi X, Huang JB, Liu DX, Wang H, Kong XQ, Xu HB.
Source
Radiology Department, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan.
Abstract
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 (L14) or non-acupoint points on the face, and through comparing their similarities and differences, to speculate on the specific cerebral areas activated by stimulating L14, for exploring the mechanism of its effect in potential clinical application.
METHODS:
EA was applied at volunteers' right L14 (of 9 subjects in the L14 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 x 1 x 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 L14 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 L14 group and 5 subjects of the control group (P<0.01). In the L14 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 L14 in regulating cerebral activities could be displayed and recorded through BOLD fMRI, the distribution of signally deactivated area evoked by EA L14 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 L14 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.




The Brain Effects of Laser Acupuncture in Healthy Individuals: An fMRI Investigation
Im Quah-Smith1, Perminder S. Sachdev1,2,3*, Wei Wen1,2,3, Xiaohua Chen1,2,3, Mark A. Williams4
1 School of Psychiatry, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia, 2 Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, New South Wales, Australia, 3 Brain & Ageing Research Program, School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia, 4 Macquarie Centre for Cognitive Sciences, Macquarie University, Sydney, New South Wales, Australia

Background: As laser acupuncture is being increasingly used to treat mental disorders, we sought to determine whether it has a biologically plausible effect by using functional magnetic resonance imaging (fMRI) to investigate the cerebral activation patterns from laser stimulation of relevant acupoints.
Methodology/Principal Findings: Ten healthy subjects were randomly stimulated with a fibreoptic infrared laser on 4 acupoints (LR14, CV14, LR8 and HT7) used for depression following the principles of Traditional Chinese Medicine (TCM), and 1 control non-acupoint (sham point) in a blocked design (alternating verum laser and placebo laser/rest blocks), while the blood oxygenation level-dependent (BOLD) fMRI response was recorded from the whole brain on a 3T scanner. Many of the acupoint laser stimulation conditions resulted in different patterns of neural activity. Regions with
significantly increased activation included the limbic cortex (cingulate) and the frontal lobe (middle and superior frontal gyrus). Laser acupuncture tended to be associated with ipsilateral brain activation and contralateral deactivation that therefore cannot be simply attributed to somatosensory stimulation.
Conclusions/Significance: We found that laser stimulation of acupoints lead to activation of frontal-limbic-striatal brain regions, with the pattern of neural activity somewhat different for each acupuncture point. This is the first study to investigate laser acupuncture on a group of acupoints useful in the management of depression. Differing activity patterns depending on the acupoint site were demonstrated, suggesting that neurological effects vary with the site of stimulation. The mechanisms of activation and deactivation and their effects on depression warrant further investigation.

Abstract











Chin Med J (Engl). 2011 Apr;124(8):1229-34.
Differential temporal neural responses of pain-related regions by acupuncture at acupoint ST36: a magnetoencephalography study.
Cheng H, Zhang XT, Yan H, Bai LJ, Ai L, Wang FB, You YB, Chen P, Wang BG.
Source
Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Abstract
BACKGROUND:
Previous neuroimaging studies primarily focused on the spatial distribution of acupuncture needling stimulation. However, a salient feature of acupuncture was its long-lasting effect. This study attempted to detect the spatial-temporal neural responses evoked by acupuncture at an analgesia acupoint ST36 by using magnetoencephalography. To further verify its functional specificity, we also adopted acupuncture at Pericardium 6 and nonacupoint as separated controls.
METHODS:
Forty-two college students, all right-handed and acupuncture naïve, participated in this study. Every participant received only one acupoint stimulation, resulting in 14 subjects in one group. Both magnetoencephalography data (151-channel whole-head system) and structural functional magnetic resonance imaging data (3D sequence with a voxel size of 1 mm(3) for anatomical localization) were collected for each subject. All processing procedures were performed in BrainStorm Toolbox.
RESULTS:
Acupuncture at ST36 showed a significantly time-varied brain activities with different onset time. Our results presented that acupuncture at different acupoints (or comparing with nonacupoint) can specifically induce neural responses in different brain areas-acupuncture at ST36 can specifically induce the neural responses of pain-inhibition areas, while acupuncture at PC6 can specifically induce the activities of the insula and amygdala.
CONCLUSIONS:
In the present study, we attempted to detect the temporal neural responses underlying the functional specificity of acupuncture at ST36, using acupoint belonging to different meridians and non-acupoint with efficacy-irreverent as separate controls. The specific neural substrates involving acupuncture at different acupoints may be related to its functional specificity in clinical settings.




Acupunct Med. 2013 Aug 6. doi: 10.1136/acupmed-2012-010297. [Epub ahead of print]
Differential brain effects of laser and needle acupuncture at LR8 using functional MRI.
Quah-Smith I, Williams MA, Lundeberg T, Suo C, Sachdev P.
Source
School of Psychiatry, University of New South Wales and Neuropsychiatric Institute (NPI), Prince of Wales Hospital, , Sydney, New South Wales, Australia.
Abstract
OBJECTIVE:
While needle acupuncture is a well-accepted technique, laser acupuncture is being increasingly used in clinical practice. The differential effects of the two techniques are of interest. We examine this in relation to brain effects of activation of LR8, a putative acupuncture point for depression, using functional MRI (fMRI).
METHODS:
Sixteen healthy participants were randomised to receive low intensity laser acupuncture to LR8 on one side and needle acupuncture to the contralateral LR8. Stimulation was in an on-off block design and brain patterns were recorded under fMRI.
RESULTS:
Significant activation occurred in the left precuneus during laser acupuncture compared with needle acupuncture and significant activation occurred in the left precentral gyrus during needle acupuncture compared with laser acupuncture.
CONCLUSIONS:
Laser and needle acupuncture at LR8 in healthy participants produced different brain patterns. Laser acupuncture activated the precuneus relevant to mood in the posterior default mode network while needle acupuncture activated the parietal cortical region associated with the primary motor cortex. Further investigations are warranted to evaluate the clinical relevance of these effects.




Acupunct Med. 2013 Sep;31(3):282-9. doi: 10.1136/acupmed-2012-010297. Epub 2013 Aug 6.
Differential brain effects of laser and needle acupuncture at LR8 using functional MRI.
Quah-Smith I, Williams MA, Lundeberg T, Suo C, Sachdev P.
Source
School of Psychiatry, University of New South Wales and Neuropsychiatric Institute NPI, Prince of Wales Hospital, Sydney, New South Wales, Australia.
Abstract
OBJECTIVE:
While needle acupuncture is a well-accepted technique, laser acupuncture is being increasingly used in clinical practice. The differential effects of the two techniques are of interest. We examine this in relation to brain effects of activation of LR8, a putative acupuncture point for depression, using functional MRI (fMRI).
METHODS:
Sixteen healthy participants were randomised to receive low intensity laser acupuncture to LR8 on one side and needle acupuncture to the contralateral LR8. Stimulation was in an on-off block design and brain patterns were recorded under fMRI.
RESULTS:
Significant activation occurred in the left precuneus during laser acupuncture compared with needle acupuncture and significant activation occurred in the left precentral gyrus during needle acupuncture compared with laser acupuncture.
CONCLUSIONS:
Laser and needle acupuncture at LR8 in healthy participants produced different brain patterns. Laser acupuncture activated the precuneus relevant to mood in the posterior default mode network while needle acupuncture activated the parietal cortical region associated with the primary motor cortex. Further investigations are warranted to evaluate the clinical relevance of these effects.
PMID: 23920052 [PubMed - in process] PMCID: PMC3786613 Free PMC Article




Forsch Komplementmed. 2014;21(2):99-104. doi: 10.1159/000360804. Epub 2014 Mar 24.
Different Cerebral Responses to Puncturing at ST36 among Patients with Functional Dyspepsia and Healthy Subjects.
Li Z1, Zeng F, Yang Y, Chen Y, Zhang D, Sun J, Qin W, Yang J, Liang F.
Author information


Abstract
Background: Little research has been done on the connection between functional status and acupuncture efficacy; however, functional status is a key factor in the study of acupuncture efficacy. Therefore, we have tried to compare functional dyspepsia (FD) patients with healthy subjects (HS) to determine the different cerebral responses elicited by acupuncture stimulation at Zusanli (ST36). Patients and Methods: In this study, 24 FD patients and 24 HS were given acupuncture stimulation at ST36 while being monitored by an fMRI scan. Results: Compared with HS, FD patients showed an fMRI signal decrease in the right anterior cingulate cortex, right medial prefrontal cortex, right orbitofrontal cortex, left superior occipital gyrus, and right cuneus; but on the other hand, there was an fMRI signal increase in the right insula, right postcentral gyrus, and right supramarginal gyrus. Conclusion: Acupuncture stimulation at ST36 evoked pronounced changes, especially in the homeostatic afferent processing network of FD patients, compared to HS. We hypothesize that the cerebral responses elicited by acupuncture stimulation in certain diseases, such as FD are correlated to specific regions. The action of stimulating acupoints might be dynamic; the functional status is therefore an essential impact factor for cerebral responses to acupuncture stimulation. © 2014 S. Karger GmbH, Freiburg.




Neurol Sci. 2014 May;35 Suppl 1:189-93. doi: 10.1007/s10072-014-1768-7.
Ear acupuncture and fMRI: a pilot study for assessing the specificity of auricular points.
Romoli M1, Allais G, Airola G, Benedetto C, Mana O, Giacobbe M, Pugliese AM, Battistella G, Fornari E.
Author information


Abstract
In recent years research explored different acupuncture stimulation techniques but interest has focused primarily on somatic acupuncture and on a limited number of acupoints. As regards ear Acupuncture (EA) there is still some criticism about the clinical specificity of auricular points/areas representing organs or structures of the body. The aim of this study was to verify through (Functional magnetic resonance imaging) fMRI the hypothesis of EA point specificity using two auricular points having different topographical locations and clinical significance. Six healthy volunteers underwent two experimental fMRI sessions: the first was dedicated to the stimulation of Thumb Auricular Acupoint (TAA) and the second to the stimulation of Brain Stem Auricular Acupoint (BSAA). The stimulation of the needle placed in the TAA of the left ear produced an increase in activation bilaterally in the parietal operculum, region of the secondary somatosensory area SII. Stimulation of the needle placed in the BSAA of the left ear showed a pattern that largely overlapped regions belonging to the pain matrix, as shown to be involved in previous somatic acupuncture studies but with local differences in the left amygdala, anterior cingulate cortex, and cerebellum. The differences in activation patterns between TAA and BSAA stimulation support the specificity of the two acupoints. Moreover, the peculiarity of the regions involved in BSAA stimulation compared to those involved in the pain matrix, is in accordance with the therapeutic indications of this acupoint that include head pain, dizziness and vertigo. Our results provide preliminary evidence on the specificity of two auricular acupoints; further research is warranted by means of fMRI both in healthy volunteers and in patients carrying neurological/psychiatric syndromes.




Neurosci Lett. 2014 Jun 3. pii: S0304-3940(14)00448-0. doi: 10.1016/j.neulet.2014.05.050. [Epub ahead of print]
Acupuncture at HT7 suppresses morphine self-administration at high dose through GABA system.
Lee BH1, Ku JY2, Zhao RJ3, Kim HY4, Yang CH4, Gwak YS4, Chang SC4, Kim NJ2, Kim JS2, Lee YK2, Lee HJ2, Lim SC5.
Author information


Abstract
OBJECTIVES:
In the previous study, acupuncture at HT7 has shown to attenuate the self-administration of morphine at a low dose (0.1mg/kg). In this study, it was further investigated whether acupuncture at HT7 could attenuate the morphine self-administration at a high dose (0.5mg/kg) MATERIALS & METHODS: Male Sprague-Dawley rats weighing 270-300g were used. After surgery of catheterization, animals were trained to self-administer morphine solution (0.5mg/kg) using daily 1h session under fixed ratio 1 schedule for 3 weeks. Animals that had shown stable morphine-taking (establish baseline: variation less than 20% of the mean of three consecutive days) were subjected to the acupuncture treatment. Bicuculline and SCH 50911 were used to investigate the possible relation between the effect of acupuncture and the GABA receptor system.
RESULTS:
Acupuncture at HT7, but not at control acupoint, LI5, suppressed spontaneous morphine-taking behavior significantly. In addition, the effect of acupuncture was blocked by both GABA receptor antagonists.
CONCLUSION:
The results of this study suggest that acupuncture at HT7 suppresses morphine-taking behavior through the mediation of GABA receptor system.
Copyright © 2014. Published by Elsevier Ireland Ltd.
KEYWORDS:
Acupuncture; GABA; HT7; High dose; Morphine; Self-administration




Brain Responses to Acupuncture Are Probably Dependent on the Brain Functional Status
Chuanfu Li,1 Jun Yang,1 Jinbo Sun,2 Chunsheng Xu,1 Yuanqiang Zhu,2 Qi Lu,1 Aihong Yuan,1 Yifang Zhu,1 Luoyi Li,1 Wei Zhang,1 Junping Liu,1 Jianjun Huang,1 Dongxiao Chen,1 Linying Wang,1 Wei Qin,2 and Jie Tian2,3
1Laboratory of Digital Medical Imaging, The First Affiliated Hospital of Anhui University of TCM, Hefei, Anhui 230031, China2Life Sciences Research Center, School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi 710071, China3Key Laboratory of Complex Systems and Intelligence Science, Institute of Automation, Chinese Academy of Sciences, P.O. Box 2728, Beijing 100190, China
Received 31 January 2013; Revised 7 April 2013; Accepted 30 April 2013
Academic Editor: Vitaly Napadow

Copyright © 2013 Chuanfu Li et al. This is an open access article distributed under the

Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In recent years, neuroimaging studies of acupuncture have explored extensive aspects of brain responses to acupuncture in finding its underlying mechanisms. Most of these studies have been performed on healthy adults. Only a few studies have been performed on patients with diseases. Brain responses to acupuncture in patients with the same disease at different pathological stages have not been explored, although it may be more important and helpful in uncovering its underlying mechanisms. In the present study, we used fMRI to compare brain responses to acupuncture in patients with Bell’s palsy at different pathological stages with normal controls and found that the brain response to acupuncture varied at different pathological stages of Bell’s palsy. The brain response to acupuncture decreased in the early stages, increased in the later stages, and nearly returned to normal in the recovered group. All of the changes in the brain response to acupuncture could be explained as resulting from the changes in the brain functional status. Therefore, we proposed that the brain response to acupuncture is dependent on the brain functional status, while further investigation is needed to provide more evidence in support of this proposition.




Cogn Neurodyn.

2014 Oct;8(5):417-28. doi: 10.1007/s11571-014-9297-x. Epub 2014 Jun 3.
WLPVG approach to the analysis of EEG-based functional brain network under manual acupuncture.
Pei X, Wang J, Deng B, Wei X, Yu H.
Author information


Abstract
Functional brain network, one of the main methods for brain functional studies, can provide the connectivity information among brain regions. In this research, EEG-based functional brain network is built and analyzed through a new wavelet limited penetrable visibility graph (WLPVG) approach. This approach first decompose EEG into δ, θ, α, β sub-bands, then extracting nonlinear features from single channel signal, in addition forming a functional brain network for each sub-band. Manual acupuncture (MA) as a stimulation to the human nerve system, may evoke varied modulating effects in brain activities. To investigating whether and how this happens, WLPVG approach is used to analyze the EEGs of 15 healthy subjects with MA at acupoint ST36 on the right leg. It is found that MA can influence the complexity of EEG sub-bands in different ways and lead the functional brain networks to obtain higher efficiency and stronger small-world property compared with pre-acupuncture control state.




J Altern Complement Med. 2014 Nov 12. [Epub ahead of print]
Acupuncture-Related Modulation of Pain-Associated Brain Networks During Electrical Pain Stimulation: A Functional Magnetic Resonance Imaging Study.
Theysohn N1, Choi KE, Gizewski ER, Wen M, Rampp T, Gasser T, Dobos GJ, Forsting M, Musial F.
Author information


Abstract
Abstract Objective: Findings of existing functional MRI (fMRI) studies on the neural mechanisms that mediate effects of acupuncture analgesia are inconsistent. This study analyzes the effects of manual acupuncture on pain ratings and brain activation in response to experimental, electrical pain stimuli. Design: Fourteen healthy volunteers were examined by using a 1.5-T MRI scanner. The intensity of pain stimuli was adjusted to individual pain ratings on a numeric rating scale. Baseline fMRI was performed during electrical pain stimulation in a blocked design. For the second session, manual acupuncture with repeated stimulation was performed on contralateral acupoints-large intestine 4, liver 3, and stomach 36-before imaging. After imaging, subjective pain ratings and ratings of the de qi sensation were assessed. Results: Compared with baseline, volunteers showed modulated brain activity under pain conditions in the cingulate gyrus, insula, primary somatosensory cortex, and prefrontal areas after the acupuncture session. In accordance with the literature, anterior insular and prefrontal activity seemed to be correlated with acupuncture treatment. Conclusion: This study supports the existence of analgesic acupuncture effects that outlast the needling period. Pain-associated brain areas were modulated in direct response to a preceding acupuncture treatment.



Evid Based Complement Alternat Med. 2014;2014:103491. doi: 10.1155/2014/103491. Epub 2014 Nov 26.
An FMRI study of neuronal specificity in acupuncture: the multiacupoint siguan and its sham point.
Shan Y1, Wang ZQ1, Zhao ZL1, Zhang M1, Hao SL2, Xu JY2, Shan BC3, Lu J1, Li KC1.
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Abstract
Clarifying the intrinsic mechanisms of acupuncture's clinical effects has recently been gaining popularity. Here, we choose the Siguan acupoint (a combination of bilateral LI4 and Liv3) and its sham point to evaluate multiacupoint specificity. Thirty-one healthy volunteers were randomly divided into real acupoint (21 subjects) and sham acupoint (10 subjects) groups. Our study used a single block experimental design to avoid the influence of posteffects. Functional magnetic resonance imaging data were acquired during acupuncture stimulation. Results showed extensive increase in neuronal activities with Siguan acupuncture and significant differences between stimulation at real and sham points. Brain regions that were activated more by real acupuncture stimulation than by sham point acupuncture included somatosensory cortex (the superior parietal lobule and postcentral gyrus), limbic-paralimbic system (the calcarine gyrus, precuneus, cingulate cortex, and parahippocampal gyrus), visual-related cortex (the fusiform and occipital gyri), basal ganglia, and the cerebellum. In this way, our study suggests Siguan may elicit specific activities in human brain.



Biomed Res Int. 2015;2015:183074. doi: 10.1155/2015/183074. Epub 2015 Jan 1.
Gender differences in cerebral regional homogeneity of adult healthy volunteers: a resting-state FMRI study.
Xu C1, Li C1, Wu H2, Wu Y3, Hu S4, Zhu Y5, Zhang W6, Wang L3, Zhu S7, Liu J5, Zhang Q8, Yang J9, Zhang X10.
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Abstract
Objective. We sought to use the regional homogeneity (ReHo) approach as an index in the resting-state functional MRI to investigate the gender differences of spontaneous brain activity within cerebral cortex and resting-state networks (RSNs) in young adult healthy volunteers. Methods. One hundred and twelve healthy volunteers (56 males, 56 females) participated in the resting-state fMRI scan. The ReHo mappings in the cerebral cortex and twelve RSNs of the male and female groups were compared. Results. We found statistically significant gender differences in the primary visual network (PVN) (P < 0.004, with Bonferroni correction) and left attention network (LAtN), default mode network (DMN), sensorimotor network (SMN), executive network (EN), and dorsal medial prefrontal network (DMPFC) as well (P < 0.05, uncorrected). The male group showed higher ReHo in the left precuneus, while the female group showed higher ReHo in the right middle cingulate gyrus, fusiform gyrus, left inferior parietal lobule, precentral gyrus, supramarginal gyrus, and postcentral gyrus. Conclusions. Our results suggested that men and women had regional specific differences during the resting-state. The findings may improve our understanding of the gender differences in behavior and cognition from the perspective of resting-state brain function.



Evid Based Complement Alternat Med. 2014;2014:103491. doi: 10.1155/2014/103491. Epub 2014 Nov 26.
An FMRI study of neuronal specificity in acupuncture: the multiacupoint siguan and its sham point.
Shan Y1, Wang ZQ1, Zhao ZL1, Zhang M1, Hao SL2, Xu JY2, Shan BC3, Lu J1, Li KC1.
Author information


Abstract
Clarifying the intrinsic mechanisms of acupuncture's clinical effects has recently been gaining popularity. Here, we choose the Siguan acupoint (a combination of bilateral LI4 and Liv3) and its sham point to evaluate multiacupoint specificity. Thirty-one healthy volunteers were randomly divided into real acupoint (21 subjects) and sham acupoint (10 subjects) groups. Our study used a single block experimental design to avoid the influence of posteffects. Functional magnetic resonance imaging data were acquired during acupuncture stimulation. Results showed extensive increase in neuronal activities with Siguan acupuncture and significant differences between stimulation at real and sham points. Brain regions that were activated more by real acupuncture stimulation than by sham point acupuncture included somatosensory cortex (the superior parietal lobule and postcentral gyrus), limbic-paralimbic system (the calcarine gyrus, precuneus, cingulate cortex, and parahippocampal gyrus), visual-related cortex (the fusiform and occipital gyri), basal ganglia, and the cerebellum. In this way, our study suggests Siguan may elicit specific activities in human brain.


Intern Med J. 2015 Jun;45(6):669-71. doi: 10.1111/imj.12767.
Using functional magnetic resonance imaging to explore the possible mechanism of the action of acupuncture at Dazhong (KI 4) on the functional cerebral regions of healthy volunteers.
Zhang Q1,2, Li A3, Yue J4,2, Zhang F5, Sun Z4, Li X5.
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Abstract
Acupuncture at right Dazhong (KI 4) mostly affects functional magnetic resonance imaging signal in the right inferior frontal gyrus, right insular lobe, right thalamus, right middle frontal gyrus and right orbitofrontal cortex, which are associated with governing executive functions, emotional activities and social behaviour.
© 2015 Royal Australasian College of Physicians.



BMC Complement Altern Med. 2015 Oct 14;15(1):361. doi: 10.1186/s12906-015-0881-3.
Acupuncture at KI3 in healthy volunteers induces specific cortical functional activity: an fMRI study.
Zhu B1, Wang Y2, Zhang G3, Ouyang H4, Zhang J5, Zheng Y6, Zhang S7, Wu C8, Qu S9, Chen J10, Huang Y11, Tang C12.
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Abstract
BACKGROUND:
Using functional magnetic resonance imaging (fMRI), we determined brain regions that were activated/deactivated more by acupuncture at Taixi (KI3) than by non-acupoint or sham acupuncture.
METHODS:
A total of 30 healthy volunteers were randomly divided into a KI3 group (15 subjects) and non-acupoint group (15 subjects). Subjects in KI3 group received a sham acupuncture and then a real acupuncture, fMRI was performed before and after sham acupuncture as well as after ture acupuncture. Subjects in non-acupoint group received a ture acupuncture and the fMRI was performed before and after ture acupuncture. The fMRI data obtained were successively analyzed using DPARSF2.3 and REST1.8 software, yielding regional homogeneity (ReHo) and amplitude of low frequency fluctuations (ALFF) values.
RESULTS:
Compared with sham acupuncture, ALFF values were higher in Brodmann area (BA) 10 and lower in BA7 and BA18. ReHo values after real acupuncture at KI3 were higher in the right sub-lobar region and BA10 and were lower in BA31. Compared with the changes before and after real acupuncture at non-acupoint, the changes at KI3 showed higher ALFF valued in the left cerebellum posterior lobe, BA10, BA39, BA31 and decreased ALFF was observed in the BA18, BA19 and BA40; and higher ReHo values were shown in left cerebellum posterior lobe pyramis, left cerebellum anterior lobe. BA37, BA10, BA39, BA31 and lower ReHo values were shown in BA18 and BA31.
CONCLUSION:
Acupuncture at KI3 has a specific effect on certain brain regions associated with perception, body movement, spirit, and association. Additionally, visual and auditory cortices were affected, which may be related to the clinical applications of KI3 acupuncture in auditory and cognitive disorders, hypomnesis, loss of concentration, and the loss of ability to work and learn.
TRIAL REGISTRATION:
The research ethics committee was achieved at 01/08/2012, the NO. was ChiECRCT-2012011. Website for Clinical Trial Registration: http://www.chictr.org.cn/showproj.aspx?proj=7123 . This study was registered at www.chictr.org, the Clinical Trial Registration Number was ChiCTR-TRC-12002427, and the registration number was achieved at 18/08/2012. The name of IRB that provided approval for the study and clearly state is Chinese Clinical Trail Registry.



Mol Pain. 2015 Oct 29;11(1):67. doi: 10.1186/s12990-015-0071-9.
The modulation effect of longitudinal acupuncture on resting state functional connectivity in knee osteoarthritis patients.
Chen X1, Spaeth RB2, Freeman SG3, Scarborough DM4, Hashmi JA5, Wey HY6, Egorova N7, Vangel M8,9, Mao J10, Wasan AD11, Edwards RR12, Gollub RL13,14, Kong J15,16.
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Abstract
Recent advances in brain imaging have contributed to our understanding of the neural activity associated with acupuncture treatment. In this study, we investigated functional connectivity across longitudinal acupuncture treatments in older patients with knee osteoarthritis (OA). Over a period of 4 weeks (six treatments), we collected resting state functional magnetic resonance imaging (fMRI) scans from 30 patients before and after their first, third and sixth treatments. Clinical outcome showed a significantly greater pain subscore on the Knee Injury and Osteoarthritis Outcome Score (KOOS) (indicative of improvement) with verum acupuncture than with sham acupuncture. Independent component analysis (ICA) of the resting state fMRI data showed that the right frontoparietal network (rFPN) and the executive control network (ECN) showed enhanced functional connectivity (FC) with the rostral anterior cingulate cortex/medial prefrontal cortex, a key region in the descending pain modulatory system, in the verum groups as compared to the sham group after treatments. We also found that the rFPN connectivity with the left insula is (1) significantly associated with changes in KOOS pain score after treatments, and (2) significantly enhanced after verum acupuncture treatments as compared to sham treatment. Analysis of the acupuncture needle stimulation scan showed that compared with sham treatment, verum acupuncture activated the left operculum/insula, which also overlaps with findings observed in resting state analysis. Our results suggest that acupuncture may achieve its therapeutic effect on knee OA pain by modulating functional connectivity between the rFPN, ECN and the descending pain modulatory pathway.


J Acupunct Meridian Stud. 2016 Feb;9(1):22-5. doi: 10.1016/j.jams.2015.11.035. Epub 2015 Nov 27.
Waiguan Stimulation May Kindle Anticorrelated Brain Networks: Functional Magnetic Resonance Imaging Data Revisited.
Wik G1, Huang Y2, Zeng T3, Qu S2, Zheng Y2, Zhang J2, Lai X4, Tang C5, Shan B6.
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Abstract
Subtraction of functional magnetic resonance imaging activity data results in a loss of information regarding possible general patterns of brain activation under experimental conditions. We, hence, reanalyzed previous Waiguan acupuncture data to qualitatively elucidate patterns of cerebral correlations to acupuncture and placebo conditions. Healthy individuals (n=24) were randomly allocated to true and sham Waiguan acupuncture and to true and sham needling of a nonacupuncture point (nonacupoint), and functional magnetic resonance imaging scans were performed during stimulation. Statistical parametric mapping group comparisons revealed clearly different patterns of activation between Waiguan stimulation and the corresponding stimulation of a nonacupoint. The former condition produced less neocortical activation than the nonacupoint stimulation. Cerebellar activation was typically seen only during true Waiguan acupuncture. The reduced neocortical activity during both true and sham Waiguan acupuncture may indicate that this point activates anticorrelated networks, with possible intrinsic healing properties. Cerebellar activation during true Waiguan acupuncture implies the region's influence on healing networks.


J Acupunct Meridian Stud. 2016 Feb;9(1):4-10. doi: 10.1016/j.jams.2015.05.007. Epub 2015 Jun 4.
Hypothalamic Norepinephrine Mediates Acupunctural Effects on Hypothalamic-Pituitary-Adrenal Axis During Ethanol Withdrawal.
Zhao ZL1, Kim SC2, Zhang J1, Liu HF1, Lee BH2, Jang EY2, Lee CW2, Cho IJ2, An WG3, Yang CH2, Kim YW2, Zhao RJ4, Wu YY5.
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Abstract
A previous study demonstrated that acupuncture at ST36 (Zu-San-Li) attenuates ethanol withdrawal (EW)-induced hyperactivation of the hypothalamic-pituitary-adrenal axis in rats. The current study investigated the involvement of hypothalamic norepinephrine (NE) in that process. Rats were intraperitoneally treated with 3 g/kg/d of ethanol or saline for 28 days. After 24 hours of EW, acupuncture was applied to rats at bilateral ST36 points or at nonacupoints (tail) for 1 minute. A high-performance liquid chromatography analysis showed that EW significantly increased both the NE and the 3-methoxy-4-hydroxy-phenylglycol (MHPG) levels in the hypothalamic paraventricular nucleus (PVN). Western blot analysis also revealed that EW markedly elevated the phosphorylation rates of tyrosine hydroxylase (TH), but spared TH protein expression in the PVN. However, acupuncture at ST36, but not at nonacupoints, greatly inhibited the increase in the hypothalamic NE, MHPG, and phosphorylation rates of TH. Additionally, postacupuncture infusion of NE into the PVN significantly attenuated the inhibitory effects of acupuncture at ST36 on the oversecretion of plasma corticosterone during EW. These results suggest that acupuncture at ST36 inhibits EW-induced hyperactivation of the hypothalamic NEergic system to produce therapeutic effects on the hypothalamic-pituitary-adrenal axis.


Acupunct Med doi:10.1136/acupmed-2015-011025
Original paper
Gender differences in the neural response to acupuncture: clinical implications
+
Author Affiliations
  • College of Korean Medicine, Sang Ji University, Wonju, Republic of Korea
    1
  • Department of Meridian & Acupoint, College of Korean Medicine, WHO Collaborating Center for Traditional Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Republic of Korea
    2
  • Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, USA
    3
  • Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
    4
  • Research Group of Pain and Neuroscience, Kyung Hee University, Seoul, Republic of Korea
    5
  • Professor Sabina Lim, Department of Meridian & Acupoint, College of Korean Medicine, WHO Collaborating Center for Traditional Medicine, East-West Medical Research Institute, Kyung Hee University, #47 Gyeonghuidae-Gil, Dongdaemun-Gu, Seoul 130-701, Republic of Korea; lims@khu.ac.kr Professor Sujung Yeo, Department of Meridian & Acupoint, College of Korean Medicine, Sang Ji University, #83 Sangjidae-Gil, Wonju 220-702, Gangwon-Do, Republic of Korea; pinkteeth@hanmail.net
    Correspondence to
  • 22 April 2016
    Accepted
  • 18 May 2016
    Published Online First
Abstract
Objective To examine gender differences and similarities in the psychophysical and brain responses to acupuncture at GB34, a point that is frequently used to treat motor function issues in Traditional Chinese Medicine.
Methods Functional MRI (fMRI) was used to measure brain activation in response to acupuncture at GB34 (on the right) in 19 healthy participants (9 male, 10 female). De qi sensations were rated to measure their psychophysical responses.
Results Overall de qi scores did not differ by gender, although females reported greater intensity of aching (p=0.04). Acupuncture activated the hippocampus, thalamus, globus pallidus, caudate body, claustrum, cingulate gyrus, and culmen in males, and the middle and inferior frontal gyrus, precuneus, postcentral gyrus, inferior parietal lobule, superior temporal gyrus, caudate body, insula, fusiform gyrus, cingulate gyrus, amygdala, and parahippocampal gyrus in females. The middle/medial frontal gyrus, middle temporal gyrus, thalamus, globus pallidus, caudate body, uvula, and cerebellar tonsil were activated when data from all subjects were combined. Relative to males, females exhibited greater brain activation in the right-sided postcentral gyrus, precentral gyrus, precuneus, postcentral gyrus, inferior parietal lobule, declive, middle occipital gyrus and parahippocampal gyrus.
Conclusions The neural effects of GB34 acupuncture might differ between males and females because different brain structures were modulated in response to acupuncture. This potential gender effect should be taken into account in future clinical research. We also revealed that the caudate body was activated by GB34 acupuncture in both males and females and may represent a major target of GB34 acupuncture.


Front Hum Neurosci. 2016 May 17;10:230. doi: 10.3389/fnhum.2016.00230. eCollection 2016.
Modulation of the Default Mode Network in First-Episode, Drug-Naïve Major Depressive Disorder via Acupuncture at Baihui (GV20) Acupoint.
Deng D1, Liao H1, Duan G1, Liu Y2, He Q3, Liu H4, Tang L4, Pang Y4, Tao J4.
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Abstract
BACKGROUND:
Previous neuroimaging studies have revealed that acupuncture modulates the default mode network (DMN) in healthy subjects and patients with certain disorder. However, few studies have been performed to investigate whether or not acupuncture might modulate the DMN in patients with major depressive disorder (MDD). Thereby, the aim of the present study was to assess alterations of the DMN induced by acupuncture stimulation in patients with first-episode, drug-naïve MDD.
MATERIALS AND METHODS:
Twenty nine patients with first-episode, drug-naïve MDD and 29 healthy subjects were enrolled in this study. All the healthy subjects underwent 6-min resting-state functional magnetic resonance imaging (R-fMRI) scan. While patients underwent acupuncture stimulation for 20-min electro-acupuncture stimulation (EAS) at Baihui acupoint (GV20) and two 6-min R-fMRI scans before and after EAS. Based on the precuneus/posterior cingulate cortex (PC/PCC) as the seed region, functional connectivity (FC) method was adopted to examine abnormal DMN in patients by comparing with healthy subjects and to evaluate the influence of EAS on intrinsic connectivity within the DMN in patients with MDD.
RESULTS:
Compared to healthy subjects, MDD patients had abnormal DMN. Moreover, results showed that EAS at GV20 induced increased FC between the PC/PCC and bilateral anterior cingulate cortex (ACC), and decreased FC between the PC/PCC and left middle prefrontal cortex, left angualr gyrus and bilateral hippocampus/parahippocampus (HIPP/paraHIPP) in patients with MDD, which were the main brain regions showing significant differences between the patients and healthy subjects.
CONCLUSION:
Our findings provide imaging evidence to support that GV20-related acupuncture stimulation may modulate the DMN in patients with first-episode, drug-naïve MDD. This study may partly interpret the neural mechanisms of acupuncture at GV20 which is used to treat patients with MDD in clinical.



J Altern Complement Med. 2016 Jul 20. [Epub ahead of print]
Changes in Regional Brain Homogeneity Induced by Electro-Acupuncture Stimulation at the Baihui Acupoint in Healthy Subjects: A Functional Magnetic Resonance Imaging Study.
Deng D1, Duan G1, Liao H1, Liu Y2, Wang G2, Liu H3, Tang L3, Pang Y3, Tao J3, He X1, Yuan W1, Liu P2.
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Abstract
INTRODUCTION:
According to the Traditional Chinese Medicine theory of acupuncture, Baihui (GV20) is applied to treat neurological and psychiatric disorders. However, the relationships between neural responses and GV20 remain unknown. Thus, the main aim of this study was to examine the brain responses induced by electro-acupuncture stimulation (EAS) at GV20.
MATERIALS AND METHODS:
Functional magnetic resonance imaging (fMRI) was performed in 33 healthy subjects. Based on the non-repeated event-related (NRER) paradigm, group differences were examined between GV20 and a sham acupoint using the regional homogeneity (ReHo) method.
RESULTS:
Compared with the sham acupoint, EAS at GV20 induced increased ReHo in regions including the orbital frontal cortex (OFC), middle cingulate cortex (MCC), precentral cortex, and precuneus (preCUN). Decreased ReHo was found in the anterior cingulate cortex (ACC), supplementary motor area (SMA), thalamus, putamen, and cerebellum.
CONCLUSIONS:
The current findings provide preliminary neuroimaging evidence to indicate that EAS at GV20 could induce a specific pattern of neural responses by analysis of ReHo of brain activity. These findings might improve the understanding of mechanisms of acupuncture stimulation at GV20.


J Altern Complement Med. 2016 Aug 22. [Epub ahead of print]
Evidence of a Synergistic Effect of Acupoint Combination: A Resting-State Functional Magnetic Resonance Imaging Study.
Zhang J1, Zheng Y1, Wang Y1, Qu S1, Zhang S1, Wu C1, Chen J2, Ouyang H3, Tang C4, Huang Y1.
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Abstract
OBJECTIVE:
This study aimed to find evidence of a synergistic effect of acupoint combinations by analyzing different brain regions activated after acupuncture at different acupoint combinations.
METHODS:
A total of 57 healthy subjects were randomly distributed into three groups: LR3 plus KI3 acupoints, LR3 plus sham acupoint, or LR3 alone. They underwent a magnetic resonance imaging scan before and after acupuncture. The amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) values of different brain regions were analyzed to observe changes in brain function.
RESULTS:
ALFF and ReHo produced an activated area in the cerebellum posterior lobe after acupuncture at LR3 plus KI3 acupoints versus LR3 alone. ALFF and ReHo revealed altered activity in Brodmann area 10 (BA10), BA18, and brainstem pons after acupuncture at LR3 plus sham acupoint compared with at LR3 alone. A comparison of acupuncture at LR3 plus KI3 acupoints with LR3 plus sham acupoint demonstrated an increase in BA6 of ALFF and a downregulation of ReHo.
CONCLUSIONS:
The increased number of brain regions with altered brain activity after acupuncture at acupoint combinations versus a single acupoint are evidence of the synergistic effect of acupoint combinations. BA6 was significantly activated after acupuncture at LR3 plus KI3 acupoints compared with at LR3 plus sham acupoint, suggesting that BA6 is the specific region of synergistic effect of acupoint combinations of LR3 plus KI3 acupoints. Affected brain regions were different between acupuncture at LR3 plus sham acupoint and LR3 alone, which indicates that the sham acupoint may have some psychological effect. However, the specific mechanism of acupoint combinations requires further research.



Sci Rep. 2016 Nov 18;6:36636. doi: 10.1038/srep36636.
Different brain responses to electro-acupuncture and moxibustion treatment in patients with Crohn's disease.
Bao C1, Liu P2, Liu H3, Jin X4, Calhoun VD5,6, Wu L1, Shi Y3, Zhang J7, Zeng X8, Ma L9, Qin W2, Zhang J1, Liu X2, Tian J2, Wu H1.
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Abstract
This study aimed to investigate changes in resting state brain activity in remissive Crohn's Disease (CD) patients after electro-acupuncture or moxibustion treatment. Fifty-two CD patients and 36 healthy subjects were enrolled, and 36 patients were equally and randomly assigned to receive either electro-acupuncture or moxibustion treatment for twelve weeks. We used resting state functional magnetic resonance imaging to assess Regional Homogeneity (ReHo) levels, and Crohn's Disease Activity Index (CDAI) and Inflammatory Bowel Disease Questionnaire (IBDQ) scores to evaluate disease severity and quality of life. The results show that (i) The ReHo levels in CD patients were significantly increased in cortical but decreased in subcortical areas, and the coupling between them was declined. (ii) Both treatments decreased CDAI, increased IBDQ scores, and normalized the ReHo values of the cortical and subcortical regions. (iii) ReHo changes in multiple cortical regions were significantly correlated with CDAI score decreases. ReHo changes in several subcortical regions in the electro-acupuncture group, and those of several cortical regions in the moxibustion group, were correlated with reduced CDAI. These findings suggest that both treatments improved cortex-subcortical coupling in remissive CD patients, but electro-acupuncture regulated homeostatic afferent processing network, while moxibustion mainly regulated the default mode network of the brain.