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.
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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.

J Altern Complement 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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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.

Am J Alzheimers Dis Other Demen. 2014 Dec;29(8):739-48. doi: 10.1177/1533317514536600. Epub 2014 Jun 6.
Acupuncture stimulation of Taichong (Liv3) and Hegu (LI4) modulates the default mode network activity in Alzheimer's disease.
Liang P1, Wang Z2, Qian T3, Li K4.
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The acupuncture has been used in the therapy of Alzheimer disease (AD), however, its neural underpins are still unclear. The aim of this study is to examine the acupuncture effect on the default mode network (DMN) in AD by using resting state functional magnetic resonance imaging (RS-fMRI).
Twenty-eight subjects (14 AD and 14 normal controls (NC)) participated in this study. RS-fMRI data were acquired before and after acupuncture, while during the acupuncture, the procession of acupuncture stimulation on the acupoints of Tai chong (Liv3) and Hegu (LI4) lasted for 3 minutes.
Region of interest analysis showed that the impaired DMN connectivity in AD (identified by comparing the pre-acupuncture RS-fMRI of AD and NC), specifically the left cingulate gyrus (CG) and right inferior parietal lobule (IPL), were significantly changed for the better. The whole-brain exploratory analysis further demonstrated these results and found some new regions respond to the acupuncture effect on AD, with a cluster in the left posterior cingulate cortex (PCC), the right middle temporal gyrus (MTG) together with right IPL showed increased within-DMN connectivity; and the bilateral CG and left PCu showed decreased within-DMN connectivity. Moreover, the acupuncture effect on the right MTG was significantly correlated with disease severity as measured by Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores.
It was found that the acupuncture stimulation could modulate the DMN activity in AD. The current findings suggest that the acupuncture treatment on the relative earlier AD patients might have a better therapy effect.

PLoS One. 2012;7(8):e42730. doi: 10.1371/journal.pone.0042730. Epub 2012 Aug 20.
Effect of acupuncture in mild cognitive impairment and Alzheimer disease: a functional MRI study.
Wang Z1, Nie B, Li D, Zhao Z, Han Y, Song H, Xu J, Shan B, Lu J, Li K.
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We aim to clarify the mechanisms of acupuncture in treating mild cognitive impairment (MCI) and Alzheimer disease (AD) by using functional magnetic resonance imaging (fMRI). Thirty-six right-handed subjects (8 MCI patients, 14 AD patients, and 14 healthy elders) participated in this study. Clinical and neuropsychological examinations were performed on all the subjects. MRI data acquisition was performed on a SIEMENS verio 3-Tesla scanner. The fMRI study used a single block experimental design. We first acquired the baseline resting state data in the initial 3 minutes; we then acquired the fMRI data during the procession of acupuncture stimulation on the acupoints of Tai chong and Hegu for the following 3 minutes. Last, we acquired fMRI data for another 10 minutes after the needle was withdrawn. The preprocessing and data analysis were performed using the statistical parametric mapping (SPM8) software. Then the two-sample t-tests were performed between each two groups of different states. We found that during the resting state, brain activities in AD and MCI patients were different from those of control subjects. During the acupuncture and the second resting state after acupuncture, when comparing to resting state, there are several regions showing increased or decreased activities in MCI, AD subjects compared to normal subjects. Most of the regions were involved in the temporal lobe and the frontal lobe, which were closely related to the memory and cognition. In conclusion, we investigated the effect of acupuncture in AD and MCI patients by combing fMRI and traditional acupuncture. Our fMRI study confirmed that acupuncture at Tai chong (Liv3) and He gu (LI4) can activate certain cognitive-related regions in AD and MCI patients.

Evid Based Complement Alternat Med.