Evid Based Complement Alternat Med. 2013;2013:329392. doi: 10.1155/2013/329392. Epub 2013 May 30.
Factors contributing to de qi in acupuncture randomized clinical trials.
Yang Y, Wang LP, Zhang L, Wang LC, Wei J, Li JJ, Sun YL.







Acupuncture de qi in stable somatosensory stroke patients: relations with effective brain network for motor recovery.
Bai L, Cui F, Zou Y, Lao L.




Evid Based Complement Alternat Med. 2013;2013:197238. doi: 10.1155/2013/197238. Epub 2013 Jun 2.
Evid Based Complement Alternat Med. 2014;2014:987365. doi: 10.1155/2014/987365. Epub 2014 Jan 16.
Local Anesthesia at ST36 to Reveal Responding Brain Areas to deqi.







BMC Complement Altern Med. 2014 Feb 21;14(1):69. [Epub ahead of print]
Effect of acupuncture on Deqi traits and pain intensity in primary dysmenorrhea: analysis of data from a larger randomized controlled trial.




Evid Based Complement Alternat Med. 2014;2014:595963. doi: 10.1155/2014/595963. Epub 2014 Feb 10.
The Effect of Acupuncture to SP6 on Skin Temperature Changes of SP6 and SP10: An Observation of "Deqi".
Yang JM, Shen XY, Zhang L, Shen SX, Qi DD, Zhu SP, Luo L, Ren XX, Ji B, Zhang LF, Li XH, Zhu J.
Author information




Complement Ther Med. 2014 Aug;22(4):592-600. doi: 10.1016/j.ctim.2014.05.010. Epub 2014 Jun 4.
Pulsed application of focused ultrasound to the LI4 elicits deqi sensations: Pilot study.
Yoo SS1, Lee W2, Kim H3.




Acupunct Med. 2013 Jun;31(2):143-50. doi: 10.1136/acupmed-2012-010280. Epub 2013 Mar 30.
Physiological changes associated with de qi during electroacupuncture to LI4 and LI11: a randomised, placebo-controlled trial.
Yu DT1, Jones AY.
Author information




J Altern Complement Med. 2014 Nov 25. [Epub ahead of print]
Historical and Clinical Perspectives on De Qi: Exposing Limitations in the Scientific Study of De Qi.
Birch S.




Evid Based Complement Alternat Med. 2014;2014:715351. Epub 2014 Nov 12.
Effect of "Deqi" during the Study of Needling "Wang's Jiaji" Acupoints Treating Spasticity after Stroke.
Li H1, Liu H1, Liu C1, Shi G1, Zhou W2, Zhao C3, Zhang T1, Wang X1, Wang G1, Zhao Y1, Sun J1, Wang J1, Wang L1.
Author information



Zhongguo Zhen Jiu. 2015 Jan;35(1):67-71.
[Primary discussion of qualitative and quantitative recognition on deqi after acupuncture: a study report of West China School of Medicine].

Evid Based Complement Alternat Med. 2015;2015:684708. doi: 10.1155/2015/684708. Epub 2015 Apr 15.
A survey of the practice and perspectives of chinese acupuncturists on deqi.
Ren YL1, Guo TP1, Du HB1, Zheng HB2, Ma TT2, Fang L3, Gao YJ4, Yang XG5, Li XZ6, Shi J7, Chen L1, Liu YW1, Zhang RW1, Zheng H1, Li DH1, Wu X1, Liang FR1.


J Acupunct Meridian Stud. 2015 Aug;8(4):203-8. doi: 10.1016/j.jams.2014.11.009. Epub 2014 Dec 16.
Perception of Therapeutic Qi, a Nonmechanical, Nonpsychological Factor in Acupuncture That Originates from the Therapist.
Hochstrasser RJ1, Endler PC2, Klein SD3.



Complement Ther Med. 2016 Apr;25:71-7. doi: 10.1016/j.ctim.2016.01.004. Epub 2016 Jan 14.
A study of the brain functional network of Deqi via acupuncturing stimulation at BL40 by rs-fMRI.
Shi Y1, Zhang S1, Li Q2, Liu Z1, Guo S1, Yang J3, Wu W4.
Author information







Complement Ther Med.
2013 Jun;21(3):207-14. doi: 10.1016/j.ctim.2012.12.009. Epub 2013 Feb 21.
Does the effect of acupuncture depend on needling sensation and manipulation?
Choi YJ, Lee JE, Moon WK, Cho SH.
Source
Department of Neuropsychiatry, College of Korean Medicine, Kyung-Hee University, Seoul, Republic of Korea.
Abstract
BACKGROUND:
Acupuncture sensation and manipulation have been considered to be an important component of acupuncture in traditional Asian medicine. However, there has been limited research as to whether acupuncture sensation is associated with therapeutic benefit. This study investigated the relationship between acupuncture sensation and analgesic effect according to acupuncture manipulation.
METHOD:
Fifty-three healthy volunteers received three different forms of acupuncture in a single-blinded crossover design: superficial needling (0.3cm), deep needling (2cm) and needling with bi-directional rotation. The effects of acupuncture were evaluated by using the pressure pain threshold. Acupuncture sensation measurement was done in two ways.
RESULTS:
Both total acupuncture sensation and increase of the pressure pain threshold were maximum in needling with rotation, followed by deep needling and superficial needling. Repeated-measure analysis of variance (ANOVA) analysis was carried out to assess whether there was a significant difference; both showed significant difference (p=0.000, 0.003). A paired sample t-test was carried out, which revealed that needling with rotation showed significant difference from both superficial needling and deep needling. Further, the correlation between the total acupuncture sensation and changes in pressure pain threshold were calculated using Pearson correlation; there was a significant correlation (p=0.002, p=0.013).
CONCLUSION:
Acupuncture sensation and pressure pain threshold increase according to the depth and rotation of acupuncture. Especially, both display significant increase with needle rotation. Further, there is a significant correlation between acupuncture needling sensation and increase in pressure pain threshold. It seems that needle rotation and acupuncture sensation play an important role in verifying the effect of acupuncture.
Copyright © 2013 Elsevier Ltd. All rights reserved.






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.
Abstract
BACKGROUND:
De qi is a sensory response elicited by acupuncture stimulation. According to traditional Chinese medicine (TCM), de qi is essential for clinical efficacy. However, the understanding of the neurobiological basis of de qi is still limited.
OBJECTIVE:
To investigate the relationship between brain activation and de qi by taking a single-photon emission computed tomography (SPECT) scan while applying acupuncture at TE5.
METHODS:
A total of 24 volunteers were randomly divided into 4 groups, and received verum or sham acupuncture at true acupuncture point TE5 or a nearby sham point according to grouping. All subjects then received a (99m)Tc-ethylcysteinate dimer (ECD) SPECT scan.
RESULTS:
All six subjects in the verum acupuncture at true acupuncture point group experienced de qi sensation; in contrast, all six subjects in the sham acupuncture at the sham point group responded with nothing other than non-sensation. Compared to the scan results from subjects who experienced non-sensation, SPECT scans from subjects with de qi sensation demonstrated significant activated points mainly located in brodmann areas 6, 8, 19, 21, 28, 33, 35, 37, 47, the parahippocampal gyrus, lentiform nucleus, claustrum and red nucleus; deactivated points were seen in brodmann areas 9 and 25.
CONCLUSIONS:
Verum acupuncture at true acupuncture points is more likely to elicit de qi sensation. De qi sensations mainly resulted in brain area activations, but not deactivations. These brain areas are related to the curative effect of Te5. The acupuncture needle sensations of de qi and sharp pain are associated with different patterns of activations and deactivations in the brain.




Evid Based Complement Alternat Med. 2013;2013:518784. Epub 2013 Sep 8.
Acupuncture De-qi: From Characterization to Underlying Mechanism.
Zhu SP, Luo L, Zhang L, Shen SX, Ren XX, Guo MW, Yang JM, Shen XY, Xu YS, Ji B, Zhu J, Li XH, Zhang LF.
Source
School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China.
Abstract
De-qi refers to the participant's subjective sensations and objective body responses as well as the acupuncturist's perceptions while the acupuncturist needles certain acupoints in the participant's body. In recent years, De-qi is getting increasing attention of the researchers and many efforts have been made to understand its mechanism. By the broad literature survey, this paper explores the subjective De-qi sensation of the patients, its influencing factors, and the resulting physiological responses. The purpose of this paper is expected to find out a possible mechanism of De-qi and to provide certain scientific evidence for acupuncture fundamental research and clinical practice.




Evid Based Complement Alternat Med. 2014;2014:987365. doi: 10.1155/2014/987365. Epub 2014 Jan 16.
Local Anesthesia at ST36 to Reveal Responding Brain Areas to deqi.
Jin LM1, Qin CJ2, Lan L2, Sun JB1, Zeng F2, Zhu YQ1, Yu SG2, Yin HY2, Tang Y2.
Author information


Abstract
Background. Development of non-deqi control is still a challenge. This study aims to set up a potential approach to non-deqi control by using lidocaine anesthesia at ST36. Methods. Forty healthy volunteers were recruited and they received two fMRI scans. One was accompanied with manual acupuncture at ST36 (DQ group), and another was associated with both local anesthesia and manual acupuncture at the same acupoint (LA group). Results. Comparing to DQ group, more than 90 percent deqi sensations were reduced by local anesthesia in LA group. The mainly activated regions in DQ group were bilateral IFG, S1, primary motor cortex, IPL, thalamus, insula, claustrum, cingulate gyrus, putamen, superior temporal gyrus, and cerebellum. Surprisingly only cerebellum showed significant activation in LA group. Compared to the two groups, bilateral S1, insula, ipsilateral IFG, IPL, claustrum, and contralateral ACC were remarkably activated. Conclusions. Local anesthesia at ST36 is able to block most of the deqi feelings and inhibit brain responses to deqi, which would be developed into a potential approach for non-deqi control. Bilateral S1, insula, ipsilateral IFG, IPL, claustrum, and contralateral ACC might be the key brain regions responding to deqi.




BMC Complement Altern Med. 2014 Feb 21;14(1):69. [Epub ahead of print]
Effect of acupuncture on Deqi traits and pain intensity in primary dysmenorrhea: analysis of data from a larger randomized controlled trial.
Shi GX, Li QQ, Liu CZ, Zhu J, Wang LP, Wang J, Han LL, Guan LP, Wu MM.
Abstract
BACKGROUND:
Deqi is a central concept in traditional Chinese acupuncture. We performed a secondary analysis on data from a larger randomized controlled trial (RCT) in order to assess the effect of acupuncture on deqi traits and pain intensity in primary dysmenorrhea.
METHODS:
A total of 60 primary dysmenorrhea patients were enrolled and randomly assigned to one of three treatment groups. Acupuncture was given at SP6, GB39 or nonacupoint. Subjective pain was measured by a 100-mm visual analogue scale (VAS) before and after acupuncture. The Massachusetts General Hospital acupuncture sensation scales (MASS) with minor modification was used to rate deqi sensations during acupuncture.
RESULTS:
The results showed that VAS scores of pain after acupuncture were significantly decreased comparing to before acupuncture treatment in all three groups (P = 0.000). However, no significant differences were found among three groups at the beginning or end of acupuncture treatment (P = 0.928, P = 0.419).
CONCLUSIONS:
There was no statistical difference among three groups in terms of intensity of deqi feeling. The types of sensation were similar across the groups with only minor differences among them.Trial registration: Trial registration number: Controlled-Trials.com ISRCTN24863192.




Evid Based Complement Alternat Med. 2014;2014:595963. doi: 10.1155/2014/595963. Epub 2014 Feb 10.
The Effect of Acupuncture to SP6 on Skin Temperature Changes of SP6 and SP10: An Observation of "Deqi".
Yang JM, Shen XY, Zhang L, Shen SX, Qi DD, Zhu SP, Luo L, Ren XX, Ji B, Zhang LF, Li XH, Zhu J.
Author information


Abstract
Background. Deqi sensation is a complex but an important component for acupuncture effect. In this study, we tried to observe the relationship between Deqi and skin temperature changes and whether there was some relativity between Deqi and needle stimulations on cold congealing and dysmenorrhea rat model. Thirty-two female Sprague Dawley (SD) rats were randomly divided into four groups (Saline Control Group, Model Group, Group A with strong stimulation, and Group B with small stimulation). Group A and Group B were performed with different stimulations. We found that, compared with saline control group, model group, and Group B, Group A showed that the skin temperature changes on right acupoint SP6 and SP10 increased significantly at 5 min-10 min interval. The skin temperature changes on left SP6 decreased at instant-5 min interval. The skin temperature changes on right SP10 decreased significantly at instant-5 min interval and 10 min-20 min interval. Thermogenic action along Spleen Meridian of Foot Greater Yin was manifested as simultaneous skin temperature increase on right SP6 and SP10 at 5 min-10 min interval after needling SP6, which was helpful to illustrate the relationship between the characteristic of Deqi and needle stimulations.
PMID: 24665334 [PubMed]




Complement Ther Med. 2014 Aug;22(4):592-600. doi: 10.1016/j.ctim.2014.05.010. Epub 2014 Jun 4.
Pulsed application of focused ultrasound to the LI4 elicits deqi sensations: Pilot study.
Yoo SS1, Lee W2, Kim H3.
Author information


Abstract
OBJECTIVES:
Focused ultrasound (FUS) techniques enable the delivery of acoustic pressure waves to a localized, specific region of anatomy, and mechanically stimulate the sonicated region when given in a train of pulses. The present pilot study examines if the pulsed application of acoustic waves focused to an acupuncture point (LI4, Hegu), i.e. FUS acupuncture, can elicit deqi sensations.
DESIGN AND SETTING:
The FUS was generated by a single-element ultrasound transducer, and delivered to the LI4 of acupuncture-naïve participants (n=10) for a duration of 1s using 2ms tone-burst-duration and 50Hz pulse repetition frequency. The subjective ratings of deqi descriptors were obtained across different conditions, i.e. FUS acupuncture using acoustic intensities of 1 and 3W/cm(2) (spatial-peak temporal-averaged intensity, Ispta), sham sonication condition, tactile stimulation using a von Frey monofilament, and needle-based real and sham acupuncture. We also measured the presence of sharp pain, unpleasantness, and anxiety level during each condition.
RESULTS:
The FUS acupuncture given at 3W/cm(2) elicited deqi sensation ratings similar to those acquired during the needle-based acupuncture condition across the subjects, with significantly reduced levels of non-deqi related sensations, such as sharp pain, anxiety and unpleasantness. The lower acoustic intensity also generated deqi sensations, but at a lesser degree than the ones acquired using the higher acoustic intensity. Neither the sham conditions nor the tactile stimulation elicited deqi sensations.
CONCLUSIONS:
The present data on acoustic acupuncture, with its exquisite spatial and depth control, along with the ability to electronically adjust its intensity, may suggest its potential utilization as an alternative mode of acupuncture, although further study is needed to probe its clinical efficacy.
Copyright © 2014 Elsevier Ltd. All rights reserved.




Acupunct Med. 2013 Jun;31(2):143-50. doi: 10.1136/acupmed-2012-010280. Epub 2013 Mar 30.
Physiological changes associated with de qi during electroacupuncture to LI4 and LI11: a randomised, placebo-controlled trial.
Yu DT1, Jones AY.
Author information


Abstract
BACKGROUND:
Studies on the relationship between de qi intensity and activity changes in the autonomic nervous system (ANS) are scarce. This study investigates the physiological responses associated with de qi. The relationship between de qi intensity and such responses was determined.
METHOD:
This was a single-blinded, randomised, placebo-controlled trial. A total of 36 subjects (19 men, 17 women), aged 34.5±4.6 years, were randomly assigned to group 1 (electroacupuncture at 2 Hz, 0.4 ms to right LI4 and LI11 for 30 min), group 2 (electroacupuncture stimulation to bilateral patellae) or group 3 (sham electroacupuncture to right LI4 and LI11 but over Duoderm pads). Heart rate (HR), mean arterial blood pressure (MAP) and HR variability by low/high frequency (LF/HF) were recorded 5 min before, during and 5 min after the intervention. Needle sensations were quantified by the Modified Massachusetts General Hospital Acupuncture Sensation Scale - Chinese version (C-MMASS) and the C-MMASS index was computed.
RESULTS:
A significant increase in LF/HF, MAP and HR was observed in group 1. A small and significant increase in LF/HF was observed in group 2 but the changes in MAP and HR in groups 2 and 3 were not significant. The C-MMASS index was highest in group 1 (5.3±1.3), moderate in group 2 (3.5±0.7) and lowest in group 3 (0.77±0.2). A positive correlation between de qi intensity and changes in LF/HF, MAP and HR was observed.
CONCLUSIONS:
This study suggests that de qi is associated with physiological changes, and that de qi intensity increases with an increase in sympathetic discharge of the ANS.
KEYWORDS:
Acupuncture




J Altern Complement Med. 2014 Nov 25. [Epub ahead of print]
Historical and Clinical Perspectives on De Qi: Exposing Limitations in the Scientific Study of De Qi.
Birch S.
Author information


Abstract
Abstract De qi is a concept most often associated with patient experiences during needling in acupuncture treatment. A review of the early historical literature on acupuncture shows that texts tended to describe de qi and its associated concept, qi zhi more in terms of practitioner-based phenomena and that this is something more in the realm of the experienced practitioner (i.e., it is skill based). Many modern authors in Asia and the West also describe the importance of practitioner-based experiences in the de qi of acupuncture, further implying that this may lie at the heart of the treatment effects of acupuncture. A review of scientific studies on de qi shows that qualitative studies have focused almost exclusively on patient-based aspects of de qi while quantitative studies have focused exclusively on them. There thus exists a gap in current research on the phenomenon of de qi that possibly reveals weakness in the wider study of acupuncture. It is important that precise qualitative studies of the practitioner-based aspects of de qi begin soon and as they become better understood, quantitative research also is initiated. This research will not only better inform clinical trials and physiologic research of acupuncture in general but could contribute significantly to rethinking of how to train practitioners.




Evid Based Complement Alternat Med. 2014;2014:715351. Epub 2014 Nov 12.
Effect of "Deqi" during the Study of Needling "Wang's Jiaji" Acupoints Treating Spasticity after Stroke.
Li H1, Liu H1, Liu C1, Shi G1, Zhou W2, Zhao C3, Zhang T1, Wang X1, Wang G1, Zhao Y1, Sun J1, Wang J1, Wang L1.
Author information


Abstract
Background. Acupuncture has been shown to reduce spasticity and prevent the onset of spasticity after stroke. The purpose of this study is to assess the effect of "Deqi" during needling "Wang's Jiaji" acupoints treating spasticity in the early stage of stroke. Methods. This study is a multicenter, prospective, randomized, controlled trial. 238 patients with stroke (<21 days) participated and were randomly allocated to the verum-acupuncture (n = 121) group or sham-acupuncture group (n = 117). The verum-acupuncture group received verum acupuncture required to produce the sense of "Deqi" while the sham-acupuncture group received sham acupuncture without "Deqi." Patients in both groups followed the same 30 min acupuncture regimen 5 times per week for a period of 4 weeks. Scales of MAS, FMA, ADL, MBI, NIHSS, SS-QOL, and MRS were measured at baseline and at 2, 4, and 12 weeks after intervention. Results. Significant differences were observed between two groups. The MRS rating composition has the statistical difference after 4 weeks (P = 0.017). The score of MAS, FMA, Barthel, and SSQOL in verum-acupuncture group has increased significantly compared with the sham-acupuncture group after 12 weeks. There was 14% reduction of higher muscle tension in the verum-acupuncture group. Conclusion. Acupuncture "Wang's Jiaji" points with sensation of "Deqi" in the early stage may reduce the occurrence and decrease the severity of spasticity after stroke.



Zhongguo Zhen Jiu. 2015 Jan;35(1):67-71.
[Primary discussion of qualitative and quantitative recognition on deqi after acupuncture: a study report of West China School of Medicine].
[Article in Chinese]
Pan H, Zhao Y, Li J, Wen Q, Li N.
Abstract
OBJECTIVE:
To determine the recognition of healthy medical students on deqi after acupuncture, reveal the qualitative and quantitative rules of deqi and understand whether these rules are the factors of the clinical application of acupuncture therapy.
METHODS:
The class questionnaires were used for the investigation study on the understanding of deqi after acupuncture at Hegu (LI 4) or Zusanli (ST 36) in 86 healthy students in the clinical medicine class.
RESULTS:
(1) Deqi was a kind of complicated compound feelings, with many sensation qualities such as distending pain, distension and pain. (2) Deqi was a kind of mild and moderate sensations. In 10-score credit sys tem of Massachusetts General Hospital acupuncture sensation scale (MASS), the scores of distending pain (4.69 +/- 2.83), distension (4.39 +/- 2.91) and soreness and distension (3.93 +/- 2.93) were around 5 (moderate degree), the scores of stabbing pain (1.89 +/- 2.02) were around 2 (mild degree). (3) The differences in the quantitative scores were significant for stabbing pain, distending pain, distention, soreness and distention and the others before and after treatment (all P<0.05).
CONCLUSION:
Deqi of acupuncture is the mild and moderate complicated sensations manifested as distension, soreness, pain and numbness. As the invasive therapy, the filiform needle puncture will bring a certain psychological impacts on the receptors. The subjective sensation is possibly the factor for the patients' selection of acupuncture treatment.



Evid Based Complement Alternat Med. 2015;2015:684708. doi: 10.1155/2015/684708. Epub 2015 Apr 15.
A survey of the practice and perspectives of chinese acupuncturists on deqi.
Ren YL1, Guo TP1, Du HB1, Zheng HB2, Ma TT2, Fang L3, Gao YJ4, Yang XG5, Li XZ6, Shi J7, Chen L1, Liu YW1, Zhang RW1, Zheng H1, Li DH1, Wu X1, Liang FR1.
Author information


Abstract
Deqi refers to the special sensation and reaction sensed mainly by both acupuncturist and patient when a needle was inserted into the acupoints and is considered to be vital to achieve acupuncture effect. For acupuncturist, it is important to judge and control Deqi in clinical practice. However, enough attention is paid to patients' feelings rather than acupuncturists' nowadays. We thus conducted this survey to determine acupuncturists' perspectives about Deqi and to further find the proper way to induce Deqi. A total of 250 questionnaires were sent out to acupuncturists and 202 (80.8%) were returned. According to the results, most acupuncturists believe that Deqi is vital to obtain preferable clinical effects. The reliability of acupuncturists' Deqi sensation ranks as sinking> tightening> astringent. The reliability of patients' Deqi sensations ranks as sourness> numbness> distention> heaviness> pain. The reliability of influential factors ranks as manipulation> specificity of acupoint> TCM constitution> disease status> patient's psychological condition> acupuncturists' psychological guidance> clinical environment. This study is believed to provide additional evidence to the qualitative and quantitative research of Deqi in the future.



J Acupunct Meridian Stud. 2015 Aug;8(4):203-8. doi: 10.1016/j.jams.2014.11.009. Epub 2014 Dec 16.
Perception of Therapeutic Qi, a Nonmechanical, Nonpsychological Factor in Acupuncture That Originates from the Therapist.
Hochstrasser RJ1, Endler PC2, Klein SD3.
Author information


Abstract
So far, most research attempts to explain the mechanism of the action of acupuncture have focused mostly on mechanically-triggered active factors and have produced inconclusive findings. In this study, we investigate whether acupuncture might also involve nonmechanical, nonpsychological active factors originating in the therapist. In 30 individuals, an acupuncture needle was inserted in the acupoint PC6 using a special device without touching the needle. A second device was used to fix the needle rigidly in place, excluding any mechanical transmission of movement from the handle to the needle's tip. Each participant was exposed in random order to a control and a stimulation phase. During the stimulation phase, the free needle's end was held by the therapist to allow the transmission of Qi; during the control phase, it was left untouched. Participants' subjective sensations during the stimulation phase and the control phase were recorded using a questionnaire. Twenty-two of 28 (79%; p = 0.003) test participants believed that they had received stimulation when it had actually been performed, and 26 (93%; p < 0.001) sensed differences between the two experimental phases. Thus, participants were able to sense the transmission of therapeutic Qi in the absence of mechanical or psychological factors.



Complement Ther Med. 2016 Apr;25:71-7. doi: 10.1016/j.ctim.2016.01.004. Epub 2016 Jan 14.
A study of the brain functional network of Deqi via acupuncturing stimulation at BL40 by rs-fMRI.
Shi Y1, Zhang S1, Li Q2, Liu Z1, Guo S1, Yang J3, Wu W4.
Author information


Abstract
OBJECTIVE:
Acupuncture is a therapeutic treatment defined as the insertion of needles into the body at specific points (i.e., acupoints). The acupuncture sensation of Deqi is an important component of acupuncture, but the functional brain responses of Deqi have not been entirely supported by the results of functional magnetic resonance imaging (fMRI) studies. The aims of this study were to test the conditions that would generate a Deqi sensation and to investigate the effect of Deqi and the response of acupuncture at different depths and intensities on brain fMRI blood oxygen level-dependent (BOLD) signals.
DESIGN/SETTING:
Healthy subjects (n=16) completed two resting-state fMRI (rs-fMRI) scans, once during shallow needling (2mm) and once during deep needling (10-20mm) pseudorandomly, at the acupoint BL40.
RESULTS:
When undergoing shallow needling, 16 subjects had a mild stabbing pain sensation, and no one had a composite Deqi sensation; when undergoing deep needling, 14 subjects had a composite Deqi sensation, and only 2 subjects had a sharp pain feeling. Composite deep needling of Deqi sensation modulated neural activity at multiple levels of the brain and cerebellum, decreased functional connectivity in the default mode networks (DMN) and the pain matrix networks, and increased connectivity in the right posterior cerebellar lobe, left parahippocampal gyrus, thalamus, and supplementary motor area (P<0.05, false discovery rate [FDR]<0.05). When subjects underwent shallow needling, the brain network increased functional connectivity in the right side (precentral gyrus, superior frontal gyrus, cerebellar tonsil) and both side thalami; moreover, the right side of the medial prefrontal cortex had a decreased functional connection (P<0.05, FDR<0.05).
CONCLUSIONS:
The hemodynamic response of deep needling of Deqi sensation hypothesis whereby deep needing could affect a variety of deep tissues and never fibers was supported as acupuncture modulates the limbic-paralimbic-neocortical network to produce its Deqi effects. The similarity of LPNN and DMN suggests that deep needing may mobilize an important intrinsic brain network for its multiple modulation effects.
Copyright © 2016 Elsevier Ltd. All rights reserved.