A pilot study of functional magnetic resonance imaging of the brain during manual and electroacupuncture stimulation of acupuncture point (LI-4 Hegu) in normal subjects reveals differential brain activation between methods.

OBJECTIVES To characterize the brain activation patterns evoked by manual and electroacupuncture on normal human subjects. DESIGN We used functional magnetic resonance imaging (fMRI) to investigate the brain regions involved in electroacupuncture and manual acupuncture needle stimulation. A block design was adopted for the study. Each functional run consists of 5 minutes, starting with 1-minute baseline and two 1-minute stimulation, the interval between the two stimuli was 1 minute. Four functional runs were performed on each subject, two runs for electroacupuncture and two runs for manual acupuncture. The order of the two modalities was randomized among subjects. During the experiment, acupuncture needle manipulation was performed at Large Intestine 4 (LI4, Hegu) on the left hand. For each subject, before scanning started, the needle was inserted perpendicular to the skin surface to a depth of approximately 1.0 cm. Electroacupuncture stimulation was delivered using a continuous rectangular wave form (pulse width 30 ms) at a frequency of 3 Hz. For manual acupuncture, the needle was rotated manually clockwise and counterclockwise at a rate of about 180 times per minute (3 Hz). SUBJECTS Eleven right-handed, normal, healthy volunteer adults, 6 male and 5 female, ages 21-64 participated in the experiment. RESULTS Results showed that electroacupuncture mainly produced fMRI signal increases in precentral gyrus, postcentral gyrus/inferior parietal lobule, and putamen/insula; in contrast, manual needle manipulation produced prominent decreases of fMRI signals in posterior cingulate, superior temporal gyrus, putamen/insula. CONCLUSION These results indicate that different brain networks are involved during manual and electroacupuncture stimulation. It suggests that different brain mechanisms may be recruited during manual and electroacupuncture.

[1]  Lei Zhang,et al.  Evidence from brain imaging with fMRI supporting functional specificity of acupoints in humans , 2004, Neuroscience Letters.

[2]  M. Torrens.  Co-Planar Stereotaxic Atlas of the Human Brain—3-Dimensional Proportional System: An Approach to Cerebral Imaging, J. Talairach, P. Tournoux. Georg Thieme Verlag, New York (1988), 122 pp., 130 figs. DM 268 , 1990 .

[3]  J. Stern,et al.  Hypno-analgesia and acupuncture analgesia: a neurophysiological reality? , 1975, Neuropsychobiology.

[4]  K. M. Wang,et al.  A study on the receptive field of acupoints and the relationship between characteristics of needling sensation and groups of afferent fibres. , 1985, Scientia Sinica. Series B, Chemical, biological, agricultural, medical & earth sciences.

[5]  E. Hurwitz,et al.  Use of acupuncture by American physicians. , 1997, Journal of alternative and complementary medicine.

[6]  B. Rosen,et al.  Acupuncture modulates the limbic system and subcortical gray structures of the human brain: Evidence from fMRI studies in normal subjects , 2000, Human brain mapping.

[7]  I. Darian‐Smith,et al.  Somatic sensation. , 1969, Annual review of physiology.

[8]  R. Kessler,et al.  Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. , 1998, JAMA.

[9]  B R Rosen,et al.  Central nervous pathway for acupuncture stimulation: localization of processing with functional MR imaging of the brain--preliminary experience. , 1999, Radiology.

[10]  C. Smith.  Straws in the wind. , 2003, Journal of alternative and complementary medicine.

[11]  R W Cox,et al.  AFNI: software for analysis and visualization of functional magnetic resonance neuroimages. , 1996, Computers and biomedical research, an international journal.

[12]  Andrew C. N. Chen,et al.  Relations between brain network activation and analgesic effect induced by low vs. high frequency electrical acupoint stimulation in different subjects: a functional magnetic resonance imaging study , 2003, Brain Research.

[13]  B. Angmar-Månsson,et al.  The influence of acupuncture on salivary flow rates in healthy subjects. , 1997, Journal of oral rehabilitation.

[14]  Andrew C. N. Chen,et al.  Modulation of cold pain in human brain by electric acupoint stimulation: evidence from fMRI , 2003, Neuroreport.

[15]  T. Lundeberg,et al.  Effects of electro-acupuncture and physical exercise on regional concentrations of neuropeptides in rat brain , 1994, Brain Research.

[16]  Dr. med. Gabriel Stux,et al.  Basics of Acupuncture , 1988, Springer Berlin Heidelberg.

[17]  B. Manyam,et al.  Traditional and complementary therapies in Parkinson's disease. , 1999, Advances in neurology.

[18]  R. Adolphs.  The neurobiology of social cognition , 2001, Current Opinion in Neurobiology.

[19]  R. Kessler,et al.  Unconventional medicine in the United States. Prevalence, costs, and patterns of use. , 1993, The New England journal of medicine.

[20]  R. Peyron,et al.  Functional imaging of brain responses to pain. A review and meta-analysis (2000) , 2000, Neurophysiologie Clinique/Clinical Neurophysiology.

[21]  H. Lee,et al.  New findings of the correlation between acupoints and corresponding brain cortices using functional MRI. , 1998, Proceedings of the National Academy of Sciences of the United States of America.

[22]  S. Ettner,et al.  Trends in alternative medicine use in the United States , 1999 .