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Rao Y, Ge L, Wu J. A systematic review and coordinate-based meta-analysis of fMRI studies on acupuncture at LR 3. Front Neurosci 2024; 18:1341567. [PMID: 38348133 PMCID: PMC10859399 DOI: 10.3389/fnins.2024.1341567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/03/2024] [Indexed: 02/15/2024] Open
Abstract
Objectives The acupoint LR3 (Taichong) is frequently utilized in clinical acupuncture. However, its underlying neural mechanisms remain not fully elucidated, with speculations suggesting its close association with specific brain activity patterns. Methods A comprehensive literature search was undertaken across several online databases, such as PubMed, Web of Science, Embase, Cochrane Library, CNKI (China National Knowledge Infrastructure), Wanfang Database, VIP Database, and the Chinese Biomedical Database. Two independent researchers handled the study selection, quality assessment, and data extraction processes. Using the seed-based d-mapping meta-analysis approach, we evaluated the brain regions activated by LR3 acupuncture in healthy subjects. Subsequent subgroup analysis was stratified by fMRI types, and regression analyses were performed considering the duration of acupuncture, depth of needle insertion, and needle diameter. The identified active brain regions were then intricately projected onto large-scale functional networks. Results A total of 10 studies met the criteria for inclusion, encompassing 319 healthy right-handed participants. The meta-analysis indicates that acupuncture at the LR3 activates regions such as the right postcentral gyrus, left thalamus, left middle frontal gyrus, and right superior frontal gyrus. Additionally, meta-regression analysis highlights that increased acupuncture duration correlates with progressively intensified activation of the right superior frontal gyrus. Subgroup analysis posits that variations in the type of fMRI employed might account for heterogeneity in the pooled results. Concurrently, functional network analysis identifies the primary activated regions as aligning with the Basal ganglia network, Auditory network, Left executive control network, Posterior salience network, Right executive control network, and Sensorimotor networks. Conclusion Acupuncture at the LR3 in healthy subjects selectively activates brain regions linked to pain perception, emotional processing, and linguistic functions. Extending the needle retention duration intensifies the activation of the right superior frontal gyrus. These findings enrich our comprehension of the neurobiological underpinnings of acupuncture's role in pain mitigation and emotional regulation.
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Affiliation(s)
- Yawen Rao
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
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Kasim AH, Viventius Y. Reduced Pain and Improved Quality of Life After Laser Acupuncture Therapy for Trigger Finger. Med Acupunct 2022; 34:261-265. [PMID: 36051412 PMCID: PMC9419975 DOI: 10.1089/acu.2022.0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Trigger fingers is a condition that causes locking/stiffness due to inflammation and hypertrophy of the tendon sheaths. This inflammatory process occurs due to degenerative conditions, such as aging, chronic daily overuse, and other factors such as metabolic disorders. Case A 51-year-old woman had grade IIIb trigger finger on her right hand for ∼2 months before going to an outpatient clinic. She also had stiffness and swelling for a longer time but it felt more severe by the time she presented at the clinic, thus, interfering with her work and quality of life (QoL). She was given acupuncture with low-level-laser therapy, using a low-energy laser, 3 times per week, on her right hand. The unilateral points used were LU-10 Yuji, LI-4 Hegu, PC-6 Neiguan, LI-11 Quchi, GB-21 Jianjing, and an Ashi point on the first finger of the metacarpophalangeal [MCP-I] joint). The bilateral body points used were ST 36 Zusanli and LR-3 Taichong. Results After 12 sessions of therapy, there was a decrease her numerical rating scale (NRS) score of 6/10 to an NRS score of 0/10. She also had an improvement in her QoL, as measured by the Short Form-36 and Quick-Disabilities of the Arm, Shoulder and Hand instruments. Conclusions Laser acupuncture may be considered for treating pain and improving QoL of patients with trigger finger. In addition, laser acupuncture causes minimal side-effects, compared with other medical treatments.
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Affiliation(s)
- Antonius Hapindra Kasim
- Medical Acupuncture Specialist Program, Faculty of Medicine, Universitas Indonesia, Depok, Jawa Barat, Indonesia
- Department of Medical Acupuncture, RSPUN Dr. Cipto Mangunkusumo, Central Jakarta, Jakarta, Indonesia
| | - Yoshua Viventius
- Medical Acupuncture Specialist Program, Faculty of Medicine, Universitas Indonesia, Depok, Jawa Barat, Indonesia
- Department of Medical Acupuncture, RSPUN Dr. Cipto Mangunkusumo, Central Jakarta, Jakarta, Indonesia
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Huang KY, Chang CH, Yu KC, Hsu CH. Assessment of quality of life and activities of daily living among elderly patients with hypertension and impaired physical mobility in home health care by antihypertensive drugs plus acupuncture: A CONSORT-compliant, randomized controlled trial. Medicine (Baltimore) 2022; 101:e29077. [PMID: 35356935 PMCID: PMC10684176 DOI: 10.1097/md.0000000000029077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 02/24/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND To evaluate the efficacy of acupuncture in improving quality of life (QOL) and activities of daily living among elderly patients with hypertension and impaired physical mobility in home health care. METHODS Seventy participants were allocated randomly to receive either acupuncture together with antihypertensive drugs (n = 35) or antihypertensive drugs only (n = 35). Acupuncture was conducted twice a week for 12 consecutive weeks, each lasting 30 minutes. Acupuncture points San Yin Jiao, Xue Hai, Taichong, Zusanli, and Hegu acupuncture points were used bilaterally. The primary outcome was change in QOL score, evaluating by Short-Form 36 Item Health Survey (SF-36). Secondary outcomes were changes in Barthel index score and blood pressure. Besides, pain evaluation by Visual analog scale, among acupuncture and control subgroups in participants with diagnosis with disease of the musculoskeletal system and connective tissue (ICD-9: 710-739). RESULTS Thirty-one participants in each of the acupuncture group and the control group completed the study. After 12 weeks of treatment, compared with the control group, the combination of antihypertensive treatments and acupuncture helped to improve bodily pain (P = .03), physical component summary (P = .04), mental health (P < .001), mental component summary (P = .008), Barthel index (P = .02), and systolic blood pressure (P = .01). In contrast, the control group showed no significant changes. Change in pain score revealed that there were a significant between-group differences after 6weeks (P = .01) and 12weeks of treatment (P = .001). CONCLUSION The results of the study suggested that in home health care elderly patients with hypertension and impaired physical mobility, antihypertensive drugs combined with acupuncture therapy will be more beneficial to improve QOL, activities of daily living, and blood pressure.
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Affiliation(s)
| | | | | | - Chung-Hua Hsu
- Correspondence: Chung-Hua Hsu, Institute of Traditional Medicine, National Yang-Ming Chiao Tung University, No. 155, Sec 2, Li-Nong Street, Beitou District, Taipei 112, Taiwan (e-mail: ).
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Resting-State fMRI in Studies of Acupuncture. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:6616060. [PMID: 33859708 PMCID: PMC8009717 DOI: 10.1155/2021/6616060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/10/2021] [Accepted: 02/28/2021] [Indexed: 01/18/2023]
Abstract
Research exploring the mechanism of acupuncture has been a hot topic in medicine. Resting-state functional magnetic resonance imaging (rs-fMRI) research is a noninvasive and extensive method, which is aimed at the research of the mechanism of acupuncture. Researchers use fMRI technologies to inspect the acupuncture process. The authors reviewed the application of rs-fMRI in acupuncture research in recent 10 years from the aspects of studying acupoints, subjects, acupuncture methods, and intensities. The results found that the application of rs-fMRI in acupuncture research mainly includes research on the onset mechanism of acupuncture treatment; visual evidence of diagnosis and treatment of dominant diseases; efficacy assessments; physiological mechanism of acupoint stimulation; and specific visualization of acupoints.
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Acupoints for Tension-Type Headache: A Literature Study Based on Data Mining Technology. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5567697. [PMID: 33777156 PMCID: PMC7979293 DOI: 10.1155/2021/5567697] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/13/2021] [Accepted: 03/01/2021] [Indexed: 02/05/2023]
Abstract
Objectives This study aimed to explore the characteristics and principles of acupoints, which were applied for treating tension-type headache (TTH). Methods Four databases were searched for the literature studies of treating TTH with acupuncture and moxibustion up to September 1, 2020. Titles, journals, authors, key words, interventions, main acupoints, and outcomes of the included literature studies were extracted and inputted into the self-established Data Excavation Platform of Acupoint Specificity for analysis. Results In total, 128 papers containing 137 prescriptions, 89 meridian acupoints, and 7 extraordinary acupoints of treating TTH with acupuncture and moxibustion were included. The total frequency of acupoints' application was 763 times. Fengchi (GB20), Baihui (GV20), Taiyang (EX-HN5), Hegu (LI4), and Taichong (LR3) were used most frequently. The acupoints in Yang meridians were utilized more than those in Yin meridians (66.1% vs. 17.8%), and the acupoints in the Gallbladder Meridian of Foot Shaoyang were applied most commonly. 59.9% (457/763) of the applied acupoints were on the head, face, and neck, and 31.7% (242/763) were on the four limbs. Additionally, the proportion of specific acupoints' application was 78.2% (597/763). Conclusions The prescription of Fengchi (GB20), Baihui (GV20), Taiyang (EX-HN5), Hegu (LI4), and Taichong (LR3) might be relatively reasonable in clinical practices of treating TTH with acupuncture, which should be verified in further studies.
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Effect of Acupuncture Stimulation of Hegu (LI4) and Taichong (LR3) on the Resting-State Networks in Alzheimer's Disease: Beyond the Default Mode Network. Neural Plast 2021; 2021:8876873. [PMID: 33747074 PMCID: PMC7960059 DOI: 10.1155/2021/8876873] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 12/02/2020] [Accepted: 02/25/2021] [Indexed: 12/29/2022] Open
Abstract
It was reported that acupuncture could treat Alzheimer's disease (AD) with the potential mechanisms remaining unclear. The aim of the study is to explore the effect of the combination stimulus of Hegu (LI4) and Taichong (LR3) on the resting-state brain networks in AD, beyond the default network (DMN). Twenty-eight subjects including 14 AD patients and 14 healthy controls (HCs) matched by age, gender, and educational level were recruited in this study. After the baseline resting-state MRI scans, the manual acupuncture stimulation was performed for 3 minutes, and then, another 10 minutes of resting-state fMRI scans was acquired. In addition to the DMN, five other resting-state networks were identified by independent component analysis (ICA), including left frontal parietal network (lFPN), right frontal parietal network (rFPN), visual network (VN), sensorimotor network (SMN), and auditory network (AN). And the impaired connectivity in the lFPN, rFPN, SMN, and VN was found in AD patients compared with those in HCs. After acupuncture, significantly decreased connectivity in the right middle frontal gyrus (MFG) of rFPN (P = 0.007) was identified in AD patients. However, reduced connectivity in the right inferior frontal gyrus (IFG) (P = 0.047) and left superior frontal gyrus (SFG) (P = 0.041) of lFPN and some regions of the SMN (the left inferior parietal lobula (P = 0.004), left postcentral gyrus (PoCG) (P = 0.001), right PoCG (P = 0.032), and right MFG (P = 0.010)) and the right MOG of VN (P = 0.003) was indicated in HCs. In addition, after controlling for the effect of acupuncture on HCs, the functional connectivity of the right cerebellum crus I, left IFG, and left angular gyrus (AG) of lFPN showed to be decreased, while the left MFG of IFPN and the right lingual gyrus of VN increased in AD patients. These findings might have some reference values for the interpretation of the combination stimulus of Hegu (LI4) and Taichong (LR3) in AD patients, which could deepen our understanding of the potential mechanisms of acupuncture on AD.
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Zhang J, Lyu T, Yang Y, Wang Y, Zheng Y, Qu S, Zhang Z, Cai X, Tang C, Huang Y. Acupuncture at LR3 and KI3 shows a control effect on essential hypertension and targeted action on cerebral regions related to blood pressure regulation: a resting state functional magnetic resonance imaging study. Acupunct Med 2020; 39:53-63. [PMID: 32529884 DOI: 10.1177/0964528420920282] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the effects of acupuncture at LR3 and KI3 on hypertension at different time points and on related cerebral regions using resting-state functional magnetic resonance imaging (rs-fMRI). METHODS We randomly divided 29 subjects into two groups: Group A (receiving acupuncture at LR3 + KI3; 15 subjects) and group B (receiving acupuncture at LR3 and a sham location not corresponding to any traditional acupuncture point; 14 subjects). Acupuncture was performed. Blood pressure (BP) changes were recorded and analyzed using SPSS 20.0 statistical software. We used a 3.0T MRI scanner and standard GE 8 channel head coil to collect whole brain fMRI data in both groups. Data analysis and processing was based on the R2009a MATLAB platform. REST 1.8 software was used to analyze the whole brain amplitude of low-frequency fluctuation (ALFF). RESULTS After acupuncture, a statistically significant reduction in BP at different time points was observed in group A. In group B, a statistically significant reduction was found only in diastolic blood pressure (DBP) and was not sustained. Acupuncture at LR3 + KI3 specifically affected brain areas involved in BP regulation, as well as those involved in auditory sense, speech, vision, movement and sensation. CONCLUSION Acupuncture at LR3 + KI3 showed positive immediate and long-term effects on BP, particularly systolic blood pressure (SBP). After ALFF analysis, we concluded that LR3 + KI3 activates brain areas related to BP regulation. In addition, after acupuncture at LR3 + KI3, a highly targeted effect was observed in brain areas associated with BP. In addition, extracerebral areas involving vision, motion control, cognition and hearing were activated, which could potentially contribute to the mitigation of hypertensive complications in patients in an advanced stage of the disease.
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Affiliation(s)
- Jiping Zhang
- School of the Tradition Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Taibiao Lyu
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yicheng Yang
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yanjie Wang
- Weinan Vocational and Technical College, Weinan, China
| | - Yu Zheng
- School of the Tradition Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Shanshan Qu
- School of the Tradition Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Zhinan Zhang
- School of the Tradition Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Xiaowen Cai
- School of the Tradition Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Chunzhi Tang
- Clinical Medical College of Acupuncture and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yong Huang
- School of the Tradition Chinese Medicine, Southern Medical University, Guangzhou, China
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Rahimi M, Farhanchi A, Taheri M, Samadi S. The Effects of Acupuncture on Hemodynamic Changes During Endotracheal Intubation for General Anesthesia. Med Acupunct 2019; 31:123-129. [PMID: 31031879 DOI: 10.1089/acu.2018.1330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: The goal of this research was to investigate the efficacy of perioperative manual acupuncture in the LV 3 and LI 4 points for lessening hemodynamic changes during endotracheal intubation in patients who were receiving anesthesia. Materials and Methods: This double-blinded randomized controlled study enrolled patients who were undergoing endotracheal intubation, in 2015-2016, during general anesthesia in the general surgery department of the Imam Khomeini Hospital complex, in the Tehran University of Medical Sciences, Iran. The patients were randomly allocated into 2 groups with 30 patients in each group. In the treatment group, acupuncture needles were placed at LV 3 and LI 4, whereas, in the control group, the needles were placed 1 cm lateral to these points. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), and heart rate (HR) before and after placing the acupuncture needles, after induction, immediately, 1 minute, and 3 minutes after intubation were measured and recorded prospectively. Results: The patients had a mean age of 44.45 ± 12.72 years and included 35 (58.3%) males. Before acupuncture, demographic data, mean blood pressure (BP), and mean HR of the patients were not significantly different in the treatment and control groups. The mean SBP, DBP, MAP, and HR of all patients changed over time significantly (P < 0.001 for all). In the treatment group, mean SBP, DBP, and MAP changes immediately after the needles were placed were significantly less than those in the control group (P = 0.033, 0.024, and 0.024, respectively). Conclusions: Although acupuncture could have a very-short-term effect that reduces BP during endotracheal intubation, hemodynamic changes might not be prevented during endotracheal intubation.
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Affiliation(s)
- Mojgan Rahimi
- Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Farhanchi
- Department of Anesthesiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahboobeh Taheri
- Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahram Samadi
- Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran
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Different Brain Activation after Acupuncture at Combined Acupoints and Single Acupoint in Hypertension Patients: An Rs-fMRI Study Based on ReHo Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:5262896. [PMID: 30719061 PMCID: PMC6335668 DOI: 10.1155/2019/5262896] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/02/2018] [Accepted: 12/17/2018] [Indexed: 12/11/2022]
Abstract
Background Acupuncture is proved to be effective on hypertension by numerous studies and resting-state functional magnetic resonance imaging (Rs-fMRI) is a widely used technique to study its mechanism. Along with lower blood pressure, patients with hypertension receiving acupuncture also presented improvement in function of cognition, emotion, language, sematic sensation, and so on. This study was a primary study to explore the acting path of acupuncture at combined acupoints in stimulated brain areas related to such functions. Methods In this research, regional homogeneity (ReHo) was applied to analyze the Rs-fMRI image data of brain activities after acupuncture at LR3, KI3, and LR3+KI3 and to compare the differences of functional brain activities between stimulating combined acupoints and single acupoint under pathological conditions. A total of thirty hypertension patients underwent Rs-fMRI scanning before acupuncture treatment and then were randomly divided into three groups following random number table, the LR3 group (3 males and 7 females), the KI3 group (3 males and 7 females), and the LR3+ KI3 group (4 males and 6 females) for needling, respectively. When the 30-min treatment finished, they received a further Rs-fMRI scanning. The Rs-fMRI data before and after the acupuncture treatment were analyzed through ReHo. Results Compared with preacupuncture, respectively, ReHo values increased in Brodmann areas (BAs) 3, 18, and 40 and decreased in BAs 7 and 31 in LR3+ KI3 group. However, ReHo values only decreased in BA7 of KI3 group while the results showed no significant difference of brain regions in LR3 group between pre- and postacupuncture. Compared with LR3 group, LR3+KI3 group exhibited decreased ReHo values in BAs 7, 9, and 31. Meanwhile, compared with KI3 group, LR3+KI3 group exhibited increased ReHo values in the BAs 2, 18, 30, and 40 and decreased ReHo values in BA13. Conclusion Combined acupoints of LR3 and KI3 could act on wider brain areas than the sum of single acupoints, whose functions include emotional processing, cognition, somatic sensation, spatial orientation, language production, and vision.
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Murg K, Raith W, Urlesberger B. Use of Acupuncture in an Infant with Restlessness and Agitation. MEDICINES 2018; 5:medicines5020055. [PMID: 29899266 PMCID: PMC6023510 DOI: 10.3390/medicines5020055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 06/07/2018] [Accepted: 06/11/2018] [Indexed: 11/24/2022]
Abstract
Abstract: Background: We are reporting here about a 3-month-old boy with a history of failure to thrive, hypertrophic obstructive cardiomyopathy and neurological misbehaviour including hypotension in body muscles, who was found to have screaming attacks, agitation and restlessness. Methods/Results: Body and ear acupuncture was used both as supporting and integrative therapy to reduce the phases of restlessness and screaming and, simultaneously, the use of hypnotic drugs, as well as to improve the baby’s thriving. Conclusions: Our case has proved that standardised ear and body acupuncture applied by trained acupuncturist paediatricians is a helpful non-pharmacological treatment tool. While acupuncture is typically used in the outpatient setting, it can equally be used in the inpatient setting, as exemplified by the positive outcome of the presented case.
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Affiliation(s)
- Katharina Murg
- Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz 8036, Austria.
| | - Wolfgang Raith
- Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz 8036, Austria.
- Research Group for Paediatric Traditional Chinese Medicine, TCM Research Centre Graz, Medical University of Graz, Graz 8036, Austria.
| | - Berndt Urlesberger
- Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz 8036, Austria.
- Research Group for Paediatric Traditional Chinese Medicine, TCM Research Centre Graz, Medical University of Graz, Graz 8036, Austria.
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Harris RE, Ichesco E, Cummiford C, Hampson JP, Chenevert TL, Basu N, Zick SM. Brain Connectivity Patterns Dissociate Action of Specific Acupressure Treatments in Fatigued Breast Cancer Survivors. Front Neurol 2017; 8:298. [PMID: 28690587 PMCID: PMC5481304 DOI: 10.3389/fneur.2017.00298] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 06/09/2017] [Indexed: 11/13/2022] Open
Abstract
Persistent fatigue is a pernicious symptom in many cancer survivors. Existing treatments are limited or ineffective and often lack any underlying biologic rationale. Acupressure is emerging as a promising new intervention for persistent cancer-related fatigue; however, the underlying mechanisms of action are unknown. Our previous investigations suggested that fatigued breast cancer survivors have alterations in brain neurochemistry within the posterior insula and disturbed functional connectivity to the default mode network (DMN), as compared to non-fatigued breast cancer survivors. Here, we investigated if insula and DMN connectivity were modulated by self-administered acupressure by randomizing breast cancer survivors (n = 19) to two distinct treatments: relaxing acupressure or stimulating acupressure. All participants underwent proton magnetic resonance spectroscopy of the posterior insula and functional connectivity magnetic resonance imaging at baseline and immediately following 6 weeks of acupressure self-treatment. As compared to baseline measures, relaxing acupressure decreased posterior insula to dorsolateral prefrontal cortex connectivity, whereas stimulating acupressure enhanced this connectivity (p < 0.05 corrected). For relaxing but not stimulating acupressure, reduced connectivity was associated with sleep improvement. In addition, connectivity of the DMN to the superior colliculus was increased with relaxing acupressure and decreased with stimulating acupressure, whereas DMN connectivity to the bilateral pulvinar was increased with stimulating and decreased with relaxing acupressure (p < 0.05 corrected). These data suggest that self-administered acupressure at different acupoints has specificity in relation to their mechanisms of action in fatigued breast cancer survivors.
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Affiliation(s)
- Richard E Harris
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States.,Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, United States
| | - Eric Ichesco
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
| | - Chelsea Cummiford
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States.,Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, United States
| | - Johnson P Hampson
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
| | - Thomas L Chenevert
- Department of Radiology, University of Michigan, Ann Arbor, MI, United States
| | - Neil Basu
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States.,Department of Epidemiology, University of Aberdeen, Aberdeen, United Kingdom
| | - Suzanna M Zick
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States.,Nutritional Sciences, University of Michigan, Ann Arbor, MI, United States
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Cerebral Targeting of Acupuncture at Combined Acupoints in Treating Essential Hypertension: An Rs-fMRI Study and Curative Effect Evidence. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:5392954. [PMID: 28003850 PMCID: PMC5149687 DOI: 10.1155/2016/5392954] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 10/12/2016] [Indexed: 01/09/2023]
Abstract
The study attempted to explore that the synergistic effect of acupoints combination is not a simple superposition of single acupoint's effect by comparing and analyzing the changes of blood pressure (BP), SF-36, and brain regions after acupuncture treatment. 47 patients were randomly divided into LR3+KI3 group, LR3 group, and KI3 group. Subjects received Rs-fMRI scan, BP measurement, and SF-36 questionnaires before and after treatment and short-term acupuncture treatment. After treatment, there were no significant differences in BP and SF-36 among 3 groups, compared to the case before treatment, SBP of 3 groups decreased, and DBP significantly decreased while vitality and mental health significantly increased in LR3+KI3 group. Both number and scopes of changes of brain regions in LR3+KI3 group were the largest, which mainly included BAs 3, 4, 8, 19, 21, 24, 32, 44, and 45. In conclusion, acupuncture at LR3+KI3 may auxiliarily reduce BP and improve the vitality and mental health of patients, and the changes of brain regions were related to somatesthesia, movement, vision, audition, emotion and mood, language, memory, etc. BAs 4, 9, 10, 24, 31, 32, and 46 may be the targeting brain areas of acupuncture in assisting hypotension. It is suggested that acupoints combination of LR3+KI3 maybe generates a synergistic effect, and it is not simple sum of single acupoint effect.
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Zheng Y, Wang Y, Lan Y, Qu X, Lin K, Zhang J, Qu S, Wang Y, Tang C, Huang Y. IMAGING OF BRAIN FUNCTION BASED ON THE ANALYSIS OF FUNCTIONAL CONNECTIVITY - IMAGING ANALYSIS OF BRAIN FUNCTION BY FMRI AFTER ACUPUNCTURE AT LR3 IN HEALTHY INDIVIDUALS. AFRICAN JOURNAL OF TRADITIONAL, COMPLEMENTARY, AND ALTERNATIVE MEDICINES 2016; 13:90-100. [PMID: 28480365 PMCID: PMC5412207 DOI: 10.21010/ajtcam.v13i6.14] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Objective: This Study observed the relevant brain areas activated by acupuncture at the Taichong acupoint (LR3) and analyzed the functional connectivity among brain areas using resting state functional magnetic resonance imaging (fMRI) to explore the acupoint specificity of the Taichong acupoint. Methods: A total of 45 healthy subjects were randomly divided into the Taichong (LR3) group, sham acupuncture group and sham acupoint group. Subjects received resting state fMRI before acupuncture, after true (sham) acupuncture in each group. Analysis of changes in connectivity among the brain areas was performed using the brain functional connectivity method. Results: The right cerebrum temporal lobe was selected as the seed point to analyze the functional connectivity. It had a functional connectivity with right cerebrum superior frontal gyrus, limbic lobe cingulate gyrus and left cerebrum inferior temporal gyrus (BA 37), inferior parietal lobule compared by before vs. after acupuncture at LR3, and right cerebrum sub-lobar insula and left cerebrum middle frontal gyrus, medial frontal gyrus compared by true vs. sham acupuncture at LR3, and right cerebrum occipital lobe cuneus, occipital lobe sub-gyral, parietal lobe precuneus and left cerebellum anterior lobe culmen by acupuncture at LR3 vs. sham acupoint. Conclusion: Acupuncture at LR3 mainly specifically activated the brain functional network that participates in visual function, associative function, and emotion cognition, which are similar to the features on LR3 in tradition Chinese medicine. These brain areas constituted a neural network structure with specific functions that had specific reference values for the interpretation of the acupoint specificity of the Taichong acupoint.
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Affiliation(s)
- Yu Zheng
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province 510515, China
| | - Yuying Wang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province 510515, China
| | - Yujun Lan
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province 510515, China
| | - Xiaodong Qu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province 510515, China
| | - Kelin Lin
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province 510515, China
| | - Jiping Zhang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province 510515, China
| | - Shanshan Qu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province 510515, China
| | - Yanjie Wang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province 510515, China
| | - Chunzhi Tang
- Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province 510405, China
| | - Yong Huang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province 510515, China
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14
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The Status of the Quality Control in Acupuncture-Neuroimaging Studies. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:3685785. [PMID: 27242911 PMCID: PMC4875991 DOI: 10.1155/2016/3685785] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 03/03/2016] [Accepted: 03/27/2016] [Indexed: 12/31/2022]
Abstract
Using neuroimaging techniques to explore the central mechanism of acupuncture gains increasing attention, but the quality control of acupuncture-neuroimaging study remains to be improved. We searched the PubMed Database during 1995 to 2014. The original English articles with neuroimaging scan performed on human beings were included. The data involved quality control including the author, sample size, characteristics of the participant, neuroimaging technology, and acupuncture intervention were extracted and analyzed. The rigorous inclusion and exclusion criteria are important guaranty for the participants' homogeneity. The standard operation process of acupuncture and the stricter requirement for acupuncturist play significant role in quality control. More attention should be paid to the quality control in future studies to improve the reproducibility and reliability of the acupuncture-neuroimaging studies.
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15
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Zhang SQ, Wang YJ, Zhang JP, Chen JQ, Wu CX, Li ZP, Chen JR, Ouyang HL, Huang Y, Tang CZ. Brain activation and inhibition after acupuncture at Taichong and Taixi: resting-state functional magnetic resonance imaging. Neural Regen Res 2015; 10:292-7. [PMID: 25883630 PMCID: PMC4392679 DOI: 10.4103/1673-5374.152385] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2014] [Indexed: 11/05/2022] Open
Abstract
Acupuncture can induce changes in the brain. However, the majority of studies to date have focused on a single acupoint at a time. In the present study, we observed activity changes in the brains of healthy volunteers before and after acupuncture at Taichong (LR3) and Taixi (KI3) using resting-state functional magnetic resonance imaging. Fifteen healthy volunteers underwent resting-state functional magnetic resonance imaging of the brain 15 minutes before acupuncture, then received acupuncture at Taichong and Taixi using the nail-pressing needle insertion method, after which the needle was retained in place for 30 minutes. Fifteen minutes after withdrawal of the needle, the volunteers underwent a further session of resting-state functional magnetic resonance imaging, which revealed that the amplitude of low-frequency fluctuation, a measure of spontaneous neuronal activity, increased mainly in the cerebral occipital lobe and middle occipital gyrus (Brodmann area 18/19), inferior occipital gyrus (Brodmann area 18) and cuneus (Brodmann area 18), but decreased mainly in the gyrus rectus of the frontal lobe (Brodmann area 11), inferior frontal gyrus (Brodmann area 44) and the center of the posterior lobe of the cerebellum. The present findings indicate that acupuncture at Taichong and Taixi specifically promote blood flow and activation in the brain areas related to vision, emotion and cognition, and inhibit brain areas related to emotion, attention, phonological and semantic processing, and memory.
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Affiliation(s)
- Shao-Qun Zhang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Yan-Jie Wang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Ji-Ping Zhang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Jun-Qi Chen
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Chun-Xiao Wu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Zhi-Peng Li
- First Clinical School, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Jia-Rong Chen
- First Clinical School, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Huai-Liang Ouyang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Yong Huang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Chun-Zhi Tang
- School of Acupuncture and Tuina, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
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16
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He T, Zhu W, Du SQ, Yang JW, Li F, Yang BF, Shi GX, Liu CZ. Neural mechanisms of acupuncture as revealed by fMRI studies. Auton Neurosci 2015; 190:1-9. [PMID: 25900479 DOI: 10.1016/j.autneu.2015.03.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Revised: 03/20/2015] [Accepted: 03/25/2015] [Indexed: 01/28/2023]
Abstract
As an ancient therapeutic method, acupuncture has been used to treat many diseases as an adjunctive therapy. However, its clinical efficacy remains controversial and the neural mechanisms have not been well understood. Accumulating studies have revealed that fMRI has made it possible to study brain responses to acupuncture. This review aims to provide scientific evidence to support the notion and discuss how these findings contribute to the neural mechanisms of acupuncture.
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Affiliation(s)
- Tian He
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, 23 Meishuguanhou Street, Dongcheng District, Beijing 100010, China
| | - Wen Zhu
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, 23 Meishuguanhou Street, Dongcheng District, Beijing 100010, China
| | - Si-Qi Du
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, 23 Meishuguanhou Street, Dongcheng District, Beijing 100010, China
| | - Jing-Wen Yang
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, 23 Meishuguanhou Street, Dongcheng District, Beijing 100010, China
| | - Fang Li
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, 23 Meishuguanhou Street, Dongcheng District, Beijing 100010, China
| | - Bo-Feng Yang
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, 23 Meishuguanhou Street, Dongcheng District, Beijing 100010, China
| | - Guang-Xia Shi
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, 23 Meishuguanhou Street, Dongcheng District, Beijing 100010, China
| | - Cun-Zhi Liu
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, 23 Meishuguanhou Street, Dongcheng District, Beijing 100010, China.
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17
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Monitoring the Effects of Acupoint Antioxidant Intervention by Measuring Electrical Potential Difference along the Meridian. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:286989. [PMID: 25861356 PMCID: PMC4377379 DOI: 10.1155/2015/286989] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 08/20/2014] [Accepted: 08/21/2014] [Indexed: 11/17/2022]
Abstract
Previous studies suggest that superoxide anions are possibly traveling along acupuncture meridians. The electrical potential difference (EPD) between acupoints may be related to the movement. To test the above hypothesis, we conducted a study investigating the effects of acupoint antioxidant interventions on the meridian EPD. Firstly, ST39 (L) and ST44 (L) were screened out for the EPD detection along the stomach meridian, and ST36 (L) was selected for interventions including acumassage with the control cream, as well as the TAT-SOD cream for 30 minutes, or injection with reduced glutathione sodium. The EPD between ST39 and ST44 was recorded for 80 minutes and measured again 48 h later. While the EPD increased during the acumassage, the acumassage with TAT-SOD cream and the glutathione injection generated waves of EPD increased, indicating the migration or removal from the visceral organ of a greater quantity of superoxide. Remarkably lower EPD readings 48 h later with both antioxidant acupoint interventions than the mere acumassage imply a more complete superoxide flushing out due to the restored superoxide pathway at the acupoint after interventions. The results confirm superoxide transportation along the meridians and demonstrate a possibility of acupoint EPD measurement as a tool to monitor changes in the meridians and acupoints.
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18
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Gao P, Gao XI, Fu T, Xu D, Wen Q. Acupuncture: Emerging evidence for its use as an analgesic (Review). Exp Ther Med 2015; 9:1577-1581. [PMID: 26136861 DOI: 10.3892/etm.2015.2348] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 02/18/2015] [Indexed: 12/17/2022] Open
Abstract
Acupuncture is an ancient Chinese technique, developed over >3,000 years, in which 'acupoints' are stimulated with the aim of treating various diseases. A number of previous studies have indicated that acupuncture may play a role in inducing analgesia. Acupuncture-induced analgesia has been hypothesized to act on various parts of the central nervous system, including the spinal cord, brain stem, cerebral ganglia and cerebral cortex. The mechanisms underlying the effects of acupuncture have been purported to include neurohumors and neurotransmitters, such as opioids and γ-aminobutyric acid, signaling pathways and the immune response, which are all involved in the induction of analgesia.
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Affiliation(s)
- Peng Gao
- Department of Anesthesiology, Dalian Medical University, Dalian, Liaoning 116044, P.R. China
| | - X I Gao
- Department of Anesthesiology, Dalian Medical University, Dalian, Liaoning 116044, P.R. China
| | - Tairan Fu
- Department of Anesthesiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Dan Xu
- Department of Anesthesiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Qingping Wen
- Department of Anesthesiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
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19
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Actigraph evaluation of acupuncture for treating restless legs syndrome. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:343201. [PMID: 25763089 PMCID: PMC4339862 DOI: 10.1155/2015/343201] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 11/26/2014] [Indexed: 01/01/2023]
Abstract
We evaluated the effects of acupuncture in patients with restless legs syndrome (RLS) by actigraph recordings. Among the 38 patients with RLS enrolled, 31 (M = 12, F = 19; mean age, 47.2 ± 9.7 years old) completed the study. Patients were treated with either standard acupuncture (n = 15) or randomized acupuncture (n = 16) in a single-blind manner for 6 weeks. Changes in nocturnal activity (NA) and early sleep activity (ESA) between week 0 (baseline), week 2, week 4, and week 6 were assessed using leg actigraph recordings, the International Restless Legs Syndrome Rating Scale (IRLSRS), and Epworth Sleepiness Scale (ESS). Standard but not randomized acupuncture reduced the abnormal leg activity of NA and ESA significantly in week 2, week 4, and week 6 based on the changes in the clinical scores for IRLSRS and ESS in week 4 and week 6 compared with the baseline. No side effects were observed. The results indicate that standard acupuncture might improve the abnormal leg activity in RLS patients and thus is a potentially suitable integrative treatment for long-term use.
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