My professor at Harvard Medical School Dr. Napadow has recently published a research on Monitoring acupuncture effects on human brain by fMRI. This confirms beyond any doubt the positive effect of Acupuncture on human brain for pain management. Here is the abstract:

Functional MRI is used to study the effects of acupuncture on the BOLD response and the functional connectivity of the human brain. Results demonstrate that acupuncture mobilizes a limbic-paralimbic-neocortical network and its anti-correlated sensorimotor/paralimbic network at multiple levels of the brain and that the hemodynamic response is influenced by the psychophysical response. Physiological monitoring may be performed to explore the peripheral response of the autonomic nerve function. This video describes the studies performed at LI4 (hegu), ST36 (zusanli) and LV3 (taichong), classical acupoints that are commonly used for modulatory and pain-reducing actions. Some issues that require attention in the applications of fMRI to acupuncture investigation are noted.

Authors: Hui KK, Napadow V, Liu J, Li M, Marina O, Nixon EE, Claunch JD, LaCount L, Sporko T, Kwong KK

PMID: 20379133 [PubMed]

Functional MRI evidence that acupuncture modulates the limbic system and subcortical gray structures of the human brain

Hui, Kathleen K.S,1,4; Liu, Jing4; Makris, Nikos2; Gollub, Randy L.1,3; Chen, Anthony J.W.1; Moore, Christopher I.1; Kennedy, David N.2; Rosen, Bruce R.1; Kwong, Kenneth K.1

1MGH-NMR Center, Department of Radiology,
2Center for Morphometric Analysis, Department of Neurology ,
3Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA,,
4 East-West Immune Institute, Lexington, MA

Introduction: Acupuncture has effects on multiple physiological systems. It is a promising complementary therapy for affective and psychosomatic disorders such as anxiety, depression, substance abuse, pain and visceral dysfunctions. We used fMRI to monitor its action on normal human brain, with the focus on the limbic system and subcortical gray structures that are intimately involved in the regulation of emotions, autonomic and endocrine functions. We demonstrated prominent and coordinated effects in these neural circuits. The pattern of response observed with acupuncture sensation was distinctly different from that observed with tactile stimulation or with pain sensation1. Follow-up study confirms reported findings and reveals involvement of additional brain regions that are closely related to the limbic system.

Method: Scanning was performed on 13 normal human volunteers in a 1.5Tesla GE Signa MRI System equipped for echo planar imaging. Ten coronal brain slices, each 6.5 mm thick with 0.5 mm gap, were used to cover the regions of interest. High-resolution structural maps were acquired by T1 weighted echo-planar recovery sequence for preliminary statistical mapping. A sagittal localizer scan with 60 slices was acquired by T1 weighted spoiled echo-gradient sequence for Talairach transformation. Functional MRI images were acquired by gradient echo T2-weighted sequence with TE 50 msec, TR 4.8 sec. Kolmogrov-Smirnov statistical images were reconstructed from individual and averaged data

Acupuncture was performed at LI. 4. The subjects received acupuncture stimulation twice, each lasting 2 minutes. The needle was twirled gently 120 times per minute using a balanced tonifying and reducing technique. The periods with needle in place (2 min before, 4 min between, 2 min after needle manipulations) served as baseline. Tactile stimulation using a matched paradigm was delivered over the acupoint for comparison with acupuncture data. Subjective sensations were recorded after each stimulation procedure.

Results: Signal increases occurred in the primary and secondary somatosensory cortices both in acupuncture and in tactile stimulation. A marked contrast was observed in the deep structures. The 11 subjects who experienced deqi demonstrated prominent decreases of fMRI signals in limbic and subcortical regions as the amygdala, hippocampus, parahippocampus, hypothalamus, septal nucleus, caudate, putamen, nucleus accumbens, anterior cingulate gyrus, anterior insula, temporal pole and fronto-orbital cortex The 2 subjects who had painful sensation during acupuncture demonstrated signal increases in these regions instead. Tactile stimulation group data did not elicit significant signal changes in the deep gray structures.

Whole brain imaging was performed on one subject with deqi and one subject with pain response more than 1 year later. Acupuncture evoked deqi in both subjects. The former demonstrated signal decreases in the limbic and subcortical gray structures as before. The latter showed a reverse in the direction of signal changes, from signal increases with pain before to signal decreases with deqi in the repeat study. Whole brain imaging revealed prominent signal decreases with deqi sensation in additional brain regions that are closely linked to the limbic system, such as the frontal pole, prefrontal cortex and cerebellar vermis.

Conclusion: The study provides evidence that supports a coordinated effect of acupuncture on a network of cortical and subcortical limbic and paralimbic structures including the frontal pole, the prefrontal cortex and cerebellar regions that are connected to the limbic system. in the human brain. Modulation of this neuronal network could initiate a sequence of effects by which acupuncture regulates multisystem functions. The effects on the limbic system could well contribute to its efficacy for the treatment of diverse affective and psychosomatic disorders.

Reference: Hui, K K.S. et al: Human Brain Mapping 2000, 9(1):13-25.

Neural bases of acupuncture: Observation of target specific and target non-specific acupuncture mechanisms observed by fMRI

Zang-Hee Cho, Radiological Sciences & Neuropsychiatry and Human Behavior, University of California, Irvine, CA

Functional Magnetic Resonance Imaging (fMRI) of the brain, using a variety of acquisition techniques, has been successfully applied to the study of large number of questions in human neuroscience. The success of the method has been due to its inherent
flexibility and non-invasiveness. The fMRI technique allows us to visualize many classes of functional behavior in the brain by detecting changes in blood oxygenation and related regional cerebral blood flow (rCBF) with high temporal resolution from a few seconds to a minute. In the brain, blood oxygenation and de-oxygenation as well as
rCBF are presumably related to neural activity and are measured by fMRI (or PET). This can be used to measure brain activity when subjects perform specific tasks or are exposed to specific stimuli such as acupuncture.

In this presentation, principles of fMRI and its applications to neuro-imaging with special emphasis to exploration of acupuncture-induced activation of the central nervous system (CNS), the brain will be discussed. Two main lines of acupuncture - cortical correlation studies will be discussed, namely Target-specific and Non-target specific, respectively. Some of the target specific studies include Gb. 37 Guangming and SJ. 5 Waiguan, for visual- and hearing-related acupoints, respectively. In addition to the target specific studies mentioned above, some of the target non-specific acupoint studies will also be discussed, especially in conjunction with pain perception and inhibition by acupuncture. It is found that, with the help of our recently obtained fMRI-acupuncture results, both classical acupuncture analgesia as well as general disease control mechanisms of acupuncture can be formulated and hypothesized.

In summary, with the help of neuro-imaging techniques such as fMRI and PET, it seems possible to study the physiological bases of acupuncture, a millennia old Oriental Medical therapy, by quantitatively examining cortical correlations of acupuncture stimulation, thereby providing clues to "How acupuncture works".