Central Nervous Pathway for Acupuncture Stimulation:
Localization of Processing with Functional MR Imaging of the Brain—Preliminary
Hsieh, MD, PhD,
Iris Chen, PhD,
Tsai, MD, PhD,
R. Rosen, MD, PhD and
K. Kwong, PhD
To characterize the
central nervous system (CNS) pathway for acupuncture stimulation in the human
brain by using functional magnetic resonance (MR) imaging.
MATERIALS AND METHODS:
Functional MR imaging of the whole brain was performed in two groups of nine
healthy subjects during four stimulation paradigms: real acupuncture at
acupoints ST.36 (on the leg) and LI.4 (on the hand) and control stimulations
(minimal acupuncture and superficial pricking on the leg). Stimulations were
performed in semirandomized, balanced order nested within two experiments.
Psychophysical responses (pain, De-Qi
acupuncture effect of needle-manipulation sensation], anxiety, and
unpleasantness) and autonomic responses were assessed. Talairach
coordinates–transformed imaging data were averaged for a group analysis.
Acupuncture at LI.4
and ST.36 resulted in significantly higher scores for De-Qi
substantial bradycardia. Acupuncture at both acupoints resulted in activation of
the hypothalamus and nucleus accumbens and deactivation of the rostral part of
the anterior cingulate cortex, amygdala formation, and hippocampal complex;
control stimulations did not result in such activations and deactivations.
imaging can demonstrate the CNS pathway for acupuncture stimulation. Acupuncture
at ST.36 and LI.4 activates structures of descending antinociceptive pathway and
deactivates multiple limbic areas subserving pain association. These findings
may shed light on the CNS mechanism of acupuncture analgesia and form a basis
for future investigations of endogenous pain modulation circuits in the human
Abbreviation: CNS = central nervous
Author contributions: Guarantor of integrity
of entire study, M.T.W.; study concepts, M.T.W., C.F.Y., B.R.R.; study design,
M.T.W., K.K.K., G.T.; definition of intellectual content, M.T.W., J.C.H.,
H.B.P.; clinical studies, M.T.W., J.X., K.K.K., Y.C.I.C.; data acquisition,
M.T.W., J.X.; data analysis, M.T.W., Y.C.I.C.; statistical analysis, M.T.W.;
manuscript preparation, M.T.W., J.X.; manuscript editing, M.T.W., J.C.H., G.T.;
manuscript review, B.R.R., K.K.K., C.F.Y.