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Brain Network Response to Acupuncture Stimuli in Experimental Acute Low Back Pain: An fMRI Study.

Shi Y, Liu Z, Zhang S, Li Q, Guo S, Yang J, Wu W - Evid Based Complement Alternat Med (2015)

Bottom Line: Most neuroimaging studies have demonstrated that acupuncture can significantly modulate brain activation patterns in healthy subjects, while only a few studies have examined clinical pain.Our results showed that, compared with the baseline, the pain state had higher regional homogeneity (ReHo) values in the pain matrix, limbic system, and default mode network (DMN) and lower ReHo values in frontal gyrus and temporal gyrus; compared with the OFF status, ACUP yielded broad deactivation in subjects, including nearly all of the limbic system, pain status, and DMN, and also evoked numerous activations in the attentional and somatosensory systems; compared with SHAM, we found that ACUP induced more deactivations and fewer activations in the subjects.Multiple brain networks play crucial roles in acupuncture analgesia, suggesting that ACUP exceeds a somatosensory-guided mind-body therapy for ALBP.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China.

ABSTRACT
Most neuroimaging studies have demonstrated that acupuncture can significantly modulate brain activation patterns in healthy subjects, while only a few studies have examined clinical pain. In the current study, we combined an experimental acute low back pain (ALBP) model and functional magnetic resonance imaging (fMRI) to explore the neural mechanisms of acupuncture analgesia. All ALBP subjects first underwent two resting state fMRI scans at baseline and during a painful episode and then underwent two additional fMRI scans, once during acupuncture stimulation (ACUP) and once during tactile stimulation (SHAM) pseudorandomly, at the BL40 acupoint. Our results showed that, compared with the baseline, the pain state had higher regional homogeneity (ReHo) values in the pain matrix, limbic system, and default mode network (DMN) and lower ReHo values in frontal gyrus and temporal gyrus; compared with the OFF status, ACUP yielded broad deactivation in subjects, including nearly all of the limbic system, pain status, and DMN, and also evoked numerous activations in the attentional and somatosensory systems; compared with SHAM, we found that ACUP induced more deactivations and fewer activations in the subjects. Multiple brain networks play crucial roles in acupuncture analgesia, suggesting that ACUP exceeds a somatosensory-guided mind-body therapy for ALBP.

No MeSH data available.


Related in: MedlinePlus

The experimental paradigm for the ALBP subjects included five steps.
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Related In: Results  -  Collection


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fig3: The experimental paradigm for the ALBP subjects included five steps.

Mentions: After the baseline scan, we located an injection point 2 cm lateral to the spinous process of the fourth lumbar vertebra for the ALBP model. Thereafter, we filled an in-dwelling needle (24 gauge) with sterile hypertonic saline (10 mL, 5%) and attached it via a long connecting tube to a computer-controlled power injector (Spectris Solaris EP; Medrad, Inc., Warrendale, PA, USA), before vertically inserting it into the above-described location at a depth of 1.5 cm (Figures 1 and 3). After 1 min, the hypertonic saline was injected intramuscularly from the above-mentioned computer-controlled power injector into the ALBP subject. This injection included a bolus injection (0.1 mL within 5 s) and subsequent continuous injection (0.15 mL/min) to produce persistent ALBP. During the first 6 min of ALBP stimulation, we performed an rs-fMRI scan to evaluate the pain status. After the pain rsfMRI scan, we obtained two functional scans for each ALBP subject: one scan during acupuncture stimulation (ACUP) and one scan during tactile stimulation (SHAM) pseudorandomly, with ALBP occurring continually throughout the scanning process. The ACUP or SHAM run comprised a block design with six 30 s blocks of rest time (OFF block) interspersed between six 30 s blocks of stimulation (ON block); ACUP (or SHAM) was administered at BL40 by the same experienced acupuncturist during the six ON blocks of each functional scan. Each functional scan lasted for 6 min, and the time interval between the two functional scans (ACUP and SHAM) was set at 20 min to maximize washout of the sustained effects induced by the former therapeutic stimulation (Figure 4). All MRI scans were performed with each subject laying still in a Philips 3.0 T Achieva scanner (Royal Philips Electronics, Eindhoven, Netherlands) with their eyes and ears covered.


Brain Network Response to Acupuncture Stimuli in Experimental Acute Low Back Pain: An fMRI Study.

Shi Y, Liu Z, Zhang S, Li Q, Guo S, Yang J, Wu W - Evid Based Complement Alternat Med (2015)

The experimental paradigm for the ALBP subjects included five steps.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4487721&req=5

fig3: The experimental paradigm for the ALBP subjects included five steps.
Mentions: After the baseline scan, we located an injection point 2 cm lateral to the spinous process of the fourth lumbar vertebra for the ALBP model. Thereafter, we filled an in-dwelling needle (24 gauge) with sterile hypertonic saline (10 mL, 5%) and attached it via a long connecting tube to a computer-controlled power injector (Spectris Solaris EP; Medrad, Inc., Warrendale, PA, USA), before vertically inserting it into the above-described location at a depth of 1.5 cm (Figures 1 and 3). After 1 min, the hypertonic saline was injected intramuscularly from the above-mentioned computer-controlled power injector into the ALBP subject. This injection included a bolus injection (0.1 mL within 5 s) and subsequent continuous injection (0.15 mL/min) to produce persistent ALBP. During the first 6 min of ALBP stimulation, we performed an rs-fMRI scan to evaluate the pain status. After the pain rsfMRI scan, we obtained two functional scans for each ALBP subject: one scan during acupuncture stimulation (ACUP) and one scan during tactile stimulation (SHAM) pseudorandomly, with ALBP occurring continually throughout the scanning process. The ACUP or SHAM run comprised a block design with six 30 s blocks of rest time (OFF block) interspersed between six 30 s blocks of stimulation (ON block); ACUP (or SHAM) was administered at BL40 by the same experienced acupuncturist during the six ON blocks of each functional scan. Each functional scan lasted for 6 min, and the time interval between the two functional scans (ACUP and SHAM) was set at 20 min to maximize washout of the sustained effects induced by the former therapeutic stimulation (Figure 4). All MRI scans were performed with each subject laying still in a Philips 3.0 T Achieva scanner (Royal Philips Electronics, Eindhoven, Netherlands) with their eyes and ears covered.

Bottom Line: Most neuroimaging studies have demonstrated that acupuncture can significantly modulate brain activation patterns in healthy subjects, while only a few studies have examined clinical pain.Our results showed that, compared with the baseline, the pain state had higher regional homogeneity (ReHo) values in the pain matrix, limbic system, and default mode network (DMN) and lower ReHo values in frontal gyrus and temporal gyrus; compared with the OFF status, ACUP yielded broad deactivation in subjects, including nearly all of the limbic system, pain status, and DMN, and also evoked numerous activations in the attentional and somatosensory systems; compared with SHAM, we found that ACUP induced more deactivations and fewer activations in the subjects.Multiple brain networks play crucial roles in acupuncture analgesia, suggesting that ACUP exceeds a somatosensory-guided mind-body therapy for ALBP.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China.

ABSTRACT
Most neuroimaging studies have demonstrated that acupuncture can significantly modulate brain activation patterns in healthy subjects, while only a few studies have examined clinical pain. In the current study, we combined an experimental acute low back pain (ALBP) model and functional magnetic resonance imaging (fMRI) to explore the neural mechanisms of acupuncture analgesia. All ALBP subjects first underwent two resting state fMRI scans at baseline and during a painful episode and then underwent two additional fMRI scans, once during acupuncture stimulation (ACUP) and once during tactile stimulation (SHAM) pseudorandomly, at the BL40 acupoint. Our results showed that, compared with the baseline, the pain state had higher regional homogeneity (ReHo) values in the pain matrix, limbic system, and default mode network (DMN) and lower ReHo values in frontal gyrus and temporal gyrus; compared with the OFF status, ACUP yielded broad deactivation in subjects, including nearly all of the limbic system, pain status, and DMN, and also evoked numerous activations in the attentional and somatosensory systems; compared with SHAM, we found that ACUP induced more deactivations and fewer activations in the subjects. Multiple brain networks play crucial roles in acupuncture analgesia, suggesting that ACUP exceeds a somatosensory-guided mind-body therapy for ALBP.

No MeSH data available.


Related in: MedlinePlus