ACUPUNCTURE MODULATES THE FUNCTIONAL CONNECTIVITY OF PRIMARY SOMATOSENSORY CORTEX ONLY IN CERTAIN PATHOLOGICAL STAGES OF BELL'S PALSY

Objective: Bell's palsy(BP) is a common peripheral idiopathic facial nerve palsy and acupuncture is a popular treatment.The aim of this study is to investigate acupuncture effect on primary somatosensory cortex(SI) functional connectivity(FC) in different pathological stages of BP.Methods: Three runs of fMRI data(before, during and after acupuncture treatment) were acquired in healthy control(normal group, n=35) and patients with BP.Patients were classified into three groups according to disease duration(DD) and House Brackmann score(HB) of BP, including early group(n=39, HBI, DD14 d), later group(n=36, HBI, DD14 d), andhealed group(n=37, HB=I).Seed point of SI from the lesion side was first decided by analysis of fMRI data during acupuncturing at Hegu(LI4), and then FC of SI was performed.The FC changes between post-acupuncture and pre-acupuncture were analyzed with pair t-test.Results: By comparing FC of post-acupuncture with that of pre-acupuncture, significantly decreased FC of SI was found in early stage in left primary somatosensory cortex, secondary somatosensory cortex, primary motor cortex, middle insula and posterior insula and increased connectivity was found in later stage in bilateral primary motor cortex, motor cingulate cortex, supplement motor area, premotor, cuneus, precuneus, lingual gyrus and right occipital gyrus.No significant differences in FC changes between pre-acupuncture and post-acupuncture were found in the normal group and in the healed group.Conclusion: Although the same paradigm of acupuncture stimulation was applied to the four groups, changes in FC of SI were only found in early and later stages of BP while no changes were found in healthy control and healed patients.It was concluded that acupuncture induced changes of FC of SI depending on the pathological status in patients with BP which is consistent with the acupuncture role in homeostasis.     

FUNCTIONAL MAPPING OF THE HUMAN BRAIN DURING ACUPUNCTURE WITH MAGNETIC RESONANCE IMAGING SOMATOSENSORY CORTEX ACTIVATION

1NTRODUCTIONHegu(Ll4)isoneofthemosteffectiveandmostfrequentlyusedacupointsintraditionalChineseacupuncture.ItisindicatedfOrpaininmanypartsofthebody,butisparticularlyeffec-tiveforheadache,migraine,toothache,sorethroatandotherd1sordersoftheheadandface.Manyanimalexperimentsindicatethathighercentersinthenervoussystemareinvolvedinacupunctureanalgesia["2]butdirectevidenceforhumansubjectsisdifficulttoobtainuntilthere-centadventofpowerfu1andn0n-invasivemeth-odsforneuroimaginginthe9O's.Werecentlya…     

猫的十字沟前皮层和 SI 区参与对中央中核针刺镇痛效应的下行性调节

<正> 我们以往工作证明,猫的十字沟前皮层参与对丘脑中央中核(CM)伤害性反应的下行性调节。本文比较了用利多卡因局部改变十字沟前皮层和 SI 区机能状态前后电针对 CM 神经元伤害性反应的影响,以探讨十字沟前皮层和 SI 区是否参与对 CM 核电针效应的下行性调节。实验用猫,硫贲妥钠麻醉下开颅,暴露右侧十字沟周围皮层,于同侧 CM 核上方颅骨钻孔。分离左侧(?)浅神经,以便施以伤害     

内脏大神经A类和C类纤维传入诱发体感皮层的电反应

<正> 内脏大神经是传导腹腔内脏感觉的主要神经。它有多种类型的传入纤维,分别传送不同的内脏传入信息。本文探讨不同的内脏传入信息是否都能到达大脑皮层,诱发电反应,为阐明“针刺与内脏-皮层相关的关系”提供资料,也将有助于内脏痛觉和牵拉感觉的研究。     

电针“足三里”穴对体感皮层慢痛反应的影响

<正> 过去,在痛觉和针刺镇痛的研究中,多以强电脉冲刺激传入神经模拟伤害性刺激,并以此引起的反应作为疼痛的指标。但强电刺激常引起多种神经纤维包括与痛觉无关的Aαβ纤维、传导“快痛”的 Aδ纤维以及传导慢痛的 C 类纤维同时兴奋。当多种神经纤维的传入冲动同时进入神经中枢时,又常常发生相互影响,往往是传导速度快的 A 类纤维传入抑制了传导较慢的 C 类纤维传入。因此,以前所用的痛反应指标不反映慢痛。     

针刺对异常短潜伏期体感诱发电位的调整作用

<正> 研究资料证明,针刺的作用可以调整中枢神经系统的异常功能,功能增高者可使之减低,功能减低者可使之增高;针刺的调整作用,一方面决定于针刺作用的强度和时间,另一方面也决定于机体的功能状态。近年来由于电子计算机技术的发展,有时能利用平均技术无伤地从体表记录到体感诱发电位(SEPs)。     

ACUPUNCTURE ON GB34 ACTIVATES THE PRECENTRAL GYRUS AND PREFRONTAL CORTEX IN PARKINSON'S DISEASE

Background: Acupuncture is increasingly used as an additional treatment for patients with Parkinson's disease(PD).Methods: In this functional magnetic resonance imaging study, brain activation in response to acupuncture in a group of 12 patients with PD was compared with a group of 12 healthy participants.Acupuncture was conducted on a specific acupoint,the right Yanglingquan(GB34), which is a frequently used acupoint for motor function treatment in the oriental medical field.Results: Acupuncture stimulation on this acupoint activated the prefrontal cortex, precentral gyrus, and putamen in patients with PD; areas that are known to be impaired in patients with PD.Compared with healthy participants, patients with PD showed significantly higher brain activity in the prefrontal cortex and precentral gyrus, especially in the left hemisphere.Conclusion: The neuroimaging results of our study suggest that in future acupuncture research, the prefrontal cortex as well as the precentral gyrus should be treated for symptoms of PD and that GB34 seems to be a suitable acupoint.Moreover, acupuncture evoked more different brain activations in patients with PD than that in healthy participants in our study, stressing the importance of conducting acupuncture studies on both healthy participants as well as patients within the same study, in order to detect acupuncture's efficacy.     

SII区对CM伤害性反应的下行调节与十字沟周围皮层有关

本文在猫上用玻璃微电极胞外记录的方法,观察到用利多卡因阻滞十字沟周围皮层后,电刺激SII区对中央中核伤害性反应的下行抑制作用被阻断,表明生理状态下SII区对中央中核神经元伤害性反应的下行性调节作用与十字沟周围皮层有关。     

WHITE MATTER MICROSTRUCTURE CHANGES IN ACUPUNCTURE FOR PATIENTS WITH STABLE SOMATOSENSORY STROKE:A DIFFUSION TENSOR MAGNETIC RESONANCE IMAGING STUDY

Objective: Acupuncture has been proved to have beneficial effects in the motor recovery process for stroke patients.In spite of its acceptance, the neural mechanism underlying acupuncture for motor recovery is still elusive.The aim of the study was to characterize acupuncture efficacy-related white matter microstructural changes in patients with stable somatosensory stroke.Methods: Twenty-four patients with right hemispheric striatocapsular infarction and stable ischemic stroke were assigned randomly to receive acupuncture or sham treatment for 4 weeks.Twelve age-matched and gender-matched normal subjects were also included.Fractional anisotropy(FA) and mean diffusivity(MD) maps from diffusion tensor imaging(DTI) were obtained for each stroke group before and after acupuncture treatments and for normal subject once.Moreover, mean FA and MD in regions with detected difference after acupuncture treatment were compared in each stroke group and correlations between diffusion quantities and severity of stroke were analyzed.Results: White matter microstructure differences were found between patients and normal subjects primarily in the contralesional primary motor cortex(M1) and insula.The clinical data demonstrated that after 4 weeks of treatment the motricity index(MI) was increased significantly in the acupuncture group but there was no difference between the acupuncture and the sham groups.Only the acupuncture group showed greater activity in the contralesional M1 and non-primary motor cortex(the insula and cingulate cortex) compared with the sham group.The changes were also related significantly with the MI.In the sham group,the activity of the parahippocampus tended to be associated with the increase in the Barthel Index of activities in daily life.Conclusion: Acupuncture and sham intervention have relatively different clinical efficacy and white matter microstructure changes.Acupuncture treatment, which better improves the symptoms and quality of life of stroke patients significantly, enhances the white integrity of both motor network and non-primary motor network.     

大脑皮层与针刺镇痛研究概况

本文就国外研究大脑皮层与疼痛关系,以及针刺镇痛过程中大脑皮层作用原理的有关文献作简要的综述。作者认为大脑在针刺镇痛过程中起一定的作用。参考文献101篇。     

Experimental Research PARTICIPATION OF GABA IN SH EMANATING DESCENDING MODULATION ON THE NUCLEUS CENTRUM MEDIANUM VIA MOTOR CORTEX IN ACUPUNCTURE ANALGESIA

The effects of electrical stimulation of second somatosensory area(S Ⅱ)andelectroacupuncture(EA)at Huantiao(GB 30)and Yanglinquan(GB 34)points on nociceptive re-sponses of neurons in the nucleus centrum medianum(CM)in the thalamus were respectively ob-served after topical application of bicuculline(Bic)at the motor cortex(MCtx),and the results werecompared with those obtained in the saline control group.It was found that following application ofBic either electrical stimulation of SII(n=11)or EA(n=11)yielded obvious inhibition on nocicep-tive responses of CM neurons(P<0.05),which was similar to the inhibitory effects obtained in thesaline control groups(n=11,n=10).After GABA application at MCtx electrical stimulation of SIIfailed to show inhibition on nociceptive responses in 3 CM neurons.It is indicated that GABA in MC-tx is involved in SII originating corticofugal regulation of nucleus CM in acupuncture analgesia.     

用操作条件反射方法探讨大脑皮层在针刺镇痛中的作用

<正> 针麻的特点之一是病人在清醒状态下接受手术。近年来针刺镇痛的原理研究多在急性实验条件下进行,并获得一些可贵资料,阐明了中枢神经系统参与针刺镇痛。我们认为在清醒的不麻醉状态下进行慢性动物实验研究也可能是研究针麻原理的另一个方面,条件反射即为其中的方法之一。最早,条件反     

伤害性刺激对躯体感觉皮层单位放电的影响及电针效应

<正> 大脑皮层在针刺镇痛中的作用是研究针刺镇痛原理的课题之一,以往我们曾在正常人、颅脑手术病人以及实验动物上,用大脑皮层诱发电为指标研究机体对痛刺激(或伤害性刺激)时的大脑皮层诱发电位,并观察某些镇痛药及针刺的影响。     

猫皮层 SI 区及十字沟前区对丘脑束旁核神经元针刺镇痛效应的下行性调节

<正> 在针刺镇痛原理研究方面曾有报道认为:丘脑束旁核(Pf)为接受痛觉冲动的结构。其神经元的痛放电可被针刺穴位所抑制。而传导痛觉的 C 类纤维的传入信号,可在皮层引起潜伏期较长的诱发电反应。本实验室也观察到:用2%利多卡因局部阻滞皮层体感(?)区(S(?))或给予 r-氨基     

丘脑及大脑皮层在穴位电针抑制内脏神经-皮层诱发电位中的作用

<正> 我们曾报导了电针单侧“胃俞”、“足三里”穴可以不同程度地抑制电刺激内脏神经引起的皮层诱发电位,证明了这些诱发电位与内脏痛觉有关以及穴位存在相对特异性,并分析了电针“足三里”穴抑制内脏神经-皮层诱发电位的外周传入途径。为了进     

绞股蓝总皂甙对肝细胞瘤细胞凋亡的诱导作用

目的:探讨绞股蓝总皂甙（Gp）对人肝细胞瘤细胞（Huh-7）细胞凋亡的影响及作用机制。方法:采用流式细胞术检测Gp对人Huh-7细胞凋亡的影响,Western blot分析Gp作用Huh-7细胞后表达的Bcl-2,Bcl-XL,Bax和Bad蛋白水平。结果:20mg/ml Gp作用于细胞24h后,64％的Huh-7细胞发生凋亡,而人纤维细胞凋亡率为12％。Westem blot结果显示Gp作用后Huh-7细胞中Bcl-2表达明显降低,而Bax表达显著上调。结论:Gp可诱导人Huh-7细胞凋亡,其作用机制是通过下调Bcl-2和上调Bax的表达而发挥作用。     

循证医学大针灸领域的发展

Since the 1970s, acupuncture has become popular in the West for many conditions, and particularly for treating chronic illnesses. With the increasing use of acupuncture and other complementary and alternative medicine （CAM） interventions, the demand for scientific evaluation of these modalities has grown. In the United States, this expansion is exemplified by the 1991 establishment of the National Institutes of Health （NIH） Office of Alternative Medicine, authorized by the US Congress, and by a 1994 FDA workshop that led to a reclassification of the acupuncture needle as a medical device and the 1997 NIH consensus conference on acupuncture. Since the latter 1990s, clinical trials on acupuncture have dramatically increased, along with increased research funding in the US and other Western countries. For example, in the US,     

绞股蓝总皂甙对肝细胞瘤细胞凋亡的诱导作用

目的：探讨绞股蓝总皂甙（Gp）对人肝细胞瘤细胞（Huh-7）细胞凋亡的影响及作用机制。方法：采用流式细胞术检测Gp对人Huh-7细胞凋亡的影响，Western blot分析Gp作用Huh-7细胞后表达的Bcl-2，Bcl-XL，Bax和Bad蛋白水平。结果：20mg／ml Gp作用于细胞24h后，64％的Huh-7细胞发生凋亡，而人纤维细胞凋亡率为12％。Western blot结果显示Gp作用后Huh-7细胞中Bcl-2表达明显降低，而Bax表达显著上调。结论：Gp可诱导人Huh-7细胞凋亡，其作用机制是通过下调Bcl-2和上调Bax的表达而发挥作用。     

手捻针对中枢体感诱发电位的反应特性

目的 探讨针刺对大脑皮层调整作用的机制。方法 观察手捻针对正常人正中神经体感诱发电位（SEPs)中枢不同水平（皮层下、皮层、皮层痛成分）的反应特性。结果 手捻针对皮层下成分P14－N16波幅有效明显的抑制作用,且有较强的后效应;手捻针对皮层成分P14－N20、P25－N30、P45－N60波幅无明显影响;手捻针对皮层痛成分P200－N300波幅的影响呈降低趋势,但未见统计学意义;手捻针对中枢不同水平体感诱发电位各成分潜伏时观察未见明显变化规律。结论 手捻针与电针的选择对针刺效应的影响具有重要意义。     

DIFFERENTIAL CEREBRAL RESPONSE TO SOMATOSENSORY STIMULATION OF AN ACUPUNCTURE POINT VERSUS TWO NONACUPUNCTURE POINTS MEASURED WITH fMRI

Objective: To evaluate whether different point locations chosen for a somatosensory stimulation with acupuncture needles differently change the brain activity in healthy volunteers.Methods: We used event-related fMRI, and resting-state functional connectivity fMRI to assess neural responses to standardized manual needle stimulation of the acupuncture point ST36(lower leg) and two control point locations(CP1 same dermatome, and CP2 different dermatome) that are not acupoints.Cerebral responses were expected to differ for stimulation in two different dermatomes(CP2 different from ST36 CP1), or stimulation at the acupuncture point versus the control points.During scans all healthy subjects(n=22) received manual needle stimulation at all 3 points in a randomized order.Each needle stimulation consisted of 6-minute intermittent penetrating needle manipulation on one point.Needle sensation was measured by the Massachusetts General Hospital Acupuncture Sensation Scale(MASS) and correlated with fMRI results.Results: The fMRI analysis found that insula and S2 activation was more pronounced with ST36 stimulation, and there was increased S2 connectivity to thalamus and brainstem following ST36 stimulation.Differences in needle sensation between ST36 vs.CP1 and ST36 vs.CP2 were statistically significant(pairwise t-test, P=0.009 and P=0.005, respectively).No correlation was found when exploring the relationship between the MASS index and the β values of the fMRI BOLD response.Conclusion: Our results suggest that stimulation at acupoints may modulate somatosensory and saliency processing regions more readily.