Control Study Of The FMRI Of Twisting Shenmen Point And Relate Points And Non Twisting Shenmen Point

1 Literature researchAcupuncture is an important component of Traditional Chinese Medicine.Its validity has been proved by long-term clinical practices.Acupuncture have been used for thousands of years in China,but were accepted in the West only recently.Reports of patient improvement may be sufficient to persuade the health care consumer but failure to completely demonstrate mechanism which limits the acceptance of acupuncture in mainstream medicine.The meridian and acupoints are the foundation of acupuncture.It has not been widely accepted in the world because the existence and mechanisms of acupoint still need to be proved by completely laboratory and clinical experiments.In recent years, noninvasive functional magnetic resonance imaging(fMRI) that can provide detailed information in mapping of brain function in real time has been generally accepted for. acupuncture research as strong tools.The research of human brain function is one of the popular focuses internationally nowadays,which is mainly concentrated on the brain senior cognitive function presently. 21 centuries has been called as have been known as a century of bio-science or brain science by many scientists.In the last century,"brain decade" plans of Europe,the United States and Japan promote multi-disciplinary and multi-level research that has become the mainstream of the scientific development of contemporary one of cognitive function in the human brain and its neural mechanisms.There are cognitive brain sciences or scientific research institutions in almost all the well-known Western universities.Many western developed countries focused on the deployment of brain and cognitive and behavioral research in their national strategic plan for science.Within this research,the reasonable experimental design and scientific data analysis guarantee the reliable results.Since the 1990s,brain functional imaging techniques are widely applied and extensively developed.The best virtue of these techniques is non-invasive.Besides,It enable us to have direct looks into the brain repeatedly without physical damage.These techniques have their own prominence in the different aspects of temporal and spatial resolutions,but fMRI hold a very important station in brain functional study because of its high spatial resolution.The application of fMRI is more and more important in the research of human brain function with the constant development of magnetic resonance imaging.fMRI based on the BOLD(Blood Oxygenation Level Dependent) signal is currently the most widely used neuroimaging technique,fMRI is non-invasive,free of radioactive materials,with high spatial/temporal resolution and fast imaging acquisition,relatively less expensive,and can be applied on the same subject multiple times and has become one of the key tools in functional brain imaging.Through presenting participants with predefined stimuli,this technique allows observation of the activity in multiple brain areas simultaneously.It combines both functional imaging with anatomical imaging,making it possible to observe mental activity in cognitive and emotional processing in living systems.Inthe recent ten years,fMRI technology has been widely used in domestic and international visual,auditory research,and has also been used to thinking,emotion and other aspects of cognition research.Its findings have been recognized internationally.In recent years,research acupuncture has gradually increased.Many results obtained demonstrate the correlation between activation of specific areas of brain cortices and corresponding acupoint stimulation predicted by ancient acupuncture literature.Therefore, fMRI studies of brain response to acupuncture points may explain the neural mechanisms of acupuncture,and so as to promote the integration of modern medicine.2 Experimental studyObjectiveShenmen point(H7) that is often used to treat cognitive impairment is original point on the hand shao yin heart channel.Chinese medicine theory holds that heart govern spirit. In other words,Shenmen point is closely related with the cognitive in theory and clinical points.However,the physiological mechanisms of this application are still not clear.There are a lot of papers to discuss the mechanisms underlying the effects of acupuncture.There is also related research of Shenmen point.But to the best of our knowledge,fMRI has little been previously applied to study different stimulating such as twisting and non-twisting, and different point located in the same level of anatomy.In this study,we compared the brain activation on fMRI between Shenmen and Yanglao point(S16),Shenmen and nonpoint,and twisting and non-twisting in different meridian channels respectively at the same volunteer.It is the purposes of the present study to characterize the cerebral cortex activation by stimulating Shenmen using fMRI,and elucidate the relationship between stimulating Shenmen and the reaction of cerebral speech cortex.It will reflect comprehensively role of affecting the brain function by stimulating acupuncture Shenmen point.MethodsTwelve healthy young cases were enrolled in this research.According to the randomized block principle,each subject were given to the acupuncture at right Shenmen, Yanglao or nonpoint,based on the sequence of random number table.A block design including three blocks which baseline and stimulation appear alternately was adapted.In stimulation phase,the needle was twisted manually(1.5HZ,180°for 35.6ms) or not twisted. Main parameter in fMRI were TR/TE/FA=3560ms/50ms/90°.Acupuncture sensation was evaluated by means of visual analog scale(VAS).Scanned images were analyzed using SPM2.The result from Group analysis was corrected(FEW,0.05,K≥10) or uncorrected (None,0.001,K≥10).Results(1) There was a feeling of Deqi in operator and "sour,numbness,heavy,distend" in patient when needle was twisted.There was no difference in VAS score of the subjects in each group(P＞0.05);(2) Activation map from group analysis refer to appendix.According to the situation to activate map and coordinates the activation of,the activation of non-correction was likely to increase the positive results;(3) Result of activation domain(group analysis,corrected,0.05,K≥10).Right postcentral gyrus of frontal lobe(BA2,BA1),left inferior frontal gyrus(BA47),postcentral gyrus(BA43),right inferior parietal lobule(BA40),left superior temporal gyrus(BA22) and right insular(BA13) were evoked by twisting Shenmen point;Left inferior parietal lobule(BA40),right inferior frontal gyrus(BA45,BA46),left medial temporal gyrus and medial temporal gyrus(BA37) and left superior frontal gyrus(BA10) were evoked by twisting Yanglao point.(4) Right postcentral gyrus of frontal lobe(BA2,BA1),left inferior frontal gyrus (BA47),postcentral gyrus(BA43),right inferior parietal lobule(BA40),left superior temporal gyrus(BA22) and right insular(BA13) were evoked by twisting Shenmen point; But there were not evoked by acupuncture at nonpoint.(5) Right postcentral gyrus of frontal lobe(BA2,BA1),left inferior frontal gyrus (BA47),postcentral gyrus(BA43),right inferior parietal lobule(BA40),left superior temporal gyrus(BA22) and right insular(BA13) were evoked by twisting Shenmen point; But there were not evoked by nontwisting Shenmen.ConclusionThere were obviously different in area evoked by between twisting Shenmen point and Yanglao point.Besides,there were not evoked by nontwisting Shenmen or twisting nonpoint.Activation of twisting point is closely related with the internal organs as well as the course of the channels and collaterals.It revealed that acupuncture can play a role by means of affecting the function of the brain.