The effect of acupuncture needle combination on central pain processing--an fMRI study.
The effect of acupuncture needle combination on central pain processing--an fMRI study.
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DOI：
10.1186/1744-8069-10-23
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发表时间：
2014-03-25
期刊：
影响因子：
3.3
通讯作者：
Shukla S
中科院分区：
文献类型：
--
作者：
Leung A;Zhao Y;Shukla S
利用腱肌经（TMM）治疗急性疼痛的经验性针灸治疗范式要求刺激听穴（TPs）和集合穴（GP）。本研究的目的是比较与TPs和GP针刺（EA 3），以及TPs单独针刺（EA 2）与功能磁共振成像的脊髓上神经元的机制。在两种模式中，扫描前（热痛）HP和EA后HP VAS评分之间存在显著差异（P < 0.01）（n = 11）。组内随机效应分析表明，EA 3 +HP> EA 3（条件EA 3 +HP减去条件EA 3）似乎对包括IPL、前扣带皮层（ACC）和岛叶皮层（IN）在内的情感性脊髓上区域的活动产生了显著程度的抑制。在EA 2 +HP> EA 2中没有观察到这种抑制水平。（条件EA 2 +HP减去条件EA 2）组内随机效应分析（P < 0.01，簇大小阈值150）在几个疼痛相关的棘上区域中的失活程度高于EA 2，所述疼痛相关的棘上区域包括右前额叶皮质、喙前扣带回（rACC）、内侧扣带皮层、左下额叶和小脑后叶。两因素方差分析结果表明，rACC和小脑后区存在显著（P < 0.01）的针刺效应，右前额区存在显著（P < 0.01）的HP效应。然而，这两个因素之间的显着相互作用，只发现在右前额叶。格兰杰因果关系分析表明，与EA 2相比，EA 3在HP相关的脊髓上躯体感觉、情感和调节成分之间引起了更高程度的推理。延髓-脑桥区的失活模式直接影响了次级躯体感觉皮层的失活模式，而次级躯体感觉皮层也影响了IN的失活。虽然EA 2和EA 3在与疼痛处理相关的人脑区域中诱导了显著程度的失活，但GP刺激的加入进一步对上行性脊髓网状疼痛通路发挥了抑制作用。因此，不同的经验针刺治疗范式所规定的不同针刺位置可能在调节疼痛相关神经元功能方面发挥不同的作用。
Empirical acupuncture treatment paradigm for acute pain utilizing Tendinomuscular Meridians (TMM) calls for the stimulation of Ting Points (TPs) and Gathering point(GP). This study aims to compare the supraspinal neuronal mechanisms associated with both TPs and GP needling (EA3), and TPs needling alone (EA2) with fMRI. A significant (P < 0.01) difference between pre-scan (heat Pain) HP, and post-EA HP VAS scores in both paradigms was noted (n = 11). The post-EA HP VAS score was significantly (P < 0.05) lower with EA3 comparing to EA2 Within-group random effect analysis indicated that EA3+HP>EA3 (condition EA3+HP subtracted by condition EA3) appeared to exert a significant degree of activity suppression in the affective supraspinal regions including the IPL, anterior cingulate cortex (ACC) and the insular cortex (IN). This level of suppression was not observed in the EA2+HP>EA2 (condition EA2+HP subtracted by condition EA2) within-group random effect analysis Between-group random effect analysis indicated that EA3 induced a significantly (P < 0.01, cluster size threshold 150) higher degree of deactivation than EA2 in several pain related supraspinal regions including the right prefrontal cortex, rostral anterior cingulate (rACC), medial cingulate cortex, left inferior frontal lobe and posterior cerebellum. The 2-factor ANOVA in those regions indicated both rACC and posterior cerebellum had a significant (P < 0.01) needle effect, and the right prefrontal area showed a significant (P < 0.01) HP effect. However, a significant interaction between the two factors was only found in the right prefrontal lobe. Granger causality analysis showed EA3 induced a much higher degree of inference among HP related supraspinal somatosensory, affective and modulatory components than EA2. Deactivation pattern at the medullary-pontine area casted a direct inference on the deactivation pattern of secondary somatosensory cortices which also affected the deactivation of the IN. While both EA2 and EA3 induced a significant degree of deactivation in the human brain regions related to pain processing, the addition of GP stimulation further exerts an inhibitory effect on the ascending spinoreticular pain pathway. Therefore, different needling position as mandated in different empirical acupuncture treatment paradigms may play a different role in modulating pain related neuronal functions.
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影响因子：
--
作者：
Leung, Albert Y.;Kim, Susan J.;Yaksh, Tony
通讯作者：
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影响因子：
7.4
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7.4
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