Characterizing Acupuncture Stimuli Using Brain Imaging with fMRI - A Systematic Review and Meta-Analysis of the Literature
Characterizing Acupuncture Stimuli Using Brain Imaging with fMRI - A Systematic Review and Meta-Analysis of the Literature
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DOI：
10.1016/j.dza.2012.08.008
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发表时间：
2012-04
期刊：
影响因子：
3.7
通讯作者：
Wen-jing Huang;D. Pach;V. Napadow;Kyungmo Park;X. Long;J. Neumann;Y. Maeda;T. Nierhaus;F. Liang-F.-L
中科院分区：
文献类型：
--
作者：
Wen-jing Huang;D. Pach;V. Napadow;Kyungmo Park;X. Long;J. Neumann;Y. Maeda;T. Nierhaus;F. Liang-F.-L
针灸的作用机制，包括穴位特异性，还没有很好的理解。在过去的十年中，越来越多的研究已经应用功能磁共振成像来研究大脑对针刺刺激的反应。我们的目的是提供一个系统的概述针灸功能磁共振成像研究考虑以下几个方面：1）真针和假针之间的差异，2）由于不同的针刺手法造成的差异，3）患者和健康志愿者之间的差异，4）不同穴位之间的差异。韩国和日本的文献数据库，从最早的到2009年9月，没有任何语言限制。我们纳入了所有使用fMRI研究针灸对人脑影响的研究（至少有一组接受了基于针的针灸）。共识别出779篇论文，149篇符合描述性分析的纳入标准，34篇符合荟萃分析的条件。从描述性的角度来看，多项研究报告说，针灸调节特定脑区的活动，包括体感皮层，边缘系统，基底神经节，脑干和小脑。对真针刺激的荟萃分析证实了上述许多区域的大脑活动。verum和假针灸之间的差异，注意到在大脑中扣带回的反应，而一些异质性，注意到其他地区，这取决于如何进行这样的荟萃分析，如感觉运动皮层，边缘区域，和cerebellum.ConclusionsBrain响应针灸刺激包括一个广泛的网络区域一致，不仅是体感，但也情感和认知处理。虽然结果是异质的，但从描述性的角度来看，大多数研究表明，针灸可以调节特定脑区的活动，基于荟萃分析的证据证实了其中一些结果。需要更多高质量的研究和更透明的方法来提高不同研究之间的一致性。
BackgroundThe mechanisms of action underlying acupuncture, including acupuncture point specificity, are not well understood. In the previous decade, an increasing number of studies have applied fMRI to investigate brain response to acupuncture stimulation. Our aim was to provide a systematic overview of acupuncture fMRI research considering the following aspects: 1) differences between verum and sham acupuncture, 2) differences due to various methods of acupuncture manipulation, 3) differences between patients and healthy volunteers, 4) differences between different acupuncture points.Methodology/Principal FindingsWe systematically searched English, Chinese, Korean and Japanese databases for literature published from the earliest available up until September 2009, without any language restrictions. We included all studies using fMRI to investigate the effect of acupuncture on the human brain (at least one group that received needle-based acupuncture). 779 papers were identified, 149 met the inclusion criteria for the descriptive analysis, and 34 were eligible for the meta-analyses. From a descriptive perspective, multiple studies reported that acupuncture modulates activity within specific brain areas, including somatosensory cortices, limbic system, basal ganglia, brain stem, and cerebellum. Meta-analyses for verum acupuncture stimuli confirmed brain activity within many of the regions mentioned above. Differences between verum and sham acupuncture were noted in brain response in middle cingulate, while some heterogeneity was noted for other regions depending on how such meta-analyses were performed, such as sensorimotor cortices, limbic regions, and cerebellum.ConclusionsBrain response to acupuncture stimuli encompasses a broad network of regions consistent with not just somatosensory, but also affective and cognitive processing. While the results were heterogeneous, from a descriptive perspective most studies suggest that acupuncture can modulate the activity within specific brain areas, and the evidence based on meta-analyses confirmed some of these results. More high quality studies with more transparent methodology are needed to improve the consistency amongst different studies.