To study the neuronal mechanism of acupunture analgesia

描述（由申请人提供）：针灸为疼痛提供了一种低成本、低风险的治疗选择。尽管最近美国国立卫生研究院的一个共识小组提出了针灸的临床疗效，但目前指导针灸实践的原则是经验性的。为了促进针灸作为一种可行的疼痛治疗方式的整合，需要建立针灸的神经元机制。本研究的长期目标是建立一种新的研究方法来关联和建立针刺镇痛机制与相应的动态脑活动之间的关系。基于我们在过去一年中获得的初步数据，我们建议利用以下方法来研究人类志愿者针灸镇痛的神经元机制：1)教科书针刺治疗急性疼痛的范式，2)强直性急性热痛模型，3)成熟的模态特定定量外周热神经感觉测试方法，以及4)脑功能磁共振成像（fMRI）数据驱动分析模型。本研究分为两个阶段，具体目的如下：1)通过行为测量和热神经感觉测试，定量建立针刺对痛觉和热阈值的影响；2)利用功能磁共振成像（fMRI）建立中枢神经系统对个体预定的有害热阈值的有害热感觉刺激的动态反应；3)利用fMRI建立针刺对中枢神经系统的动态反应；4)应用功能磁共振成像（fMRI）评价针刺对周围性急性热痛刺激的相应效果；5)评价针刺方式变化对疼痛感知、外周热阈值及相关fMRI指标的影响。

DESCRIPTION (provided by applicant): Acupuncture provides an alternative means of low cost and risk treatment option for pain. Despite the clinical efficacy of acupuncture suggested by a recent NIH consensus panel, the current principles, which govern the practice of acupuncture, are empirical. To facilitate the integration of acupuncture as a viable treatment modality for pain, a neuronal mechanism of acupuncture needs to be established. The long-term goal of the proposed study is to establish a new investigational approach that can correlate and establish the relationship between the analgesic mechanism of acupuncture and the corresponding dynamic brain activities. Based on the preliminary data that we have obtained in the past year, we propose to utilize the following for studying the neuronal mechanism of acupuncture analgesia in human volunteers: 1) a textbook acupuncture paradigm for treating acute pain, 2) a tonic acute thermal pain model, 3) a well established method of modality specific quantitative peripheral thermal neurosensory testing, and 4) functional Magnetic Resonance Imaging (fMRI) of the brain with a data-driven analysis model. This proposed study contains two phases with the following specific aims: 1) To quantitatively establish the effect of acupuncture on pain perception and thermal thresholds by using behavioral measurement and thermal neurosensory testing; 2) To establish the dynamic central nervous system response to the noxious thermal sensory stimulation with individually predetermined noxious thermal heat thresholds by using fMRI; 3) To establish the dynamic central nervous system response to acupuncture by using fMRI; 4) To assess the corresponding effect of acupuncture on peripheral acute thermal heat pain stimulation by using fMRI; 5) To assess the effect of variation in acupuncture needling on pain perception, peripheral thermal thresholds and correlated fMRI indices.