Brain correlates of phasic autonomic response to acupuncture stimulation: An event-related fMRI study

Abstract

Autonomic nervous system (ANS) response to acupuncture has been investigated by multiple studies; however, the brain circuitry underlying this response is not well understood. We applied event-related fMRI (er-fMRI) in conjunction with ANS recording (heart rate, HR; skin conductance response, SCR). Brief manual acupuncture stimuli were delivered at acupoints ST36 and SP9, while sham stimuli were delivered at control location, SH1. Acupuncture produced activation in S2, insula, and mid-cingulate cortex, and deactivation in default mode network (DMN) areas. On average, HR deceleration (HR–) and SCR were noted following both real and sham acupuncture, though magnitude of response was greater following real acupuncture and inter-subject magnitude of response correlated with evoked sensation intensity. Acupuncture events with strong SCR also produced greater anterior insula activation than without SCR. Moreover, acupuncture at SP9, which produced greater SCR, also produced stronger sharp pain sensation, and greater anterior insula activation. Conversely, acupuncture-induced HR– was associated with greater DMN deactivation. Between-event correlation demonstrated that this association was strongest for ST36, which also produced more robust HR–. In fact, DMN deactivation was significantly more pronounced across acupuncture stimuli producing HR–, versus those events characterized by acceleration (HR+). Thus, differential brain response underlying acupuncture stimuli may be related to differential autonomic outflows and may result from heterogeneity in evoked sensations. Our er-fMRI approach suggests that ANS response to acupuncture, consistent with previously characterized orienting and startle/defense responses, arises from activity within distinct subregions of the more general brain circuitry responding to acupuncture stimuli.

The Autonomic Brain: An Activation Likelihood Estimation Meta-Analysis for Central Processing of Autonomic Function

“…Its involvement in parasympathetic regulation, however, is an interesting and new finding that may reflect the need for balancing both increased sympathetic and decreased parasympathetic outflow in response to aversive stimuli. Furthermore, left lateralization of amygdala function, as noted in our results, has been shown before in the context of emotion processing (Morris et al, 1998;Wager et al, 2003), especially, when subjects were aware of the presented stimuli. Left dominance was also described by Thayer et al (2012) in their meta-analysis of HRV-related brain activity.…”

“…Interestingly, a linkage between DMN activity and autonomic regulation has been described in several previous studies (Nagai et al, 2004a;Wong et al, 2007;. Parasympatheticmodulatory brain regions were identified in our analysis by studies adopting HF-HRV, a cardiovagal metric.…”

Acupuncture Evoked Response in Contralateral Somatosensory Cortex Reflects Peripheral Nerve Pathology of Carpal Tunnel Syndrome

“…2 However, only a few individual fMRI studies evaluated more than a single acupoint with direct statistical contrasts corrected for many comparisons. 3,4 Hence, acupoint and meridian specificity in brain response has remained a controversial subject.…”

Complete response to acupuncture therapy in female patients with refractory interstitial cystitis/bladder pain syndrome

“…Human brain is closely involved in the control of the micturation. Functional magnetic resonance imaging (MRI) studies demonstrated that there is a significant connection between brain activity and acupuncture treatment [28]. This was confirmed by Hui Wang and et al in which acupuncture stimulation of the sacral vertebrae affects the neurons in the micturition center [29].…”