Evidence of a Synergistic Effect of Acupoint Combination: A Resting-State Functional Magnetic Resonance Imaging Study

Abstract

Objective: This study aimed to find evidence of a synergistic effect of acupoint combinations by analyzing different brain regions activated after acupuncture at different acupoint combinations.Methods: A total of 57 healthy subjects were randomly distributed into three groups: LR3 plus KI3 acupoints, LR3 plus sham acupoint, or LR3 alone. They underwent a magnetic resonance imaging scan before and after acupuncture. The amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) values of different brain regions were analyzed to observe changes in brain function.Results: ALFF and ReHo produced an activated area in the cerebellum posterior lobe after acupuncture at LR3 plus KI3 acupoints versus LR3 alone. ALFF and ReHo revealed altered activity in Brodmann area 10 (BA10), BA18, and brainstem pons after acupuncture at LR3 plus sham acupoint compared with at LR3 alone. A comparison of acupuncture at LR3 plus KI3 acupoints with LR3 plus sham acupoint demonstrated an increase in BA6 of ALFF and a downregulation of ReHo.Conclusions: The increased number of brain regions with altered brain activity after acupuncture at acupoint combinations versus a single acupoint are evidence of the synergistic effect of acupoint combinations. BA6 was significantly activated after acupuncture at LR3 plus KI3 acupoints compared with at LR3 plus sham acupoint, suggesting that BA6 is the specific region of synergistic effect of acupoint combinations of LR3 plus KI3 acupoints. Affected brain regions were different between acupuncture at LR3 plus sham acupoint and LR3 alone, which indicates that the sham acupoint may have some psychological effect. However, the specific mechanism of acupoint combinations requires further research.

An integrative review of acupressure interventions for older people: A focus on sleep quality, depression, anxiety, and agitation

“…In TCM, the acupoints have different treatment functions when used in different conditions; therefore selection of the acupoints is based on the actions of specific acupoint and the patient's condition. A combination of two or more different acupoints is frequently used to enhance treatment efficacy . In sleep deprivation, acupressure application on common acupoints; HT7, PC6 and SP6 that regulate internal organ functioning, may enhance efficacy of acupressure to improve sleep quality.…”

Changes in resting‐state functional connectivity in nonacute sciatica with acupuncture modulation: A preliminary study

“…We reviewed previous acupuncture treatment for sciatica in MEDLINE (PubMed) since 1970 and selected acupoints that were effective for treatment (Liu & Chen, 2017). We chose to use a combined acupoint treatment strategy, considering that treatment using acupoint combinations may achieve a synergistic effect in the brain (Zhang et al, 2019(Zhang et al, , 2016 (Qin, Liu, Liu, Wu, Zhai, & Liu, 2015).…”

Noneffectiveness of electroacupuncture for comorbid generalized anxiety disorder and irritable bowel syndrome

“…Electroacupuncture, by virtue of its effect on neuroanatomical systems that underpin both disorders, may become a promising “one‐stop” solution for patients with comorbid GAD and IBS, which mutually predict impairment from each other . There was also evidence to suggest synergistic effects in combination of acupoints . EA may also be more accessible in many localities than Western medical services that can deliver the expertise required for combined gastroenterology and psychological care.…”

“…1 There was also evidence to suggest synergistic effects in combination of acupoints. 16 EA may also be more accessible in many localities than Western medical services that can deliver the expertise required for combined gastroenterology and psychological care. In the absence of any evidence on the use of EA on comorbid IBS and GAD, we set out to investigate it using a combination of relevant acupoints (PC6, HT7, LR3, GV20, and EX-HN3 for GAD and ST36, ST37, and SP6 for IBS), on Chinese adults with comorbid IBS and GAD in a gastroenterology clinic in Hong Kong.…”

“…Because the use of penetrating sham acupuncture has been shown to lead to underestimation of effect, 18 we adopted non-penetrating sham acupuncture in this study, as in our pilot study. 16 Blunted telescopic placebo needles hidden inside foam cubes were placed on the same acupoints as the EA group, touching the skin but without deep penetration into the acupoints. The needles were connected with electrical wire, but no electrical stimulation was applied during the sessions.…”