Neural Responses of Acupuncture for Treating Functional Dyspepsia: An fMRI Study

Abstract

Different acupoints exhibiting similar therapeutic effects are a common phenomenon in acupuncture clinical practice. However, the mechanism underlying this phenomenon remains unclear. This study aimed to investigate the similarities and differences in cerebral activities elicited through stimulation of CV12 and ST36, the two most commonly used acupoints, in the treatment of gastrointestinal diseases, so as to partly explore the mechanism of the different acupoints with similar effects. Thirty-eight eligible functional dyspepsia (FD) patients were randomly assigned into either group A (CV12 group) or group B (ST36 group). Each patient received five acupuncture treatments per week for 4 weeks. The Symptom Index of Dyspepsia (SID), Nepean Dyspepsia Symptom Index (NDSI), and Nepean Dyspepsia Life Quality Index (NDLQI) were used to assess treatment efficacy. Functional MRI (fMRI) scans were performed to detect cerebral activity changes at baseline and at the end of the treatment. The results demonstrated that (1) improvements in NDSI, SID, and NDLQI were found in both group A and group B (p < 0.05). However, there were no significant differences in the improvements of the SID, NDSI, and NDLQI scores between group A and group B (p > 0.05); (2) all FD patients showed significantly increased amplitude of low-frequency fluctuation (ALFF) in the left postcentral gyrus after acupuncture treatment, and the changes of ALFF in the left postcentral gyrus were significantly related to the improvements of SID scores (r = 0.358, p = 0.041); and (3) needling at CV12 significantly decreased the resting-state functional connectivity (rsFC) between the left postcentral gyrus and angular gyrus, caudate, middle frontal gyrus (MFG), and cerebellum, while needling at ST36 significantly increased the rsFC between the left postcentral gyrus with the precuneus, superior frontal gyrus (SFG), and MFG. The results indicated that CV12 and ST36 shared similar therapeutic effects for dyspepsia, with common modulation on the activity of the postcentral gyrus in FD patients. However, the modulatory pattern on the functional connectivity of the postcentral gyrus was different. Namely, stimulation of CV12 primarily involved the postcentral gyrus–reward network, while stimulation of ST36 primarily involved the postcentral gyrus–default mode network circuitry.

Brain Activities Responding to Acupuncture at ST36 (zusanli) in Healthy Subjects: A Systematic Review and Meta-Analysis of Task-Based fMRI Studies

“…However, Jin et al (18) blocked the local sensation with lidocaine infiltration subcutaneously in healthy subjects before MA, resulting in an attenuation of the activated regions without anesthesia, indicating that cutaneous sensation (deqi feelings) may be the major aspect of stimulation that generates brain activation. The effects of ST36 on gastrointestinal diseases have been frequently reported (49,50). One of the included studies showed that the oscillated secretion of gastric-related peripheral humoral factors is accompanied by hypothalamus activation in healthy subjects during EA stimulation (27).…”

Overview of Radiation Enteritis and Progress in Treatment of Traditional Chinese and Western Medicine

“…The results showed that the improvement of relevant indicators in the Jianpi Qinghua Tang treatment group was better than that in the levofloxacin + montmorillonite powder treatment group, and the difference was statistically significant. Jiang Weidong [17] used Hongyu Yin (Radix et Rhizoma Rhei, Herba Artemisiae Scopariae, Radix Astragali, Caulis Spatholobi, Radix Clematidis, Radix et Rhizoma Coptidis) for oral treatment of radiation enteritis, and the total effective rate and symptom scores before and after treatment were significantly improved, confirming the definite therapeutic effect of Hongyu Yin in the treatment of radiation enteritis. Cai Ge [18] selected 80 patients with radiation enteritis and randomly divided them into a control group and a treatment group.…”

Research trends in the field of the gut-brain interaction: Functional dyspepsia in the spotlight – An integrated bibliometric and science mapping approach

“…Neuroimaging research has accumulated a growing body of evidence indicating significant functional and structural changes in multiple brain regions in FD sufferers, including the frontal cortex, somatosensory cortex, postcentral gyrus, precuneus, and caudate tail ( Zeng et al, 2009 ; Nan et al, 2014 ; Lee et al, 2016 ; Qi et al, 2020 ). Interestingly, acupuncture can regulate, to a certain extent, some of the aforementioned abnormal functional activities ( Zeng et al, 2012 ; Chen et al, 2021 ; Dong et al, 2022 ). Acupuncture and electroacupuncture have been studied extensively for their effects on gastric and intestinal motility impairments.…”