Li La-Mei, Lü Fa-Jin, Guo Zhong-Jie, Song Yun-E, Xie Hong-Wu, Tang Xi, Ren Yi, Li Xue-Zhi
College of Chinese Medicine, Chongqing Medical University, Chongqing 400016, China.
Zhen Ci Yan Jiu. 2013 Aug;38(4):306-13.
To observe the synchronism difference of brain region activities in response to acupuncture stimulation of Zusanli (ST 36) in healthy volunteer subjects with different acupuncture analgesia sensitivity, so as to study the central factors influencing acupuncture intervention outcomes.
Forty-five healthy volunteer subjects with different constitutions (different sensitivities in response to needling stimulation) were divided into insensitive group, normal group and sensitive group (n = 15). The pressure pain threshold (PPT) of the Zusanli (ST 36) region before and after acupuncture stimulation of ST36 was assessed using visual analog scale (VAS). Two weeks later after acupuncture stimulation of ST 36, resting-state fMRI images were acquired by using a nuclear magnetic resonance imaging system and analyzed by using DPARSFV 2.1 software package, software SPM 8 and REST 1.7. The cerebral regional homogeneity (ReHo) of the subjects was then calculated by Resting-State fMRI Data Analysis Toolkit (REST).
Compared with pre-acupuncture, PPT levels of the normal and sensitive groups were significantly increased after acupuncture of ST 36 (P < 0.05), and that of the insensitive group had no significant change (P > 0.05). Following acupuncture stimulation of ST 36, the insensitive group only showed a significant decreased ReHo in the left fusiform gyrus, left inferior temporal gyrus, bilateral postcentral gyrus, and left anterior central gyrus. In the normal group, a significantly increased ReHo was found in left brainstem, the right cerebellum posterior lobe, right parahippocampa gyrus, right fusiform gyrus, left angular gyrus, temporal lobe and the left frontal lobe; and a significantly decreased ReHo in the occipital lobes and the right superior temporal gyrus after acupuncture stimulation of ST 36. In the sensitive group, a markedly increased ReHo was found in the left brainstem, bilateral cerebellum posterior lobes, left inferior temporal gyrus, basal ganglia, the left insular lobe, anterior cingutate, frontal lobe, inferior parietal lobule, and the right supplementary motor area, and an obviously decreased ReHo found in the bilateral occipital lobes, fusiform gyrus, posterior central gyrus, the right posterior cingutate, the left temporal lobe and the left paracentral lobule, etc. after acupuncture of ST 36.
Constitution-associated needling sensation may be an important influential factor for acupuncture analgesia in normal subjects. The change of ReHo in different cerebral areas is probably responsible for the difference of acupuncture analgesia in different constitution people.
观察不同针刺镇痛敏感度的健康志愿者在针刺足三里（ST 36）时脑区活动的同步性差异，以研究影响针刺干预效果的中枢因素。
将45名体质不同（对针刺刺激敏感度不同）的健康志愿者分为不敏感组、正常组和敏感组（每组n = 15）。采用视觉模拟评分法（VAS）评估针刺ST36前后足三里（ST 36）区域的压痛阈值（PPT）。在针刺ST 36两周后，使用核磁共振成像系统采集静息态功能磁共振成像（fMRI）图像，并使用DPARSFV 2.1软件包、软件SPM 8和REST 1.7进行分析。然后通过静息态功能磁共振成像数据分析工具包（REST）计算受试者的脑区局部一致性（ReHo）。
与针刺前相比，正常组和敏感组针刺ST 36后PPT水平显著升高（P < 0.05），不敏感组无显著变化（P > 0.05）。针刺ST 36后，不敏感组仅在左侧梭状回、左侧颞下回、双侧中央后回和左侧中央前回出现ReHo显著降低。在正常组中，针刺ST 36后发现左侧脑干、右侧小脑后叶、右侧海马旁回、右侧梭状回、左侧角回、颞叶和左侧额叶的ReHo显著增加；枕叶和右侧颞上回的ReHo显著降低。在敏感组中，针刺ST 36后发现左侧脑干、双侧小脑后叶、左侧颞下回、基底神经节、左侧岛叶、前扣带回、额叶、顶下小叶和右侧辅助运动区的ReHo明显增加，双侧枕叶、梭状回、中央后回、右侧后扣带回、左侧颞叶和左侧中央旁小叶等的ReHo明显降低。
体质相关的针感可能是正常受试者针刺镇痛的重要影响因素。不同脑区ReHo的变化可能是不同体质人群针刺镇痛差异的原因。
