Acupuncture for ischemic stroke: cerebellar activation may be a central mechanism following Deqi

Abstract

The needling sensation of Deqi during acupuncture is a key factor of influencing acupuncture outcome. Recent studies have mainly focused on the brain function effects of Deqi in a physiological state. Functional magnetic resonance imaging (fMRI) on the effects of acupuncture at Waiguan (SJ5) in pathological and physiological states is controversial. In this study, 12 patients with ischemic stroke received acupuncture at Waiguan (SJ5) and simultaneously underwent fMRI scanning of the brain, with imaging data of the activated areas obtained. Based on the patient's sensation, imaging data were allocated to either the Deqi group or non-Deqi group. In the Deqi group, the activated/deactivated areas were the left superior temporal gyrus (BA39)/right anterior lobe of the cerebellum and left thalamus. In the non-Deqi group, the activated areas included the medial frontal gyrus of the right frontal lobe (BA11), right limbic lobe (BA30, 35), and left frontal lobe (BA47), while the only deactivated area was the right parietal lobe (BA40). Compared with the non-Deqi group, the Deqi group exhibited marked activation of the right anterior lobe of the cerebellum and right limbic lobe (BA30). These findings confirm that the clinical effect of Deqi during acupuncture is based on brain functional changes. Cerebellar activation may be one of the central mechanisms of acupuncture in the treatment of ischemic stroke.

Keywords: 973 Program; Brodmann area; Deqi; Waiguan (SJ5) acupoint; acupuncture; functional magnetic resonance imaging; ischemic stroke; nerve regeneration; neural regeneration; non-Deqi; traditional Chinese medicine.

Figure 1

Acupuncture stimulus procedure at Waiguan (SJ5). S: Second.

Figure 2

Brain regions activated during acupuncture at Waiguan (SJ5) in the Deqi group. The left superior temporal gyrus (BA39) was activated, while the right anterior lobe of the cerebellum and left thalamus were deactivated. Activation: Nervous activity increased above baseline level with increased blood oxygen levels (red). Deactivation: Nervous activity decreased below baseline level with decreased blood oxygen levels (blue).

Figure 3

Brain regions activated during acupuncture at Waiguan (SJ5) in the non-Deqi group. The right medial gyrus frontalis (BA11), right limbic lobe (BA30, BA35), and left frontal lobe (BA47) were activated, and the right parietal lobe (BA40) deactivated. Activation: Nervous activity increased above baseline level with increased blood oxygen levels (red). Deactivation: Nervous activity decreased below baseline level with decreased blood oxygen levels (blue).

Figure 4

Difference of brain regions activated during acupuncture at Waiguan (SJ5) in the Deqi and non-Deqi groups. Compared with the non-Deqi group, the right anterior lobe of the cerebellum and right limbic lobe (BA30) were significantly activated in the Deqi group. Activation: Nervous activity increased above baseline level with increased blood oxygen levels (red). Deactivation: Nervous activity decreased below the baseline level with decreased blood oxygen levels (blue).