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. 2022 Jul 22:13:930753.
doi: 10.3389/fneur.2022.930753. eCollection 2022.

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

Haoming Huang  1   2 , Xiaomei Yue  1 , Xi Huang  3 , Wenjie Long  3 , Shangyu Kang  2 , Yawen Rao  2 , Jingchun Zeng  4 , Junling Zuo  5 , Lin Wang  5 , Hongjuan Li  6 , Yeqing Wang  7 , Shijun Qiu  2 , Weixuan Zhao  7
Affiliations

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

Haoming Huang et al. Front Neurol. .

Abstract

Purpose: Stomach 36 (ST36, zusanli) is one of the important acupoints in acupuncture. Despite clinical functional magnetic resonance imaging (fMRI) studies of ST36 acupuncture, the brain activities and the neural mechanism following acupuncture at ST36 remain unclear.

Methods: Literature searches were conducted on online databases, including MEDLINE, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang database, WeiPu database, and China Biology Medicine, for task-based fMRI studies of acupuncture at ST36 in healthy subjects. Brain regions activated by ST36 acupuncture were systematically evaluated and subjected to seed-based d mapping meta-analysis. Subgroup analysis was conducted on control procedures, manual acupuncture, electrical acupuncture (EA), and acupuncture-specific activations. Meta-regression analysis was performed to explore the effects of needle retention time on brain activities following ST36 acupuncture stimulation. The activated brain regions were further decoded and mapped on large-scale functional networks to further decipher the clinical relevance of acupuncturing at ST36.

Results: A total of sixteen studies, involving a total of 401 right-handed healthy participants, that satisfied the inclusion criteria were included in the present meta-analysis. Meta-analysis showed that acupuncturing on ST36 positively activates the opercular part of the right inferior frontal gyrus (IFG.R), left superior temporal gyrus (STG.L), and right median cingulate/paracingulate gyri (MCG.R) regions. Needle retention time in an acupuncture session positively correlates with the activation of the left olfactory cortex, as shown in meta-regression analysis. Subgroup analysis revealed that EA stimulation may be a source of heterogeneity in the pooled results. Functional network mappings showed that the activated areas were mapped to the auditory network and salience network. Further functional decoding analysis showed that acupuncture on ST36 was associated with pain, secondary somatosensory, sound and language processing, and mood regulation.

Conclusion: Acupuncture at ST36 in healthy individuals positively activates the opercular part of IFG.R, STG.L, and MCG.R. The left olfactory cortex may exhibit positive needle retention time-dependent activities. Our findings may have clinical implications for acupuncture in analgesia, language processing, and mood disorders.

Systematic review registration: https://inplasy.com/inplasy-2021-12-0035.

Keywords: ST36 (zusanli); acupuncture; brain activation; systematic review; task-based fMRI.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The PRISMA flow diagram of the detailed search and literature selection processes. fMRI, functional magnetic resonance imaging.
Figure 2
Figure 2
The brain regions activated by acupuncture at ST36. The color map indicates the SDM-Z values with a cutoff level of 0.5; STG, superior temporal gyrus; IFG, inferior frontal gyrus; MCG, median cingulate/paracingulate gyri; L/R indicates the left or right hemisphere.
Figure 3
Figure 3
Meta-regression of the relationship between needle retention time and the estimated effect size of the left olfactory cortex.
Figure 4
Figure 4
The relevant decoded functions of acupuncture at ST36.
See this image and copyright information in PMC

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References

    1. Yu Z. Neuromechanism of acupuncture regulating gastrointestinal motility. World J Gastroenterol. (2020) 26:3182–200. 10.3748/wjg.v26.i23.3182 - DOI - PMC - PubMed
    1. Yang L, Sui J, Shi H. Control modeling and Chinese acupuncture treatment on cerebral circulation. Technol Health Care Off J Eur Soc Eng Med. (2015) 23 Suppl 1:S77–82. 10.3233/thc-150934 - DOI - PubMed
    1. Lou X, Liu X, Liu C, Lin H-J, Liu H, Ling J. Therapeutic effect of electric-balance stimulation with scalp acupuncture for motor aphasia after cerebral infarction. Chin Acupunct Moxibustion. (2021) 41:1211–5. 10.13703/j.0255-2930.20210302-k0005 - DOI - PubMed
    1. Bai L, Tian J, Zhong C, Xue T, You Y, Liu Z, et al. . Acupuncture modulates temporal neural responses in wide brain networks: evidence from fMRI study. Mol Pain. (2010) 6:73. 10.1186/1744-8069-6-73 - DOI - PMC - PubMed
    1. He Z, Hou L, Sun R, Yin T, Ma P, Chen L, et al. . The status of the acupuncture mechanism study based on PET/PET-CT technique: design and quality control. Evid-Based Complement Altern Med ECAM. (2019) 2019:9062924. 10.1155/2019/9062924 - DOI - PMC - PubMed

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