Functional Magnetic Resonance Imaging Study on Acupuncturing Shenmen (HT 7) and Sham Acupoint
     CHEN Shang-jie 1, LIU Jian-wei 2, LIU Bo 3, WU Shan-shan 3, CHEN Jun 3, RAN Peng-cheng 3
     1 Department of Rehabilitation, Baoan People's Hospital, Shenzhen 51810 l, R R. China
     2 Guangzhou University of Traditional Chinese Medicine, Guangzhou 510405, E R. China
     3 Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510120, P. R. China

[Abstract] Objective: To observe the conditions of the activating areas in the brain evoked by needling Shenmen (HT 7) acupoint. Methods: Twelve healthy young volunteers were needled at Shenmen (HT 7) acupoint with rotating and twisting techniques. Functional magnetic resonance imaging (fMRI) was adopted to detect the brain activating areas, TR/TE/FA=3560 ms/50 ms/900. After scanning, the images were dealt with SPM2. Results: Needling Shenmen (HT 7) primarily activated BA2 and BA1 of the gyms postcentralis in right-sided frontal lobe, BA47 of left-sided inferior frontal gyms and BA43 of left-sided gyms postcentralis, and also activated BA40 of inferior parietal lobule in fight-sided parietal lobe, BA22 of gyms temporalis superior in left-sided lobus temporalis, and BA40 of right-sided insula; however, the sham acupoints could not activate these nucleus. Conclusion: Needling Shenmen (HT 7) can activate the relevant functional areas in the brain.
[ Key Words ] Acupuncture; Magnetic Resonance Imaging; Acupoint; Shenmen (HT 7)
[CLC Number] R2-03
[Document Code] A
 
Acupuncture has been extensively used in clinical practice, but its treatment mechanisms, including the correlativity between acupoints and the brain, remain to be studied. Invasive technique is difficult to observe the working process of the brain in vivo, while functional magnetic resonance imaging (fMR1) becomes a quite effective means for in vivo brain research. Studying the brain reaction after acupuncture at acupoints by fMRI helps to clarify the nerve mechanisms of acupuncture. Therefore, this research applied fMRI to observe the signals of the brain functional areas after acupuncture at Shenmen (HT 7), an acupoint of the Heart Meridian, in an attempt to explore the nerve mechanisms of acupoint.

1 Material

1.1 Inclusive criteria
Being well in the past; aged at 18-25 years old; unmarried; graduated from polytechnic schools or colleges; right-handed people; body weight index being 20-24 kg/m2; Signed the informed consent.

1.2 Exclusive criteria
 No any discomforts within one week; unconsciousness, severe visual, hearing and speech dysfunction, and poor health unable to carry out other health evaluation; no metal residual inside the body; not undergoing MRI examination for being afraid of MRI and else; with the history of surgery; abnormality in circulation system, respiratory system and nervous system; women in menstrual period or with the history of pregnancy; severe primary diseases in the liver, kidney, hemopoietic system and endocrine system; psychosis, epilepsy; patients taking overdue alcohol and drugs or with malignant tumors.

1.3 General data
Twelve healthy volunteers were interns, 6 men and 6 women, aged 18-23 years old; men students were between 165-178 cm in height and women students between 152-166 cm; men students were between 52-72 kg in body weight and women between 45-59 kg, all with normal body weight indexes; one man and one woman were from collages and others from polytechnic schools; all subjects were right-handed.

2 Experimental Methods

2.1 Preparation before experiment
Several days before experiment, all testees should first undergo needling manipulation to prevent fear and adapt needing techniques; one day before experiment, the testees were told the test process and asked to sleep early and ensure adequate sleep. On the test day, after lunch at 11:30, the testees did not take foods any longer and had a rest; at 14:00 pm, they were waiting outside the fMRI room and emptied the bladder and bowels; 30 min later, they lay on the examination table, relaxing themselves, closing eyes and remaining motionless, and their heads were stabilized with headgears, the ears were plugged with earplugs; the experiment was done in room with no lights and visual and hearing interference.

2.2 Needling techniques
 The right-side Shenmen (HT 7) and sham acupoints were selected. Shenmen (HT 7) was located in the light of related literature[1], while sham acupoint was located at the midpoint of the line between acupoints Shenmen (HT 7) and Daling (PC 7). These two points were  routinely  disinfected  and  perpendicularly punctured 15 mm with silver needles 0.35 mm in diameter and 25 mm in length; the needles were manipulated  by  lifting-thrusting  and  twisting techniques to induce needling sensation for every testee. When the needling sensation arrived at acupoints, group-piece stimulation mode was adopted, with alternating rest period of 35.6 s and exciting period of 35.6 s. This stimulation was repeated three times and made up of three parts. The stimulation was done by twisting the needles at the angle of 1800 and frequency of 90 times every minute.

2.3 fMRI examination method
Siemens Avanto 1.5T magnetic resonance scanner and standard coil were used to stabilize the head, which  was  then  anatomically  and  functionally scanned. Functional scanning image was collected with echo-planar imaging (EPI) sequence and T2 Weighed imaging (T2WI). In axial position, the image was collected parallel with the line along the anterior and posterior callosum including the whole cerebrum from endbrain and cerebellum, at layer thickness of 3 ram, layer number of 36 and 60 times
per cycle, with scanning parameters:  repetition time/echo time/flip angle (TR/TE/FA)=3560 ms/ 50ms/900, field of view (FOV) at 230 ram, matrix at 64 x 128, pixel size at 3.59 mmx 1.80 mm, scan time was 3 s and interval was 5 s. Anatomical scan fast spin echo (FSE) sequence and T1 Weighed imagin