Abstract
The javascript:void(0)manipulation and sustained effects of acupuncture have been investigated in multiple studies, but several findings are inconsistent with one another. One possible explanation for these discrepancies is that different modalities of acupuncture were utilized in these studies. In the present study, we investigated both the manipulation and sustained effects of acupuncture in different modalities, including manual acupuncture (MA), electroacupuncture (EA) and transcutaneous electrical acupoint stimulation (TEAS). MA, EA, TEAS and sensory control stimulation were applied to 18 healthy subjects, and combined block-designed and resting-state fMRI scans were performed. In analyzing these data, the block-designed datasets were used to assess the manipulation effect by employing a modified general linear model. The data from the resting states, before and after stimulation, were used to explore the brain networks involved in the sustained effect. The results showed that the two 1-min stimulation periods produced similar activation patterns in the sensory control with positive activation in the sensorimotor areas and negative activation in the default mode areas. Although similar patterns could be detected in the first stimulation period in MA, EA and TEAS, no positive activation result was observed in the second stimulation period, and EA showed a more extensive deactivation compared to MA and TEAS. Additionally, all three of the modalities of acupuncture stimulation could increase the instinct brain network in rest. A more secure and spatially extended connectivity of the default mode network was observed following MA and EA, and TEAS specifically increased the functional connectivity in the sensorimotor network. The present study suggested that different brain mechanisms might be recruited in different acupuncture modalities. In addition, the findings from our work could provide methodological information for further research into the mechanism of acupuncture.
Highlights
Acupuncture is a traditional Chinese treatment that has been used in the Orient for thousands of years and is gaining widespread acceptance as an alternative and complementary treatment in modern medicine [1]
Stronger soreness and numbness feelings were reported in manual acupuncture (MA) and transcutaneous electrical acupoint stimulation (TEAS), respectively, and there were no differences in dull pain (Fig. 2B)
The mean intensities of all sensations were compared, and significant higher mean deqi scores were observed in MA and EA, compared to the sensory control (F3,62 = 7.252, P,0.001) (Fig. 2C)
Summary
Acupuncture is a traditional Chinese treatment that has been used in the Orient for thousands of years and is gaining widespread acceptance as an alternative and complementary treatment in modern medicine [1]. In addition to traditional manual acupuncture (MA), new acupuncture modalities, such as electroacupuncture (EA) and transcutaneous electrical acupoint stimulation (TEAS), are gaining in popularity. Unlike MA, which uses manual needling at specific acupoints to achieve a therapeutic effect, in EA, electrical pulses are delivered on the needles inserted into the acupoints, and in TEAS, electrical pulses are delivered on the skin of the acupoints via electrode. There is solid evidence that both EA and TEAS have treatment effects on pain [2,3] and substance abuse [4,5] in both humans and animal models. TEAS has been shown to be as effective as EA in analgesia [10], and with training for nurses and patients, it can be performed even without an acupuncturist. The noninvasiveness of the procedure makes it more acceptable to patients
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