Acupuncture Analgesia : A Sensory Stimulus Induced Analgesia Observed by functional Magnetic Resonance Imaging

침의 진통효과: 체성감각신경자극으로 유도된 진통작용에 대한 기능성자기공명영상장치를 이용한 연구

  • Cho, Zang-hee (Department of Radiological Sciences, University of California) ;
  • Hwang, Seon-chool (Department of Neurology, Maryknoll General Hospital) ;
  • Son, Young-don (Department of Radiological Sciences, University of California) ;
  • Kang, Chang-ki (Department of Radiological Sciences, University of California) ;
  • Wong, Edward K. (Department of Ophthalmology, University of California) ;
  • Bai, Sun-joon (Department of Anesthesiology, Yonsei University) ;
  • Lee, Un-jung (Won-Kwang University, Oriental Medical School) ;
  • Sung, Kang-kyung (Won-Kwang University, Oriental Medical School) ;
  • Park, Tae-seok (Department of Biomedical Engineering, Graduate School of East-West Medical Science, Kyung Hee University) ;
  • Kim, Young-bo (Department of Neurosurgery, Gachon Medical School) ;
  • Min, Hoon-ki (Department of Radiological Sciences, University of California) ;
  • Oleson, Terry (Emperor's College of Traditional Oriental Medicine)
  • Received : 2004.03.12
  • Accepted : 2004.03.25
  • Published : 2004.04.20

Abstract

Objective : Physiological evidence regarding acupuncture's effect in human patients is not yet well established, despite considerable evidence for its therapeutic efficacy. Besides target or disease specificity of acupuncture, acupuncture analgesia (AA) appears to be another large subclass that poses many questions, such as whether there is point specificity with respect to which acupoint is most effective for a particular condition. Methods : We observed brain activation with functional magnetic resonance imaging (fMRI) using a set of stimuli that consist of pain, pain following Meridian acupuncture, and pain following Sham acupuncture. Results : Among the new observations, the most interesting fact is that data sets of both Meridian acupuncture and Sham acupuncture show decreased activation of the same brain areas related to the pain processing signals. Present functional MRI study demonstrate two important biological observations that could elucidate AA mechanism in human participants: the effects of acupuncture occur through mediation of the higher brain areas. Sham acupuncture stimulation appears to be almost as effective as traditional Meridian acupoint stimulation, suggesting that acupuncture is not entirely point specific. Decreased activation in the limbic paleo cortical areas appears to be the probable neurological manifestation of AA and strongly implies that acupuncture stimulation inhibits the transmission of ascending pain signals to the higher cortical areas by the previously known descending pain inhibitory circuit. Conclusion : We, therefore, a hypothesized that this pain inhibitory circuit is initiated and mediated via the broad sense Hypothalamus Pituitary Adrenal (BS HPA) axis in conjunction to the "sensory stimulation."

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