곡지, 족삼리 침자극이 뇌활성화에 미치는 영향에 대한 뇌기능적 자기공명영상을 이용한 연구

Functional MRI Study of Changes in Brain Activity by Manual Acupuncture at LI11 or ST36

  • 조승연 (경희대학교 동서신의학병원 중풍뇌질환센터 한방내과) ;
  • 장건호 (경희대학교 동서신의학병원 영상의학과) ;
  • 박성욱 (경희대학교 동서신의학병원 중풍뇌질환센터 한방내과) ;
  • 정우상 (경희대학교 경희의료원 한방병원 한의과대학 심계내과학 교실) ;
  • 문상관 (경희대학교 경희의료원 한방병원 한의과대학 심계내과학 교실) ;
  • 고창남 (경희대학교 동서신의학병원 중풍뇌질환센터 한방내과) ;
  • 조기호 (경희대학교 경희의료원 한방병원 한의과대학 심계내과학 교실) ;
  • 김영석 (경희대학교 경희의료원 한방병원 한의과대학 심계내과학 교실) ;
  • 배형섭 (경희대학교 동서신의학병원 중풍뇌질환센터 한방내과) ;
  • 박정미 (경희대학교 동서신의학병원 중풍뇌질환센터 한방내과)
  • Cho, Seung-Yeon (Department of Cardiovascular & Neurologic Disease(Stroke Center), East-West Neo Medical Center, College of Korean Medicine, Kyung Hee University) ;
  • Jahng, Geon-Ho (Department of Radiology, East-West Neo Medical Center, School of Medicine, Kyung Hee University) ;
  • Park, Seong-Uk (Department of Cardiovascular & Neurologic Disease(Stroke Center), East-West Neo Medical Center, College of Korean Medicine, Kyung Hee University) ;
  • Jung, Woo-Sang (Department of Cardiovascular & Neurologic Diseases(Stroke center), Hospital of Korean Medicine, Kyung Hee Medical Center, College of Korean Medicine, Kyung Hee University) ;
  • Moon, Sang-Kwan (Department of Cardiovascular & Neurologic Diseases(Stroke center), Hospital of Korean Medicine, Kyung Hee Medical Center, College of Korean Medicine, Kyung Hee University) ;
  • Gho, Chang-Nam (Department of Cardiovascular & Neurologic Disease(Stroke Center), East-West Neo Medical of Korean Medicine, Kyung Hee University Center) ;
  • Cho, Ki-Ho (Department of Cardiovascular & Neurologic Diseases(Stroke center), Hospital of Korean Medicine, Kyung Hee Medical Center, College of Korean Medicine, Kyung Hee University) ;
  • Kim, Young-Suk (Department of Cardiovascular & Neurologic Diseases(Stroke center), Hospital of Korean Medicine, Kyung Hee Medical Center, College of Korean Medicine, Kyung Hee University) ;
  • Bae, Hyung-Sup (Department of Cardiovascular & Neurologic Disease(Stroke Center), East-West Neo Medical Center, College of Korean Medicine, Kyung Hee University) ;
  • Park, Jung-Mi (Department of Cardiovascular & Neurologic Disease(Stroke Center), East-West Neo Medical Center, College of Korean Medicine, Kyung Hee University)
  • 투고 : 2009.07.24
  • 심사 : 2009.08.31
  • 발행 : 2010.01.30

초록

Objectives: The objective of this study was to assess bra in activation and difference by LI11 or ST36 acupuncture stimulation using functional MRI (fMRI). Methods: A total of 10 healthy right-handed volunteers were studied. LI11 acupuncture and ST36 acupuncture stimulations were applied in order on the left. The block design paradigm of RARARA was used for the task, with R representing rest and A representing stimulation, and each period lasted 30 seconds. fMRI data were analyzed using SPM2. Results: The left LI11 acupuncture stimulation activated both sides of the inferior parietal lobule, the left side of the extra-nuclear, culmen and inferior semi-lunar lobules. On the right side, the nodule and midbrain regions were activated by the left LI11 acupuncture stimulation. The left ST36 acupuncture stimulation activated the right side of the superior frontal gyrus, middle frontal gyrus, superior parietal lobule, inferior semi-lunar lobule and pyramis. On the left side, the sub-gyral, middle temporal gyrus, fusiform gyrus, supramarginal gyrus, extra-nuclear, cingulate gyrus and fastigium regions were activated by the left ST36 acupuncture stimulation. Besides, both sides of the paracentral lobule, inferior parietal lobule, culmen, cerebellar tonsil and midbrain regions were activated. Conclusions: In conclusion, brain signal activation patterns according to acupoints were observed to differ, and ST36 acupuncture stimulation activated more regions than LI11. It is supposed that LI11 and ST36 acupuncture stimulations have an influence on motor function and sensory aphasia, and these stimulations thus represent potential for ocular motor dysfunction, discriminative touch or position sense disorder. Moreover, ST36 acupuncture stimulation activated the cingulate gyrus of the limbic system, so it seems to have an influence over autonomic functions.

키워드

참고문헌

  1. Nishijo K, et al:translator Cho KH, Lee JD. Scientific Appraisal of Clinical Acupuncture. Koonja Publisher 2005:34-41.
  2. Son CS. A research on the composed theory of Channel and Collateral. Dong Guk University Graduate School 1998.
  3. Kim YH. Usefulness of Functional MRI for the Study of Brain Function. Korean Journal of Brain Science and Technology 2001;1(1):65-76.
  4. Nakagoshi A, Fukunaga M, Umeda M, Mori Y, Higuchi T, Tanaka C. Somatotopic representation of acupoints in human primary somatosensory cortex : an FMRI study. Magn Reson Med Sci 2005;4(4):187-9. https://doi.org/10.2463/mrms.4.187
  5. Siedentopf CM, Koppelstaetter F, Haala IA, Haid V, Rhomberg P, Ischebeck A, et al. Laser acupuncture induced specific cerebral cortical and subcortical activations in humans. Lasers Med Sci 2005;20(2):68-73. https://doi.org/10.1007/s10103-005-0340-3
  6. Jeun SS, Kim JS, Kim BS, Park SD, Lim EC, Choi GS, et al. Acupuncture stimulation for motor cortex activities: a 3T fMRI study. Am J Chin Med 2005;33(4):573-8. https://doi.org/10.1142/S0192415X0500317X
  7. Napadow V, Makris N, Liu J, Kettner NW, Kwong KK, Hui KK. Effects of electroacupuncture versus manual acupuncture on the human brain as measured by fMRI. Hum Brain Mapp 2005; 24(3):193-205. https://doi.org/10.1002/hbm.20081
  8. Li G, Cheung RT, Ma QY, Yang ES. Visual cortical activations on fMRI upon stimulation of the vision-implicated acupoints. Neuroreport 2003; 14(5):669-73. https://doi.org/10.1097/00001756-200304150-00002
  9. Siedentopf CM, Golaszewski SM, Mottaghy FM, Ruff CC, Felber S, Schlager A. Functional magnetic resonance imaging detects activation of the visual association cortex during laser acupuncture of the foot in humans. Neurosci Lett 2002;327(1):53-6. https://doi.org/10.1016/S0304-3940(02)00383-X
  10. Biella G, Sotgiu ML, Pellegata G, Paulesu E, Castiglioni I, Fazio F. Acupuncture produces central activations in pain regions. Neuroimage 2001;14:60-6. https://doi.org/10.1006/nimg.2001.0798
  11. Hui KK, Liu J, Makris N, Gollub RL, Chen AJ, Moore CI, et al. Acupuncture modulates the limbic system and subcortical gray structures of the human brain: evidence from fMRI studies in normal subjects. Hum Brain Mapp 2000;9(1):13-25. https://doi.org/10.1002/(SICI)1097-0193(2000)9:1<13::AID-HBM2>3.0.CO;2-F
  12. Wu MT, Hsieh JC, Xiong J, Yang CF, Pan HB, Chen YC, et al. Central nervous pathway for acupuncture stimulation: localization of processing with functional MR imaging of the brainpreliminary experience. Radiology 1999;212(1):133-41.
  13. Wu MT, Sheen JM, Chuang KH, Yang P, Chin SL, Tsai CY, et al. Neuronal specificity of acupuncture response: a fMRI study with electroacupuncture. Neuroimage 2002;16(4):1028-37. https://doi.org/10.1006/nimg.2002.1145
  14. Li G, Jack CR Jr, Yang ES. An fMRI study of somatosensory-implicated acupuncture points in stable somatosensory stroke patients. J Magn Reson Imaging 2006;24(5):1018-24. https://doi.org/10.1002/jmri.20702
  15. Kim YI, Kim YH, Im YK, Lee H, Lee BL, Kim YJ. A fMRI study on the cerebral activity induced by electroacupuncture on Zusanli(ST36). The Journal of Korean Acupuncture and Moxibustion Society 2003;20(5):133-150.
  16. Talairach J, Tournoux P. Coplanar stereotactic atlas of the human brain. New York. Thieme 1998.
  17. Bandettini PA, Wong EC. A hypercapnia-based normalization method for improved spatial localization of human brain activation with fMRI. NMR Biomed. 1997;10(4-5):197-203. https://doi.org/10.1002/(SICI)1099-1492(199706/08)10:4/5<197::AID-NBM466>3.0.CO;2-S
  18. Friston KJ, Jezzard P, Turner R. Analysis of functional MRI time-series. Hum Brain Mapp 1994;1:153-71. https://doi.org/10.1002/hbm.460010207
  19. Friston KJ, Ashburner J, Frith CD, Poline JB, Frackowiak RSJ. Spatial registration and normalization of images. Hum Brain Mapp 1995;3(3): 165-89. https://doi.org/10.1002/hbm.460030303
  20. Park JB, Park HJ, Lee HJ. The methodological study of the change of Brain activity with acupoint stimulaton using functional MRI-focusing on visual areas. The Journal of Korean Acupuncture and Moxibustion Society 1997;14(1):266-72.
  21. Frackowiak RSJ, Friston KJ, Frith CD, Dolan RJ, Mazziotta RJ. Human brain function. 1st ed, San Diego: Academic Press 1997:25-106, 141-62, 275-300.
  22. Kwon CH, Lee JB, Hwang MS, Yoon JH. The New Finding on BOLD Response of Motor Acupoint KI6 by fMRI. The Journal of Korean Acupuncture and Moxibustion Society 2004;21(6):177-186.
  23. Rheu KH, Choe IH, Park HJ, Lim S. fMRI Study on the Brain Activity Induced by Manual Acupuncture at BL62. The Korean Journal of Meridian & Acupoint 2006;23(2):89-103.
  24. Hong KE, Lee BR, Lee H, Yim YK, Kim YJ. fMRI study on the cerebral activity induced by electroacupuncture on SP6. The Journal of Korean Acupuncture and Moxibustion Society 2003;20 (3):86-103.
  25. Bae EJ, Hong GU, Lee H, Lee BL, Im YG, Kim YJ. fMRI study on the cerebral activity induced by electroacupuncture on ST40. The Journal of Korean Acupuncture and Moxibustion Society 2003;20(5):208-226.
  26. Park KY, Lee BR, Lee H, Yim YK, Hong KE, Kim YJ. fMRI study on the cerebral activity induced by electroacupuncture on KI3. The Journal of Korean Acupuncture and Moxibustion Society 2003;20(3):194-208.
  27. Ha CH, Lee H, Im YG, Hong GU, Lee BL, Kim YJ. A fMRI study on the cerebral activity induced by electroacupuncture on LR3. The Journal of Korean Acupuncture and Moxibustion Society 2003;20(5):187-207.
  28. Park TG, Kim YI, Hong KE, Yim YK, Lee H, Lee BR. A study on brain activity induced by electroacupuncture on LR3 and LI4 using functional Magnetic Resonance Imaging. The Korean Journal of Meridian & Acupoint 2004; 21(2):29-46.
  29. Park SU, Shin AS, Gahng GH, Moon SK, Park JM. Effects of scalp acupuncture versus upper and lower limb acupuncture on signal activation of blood oxygen level dependent (BOLD) fMRI of the brain and somatosensory cortex. J Altern Complement Med 2010;15(11):1193-1200
  30. Yoo SS, Teh EK, Blinder RA, Jolesz FA. Modulation of cerebellar activities by acupuncture stimulation: evidence from fMRI study. Neuroimage 2004;22(2):932-40. https://doi.org/10.1016/j.neuroimage.2004.02.017
  31. Yan B, Li K, Xu J, Wang W, Liu H, Shan B, et al. Acupoint-specific fMRI patterns in human brain. Neurosci Lett 2005;383(3):236-40. https://doi.org/10.1016/j.neulet.2005.04.021
  32. Fang JL, Krings T, Weidemann J, Meister IG, Thron A. Functional MRI in healthy subjects during acupuncture: different effects of needle rotation in real and false acupoints. Neuroradiology 2004;46(5):359-62. https://doi.org/10.1007/s00234-003-1125-7
  33. Li K, Shan B, Xu J, Liu H, Wang W, Zhi L, et al. Changes in FMRI in the human brain related to different durations of manual acupuncture needling. J Altern Complement Med 2006;12(7): 615-23. https://doi.org/10.1089/acm.2006.12.615
  34. Liu WC, Feldman SC, Cook DB, Hung DL, Xu T, Kalnin AJ, et al. fMRI study of acupunctureinduced periaqueductal gray activity in humans. Neuroreport 2004;15(12):1937-40. https://doi.org/10.1097/00001756-200408260-00021
  35. Schaechter JD, Connell BD, Stason WB, Kaptchuk TJ, Krebs DE, Macklin EA, et al. Correlated change in upper limb function and motor cortex activation after verum and sham acupuncture in patients with chronic stroke. J Altern Complement Med 2007;13(5):527-32. https://doi.org/10.1089/acm.2007.6316
  36. Hui KK, Nixon EE, Vangel MG, Liu J, Marina O, Napadow V, et al. Characterization of the "de qi" response in acupuncture. BMC Compl Alternative Med 2007;7:33. https://doi.org/10.1186/1472-6882-7-33
  37. 안영기. 경혈학총서. 성보사 2006:116-7, 196-7
  38. Lee WT, Park KA. Medical Neuroanatomy. 2nd. Seoul:Korea Medical Book Publisher. 2008.
  39. Bronen RA. Hippocampal and limbic terminology. Am J Neuroradial 1992;13(3):943-5.