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Different Responses to Acupuncture in Electroencephalogram according to Stress Level: A Randomized, Placebo-Controlled, Cross-Over Trial

스트레스 정도에 따라 침 치료가 뇌파(EEG)에 미치는 영향: 무작위배정 플라시보 대조군 교차연구

  • Kim, Song-Yi (Acupuncture and Meridian Science Research Center(AMSRC)) ;
  • Kim, Sang-Woo (Department of Meridian and Acupoint, College of Korean Medicine, Kyung Hee University) ;
  • Park, Hi-Joon (Acupuncture and Meridian Science Research Center(AMSRC))
  • 김송이 (경희대학교 침구경락과학연구센터) ;
  • 김상우 (경희대학교 한의과대학 경혈학교실) ;
  • 박히준 (경희대학교 침구경락과학연구센터)
  • Received : 2014.09.04
  • Accepted : 2014.09.22
  • Published : 2014.09.27

Abstract

Objectives : The purpose of this randomized, placebo-controlled, cross-over trial was to examine how acupuncture treatment at Shinmun(HT7) affects the brain activity and the autonomic nervous system(ANS), using electroencephalograms(EEG) and heart rate variability(HRV). Methods : Eighteen healthy volunteers participated in two separate experiments: in each experiment, either real acupuncture(RA) or non-penetrating sham acupuncture(SA) was applied at HT7 in random sequences to each person. The EEG and HRV measurements were conducted simultaneously before and during the acupuncture stimulation for 5 minutes, respectively. Resulting EEG and HRV parameters were compared between RA and SA groups. To assess differences according to the stress levels for participants, subgroup analysis was performed based on the results of the stress response index questionnaire. Results : In the results, acupuncture stimulation at HT7 increased ${\alpha}$ band in EEG. In the HRV analysis, heart rate was decreased significantly but HF and RMS-SD were increased in the RA group, compared with those of the SA group. In the subgroup analysis by stress level, participants in the RA group with high stress exhibited an increased in ${\alpha}$ band in their EEG while the low stress participants showed decrease or little increase in the band. For the SA group, ${\alpha}$ band reported relatively moderate changes in all channels. Conclusions : Our results showed that acupuncture induces changes in brain activation and the ANS. Acupuncture was related to the activation of the parasympathetic nervous system. The brain activities of the participants were different depending on the stress level.

목적 : 본 무작위배정 플라시보 대조군 교차연구는 신문혈의 침 치료가 뇌 활성도와 자율신경계에 어떠한 영향을 미치는지 뇌파(EEG)와 심박변이도(HRV)를 통해 알아보고자 한 연구이다. 방법 : 18명의 건강인 피험자가 참여하여 1-3일의 간격을 두고 무작위배정 순서에 따라 신문혈에 진짜침과 가짜침으로 시술받았고, 치료 전, 후에 각각 뇌파와 심박변이도를 측정하였다. 피험자의 스트레스 정도에 따른 반응의 차이를 살펴보기 위하여 스트레스설문지를 이용하여 서브그룹분석을 시행하였다. 결과 : 그 결과, 침 치시술은 뇌파 중 ${\alpha}$밴드 값의 증가를 나타냈으며, 진짜침 그룹의 경우 심박변이도의 결과값 중 HF와 RMS-SD의 증가가 대조군에 비해 유의하게 높았다. 스트레스 정도에 따른 서브그룹 분석에서는 진짜침 그룹 중 스트레스 정도가 높은 피험자는 ${\alpha}$밴드 값이 증가한 반면, 스트레스 정도가 낮은 피험자는 감소하거나 증가의 폭이 낮은 것을 알 수 있었으며, 거짓침 그룹에서는 비교적 적은 변화를 나타내었다. 결론 : 본 연구 결과를 통해 침이 뇌 활성도 및 자율신경계에 영향을 미치며, 이는 부교감신경계통과 관련이 있음을 알 수 있었다. 또한 이러한 결과는 환자의 스트레스 정도에 따라 다른 반응을 나타냄을 보여주었다.

Keywords

References

  1. WHO. World Health Organization(WHO) International Standard Terminologies on Traditional Medicine in the Western Pacific Region. Manila : WHO Regional Office for the Western Pacific. 2007.
  2. Park J, Linde K, Manheimer E, Molsberger A, Sherman K, Smith C, et al. The status and future of acupuncture clinical research. J Altern Complement Med. 2008 ; 14 : 871-81. https://doi.org/10.1089/acm.2008.SAR-4
  3. Cabioglu MT, Cetin BE. Acupuncture and immunomodulation. Am J Chin Med. 2008 ; 36 : 25-36. https://doi.org/10.1142/S0192415X08005552
  4. Lin JG, Chen WL. Acupuncture analgesia : a review of its mechanisms of actions. Am J Chin Med. 2008 ; 36 : 635-45. https://doi.org/10.1142/S0192415X08006107
  5. Ulett GA, Han S, Han JS. Electroacupuncture : mechanisms and clinical application. Biol Psychiatry. 1998 ; 44 : 129-38. https://doi.org/10.1016/S0006-3223(97)00394-6
  6. Langevin HM, Yandow JA. Relationship of acupuncture points and meridians to connective tissue planes. Anat Rec. 2002 ; 269 : 257-65. https://doi.org/10.1002/ar.10185
  7. Han JS. Acupuncture : neuropeptide release produced by electrical stimulation of different frequencies. Trends Neurosci. 2003 ; 26 : 17-22. https://doi.org/10.1016/S0166-2236(02)00006-1
  8. 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 : 13-25. https://doi.org/10.1002/(SICI)1097-0193(2000)9:1<13::AID-HBM2>3.0.CO;2-F
  9. Kong J, Gollub RL, Rosman IS, Webb JM, Vangel MG, Kirsch I et al. Brain activity associated with expectancy-enhanced placebo analgesia as measured by functional magnetic resonance imaging. J Neurosci. 2006 ; 26 : 381-8. https://doi.org/10.1523/JNEUROSCI.3556-05.2006
  10. Bonnet MH, Arand DL. Impact of activity and arousal upon spectral EEG parameters. Physiol Behav. 2001 ; 74 : 291-8. https://doi.org/10.1016/S0031-9384(01)00581-9
  11. Yu X, Zhang J, Xie D, Wang J, Zhang C. Relationship between scalp potential and autonomic nervous activity during a mental arithmetic task. Auton Neurosci. 2009 ; 146 : 81-6. https://doi.org/10.1016/j.autneu.2008.12.005
  12. Sakai S, Hori E, Umeno K, Kitabayashi N, Ono T, Nishijo H. Specific acupuncture sensation correlates with EEGs and autonomic changes in human subjects. Auton Neurosci. 2007 ; 133 : 158-69. https://doi.org/10.1016/j.autneu.2007.01.001
  13. Hsu CC, Weng CS, Sun MF, Shyu LY, Hu WC, Chang YH. Evaluation of scalp and auricular acupuncture on EEG, HRV, and PRV. Am J Chin Med. 2007 ; 35 : 219-30. https://doi.org/10.1142/S0192415X0700476X
  14. Kim MS, Kim HD, Seo HD, Sawada K, Ishida M. The effect of acupuncture at PC-6 on the electroencephalogram and electrocardiogram. Am J Chin Med. 2008 ; 36 : 481-91. https://doi.org/10.1142/S0192415X08005928
  15. Streitberger K, Steppan J, Maier C, Hill H, Backs J, Plaschke K. Effects of verum acupuncture compared to placebo acupuncture on quantitative EEG and heart rate variability in healthy volunteers. J Altern Complement Med. 2008 ; 14 : 505-13. https://doi.org/10.1089/acm.2007.0552
  16. Chen AC, Liu FJ, Wang L, Arendt-Nielsen L. Mode and site of acupuncture modulation in the human brain : 3D (124-ch) EEG power spectrum mapping and source imaging. Neuroimage. 2006 ; 29 : 1080-91. https://doi.org/10.1016/j.neuroimage.2005.08.066
  17. Yin CS, Park HJ, Kim SY, Lee JM, Hong MS, Chung JH et al. Electroencephalogram changes according to the subjective acupuncture sensation. Neurol Res. 32 Suppl 1 : 31-6.
  18. Knardahl S, Elam M, Olausson B, Wallin BG. Sympathetic nerve activity after acupuncture in humans. Pain. 1998 ; 75 : 19-25. https://doi.org/10.1016/S0304-3959(97)00197-8
  19. Li Z, Wang C, Mak AF, Chow DH. Effects of acupuncture on heart rate variability in normal subjects under fatigue and non-fatigue state. Eur J Appl Physiol. 2005 ; 94 : 633-40. https://doi.org/10.1007/s00421-005-1362-z
  20. Haker E, Egekvist H, Bjerring P. Effect of sensory stimulation (acupuncture) on sympathetic and parasympathetic activities in healthy subjects. J Auton Nerv Syst. 2000 ; 79 : 52-9. https://doi.org/10.1016/S0165-1838(99)00090-9
  21. Chae Y-B, Park H-J, Koo S-T, Lee H-J. Review on acupuncture and autonomic nervous system : Heart rate variability analysis in humans. Journal of Meridian & Acupoint. 2007 ; 24 : 25-36.
  22. Lee S, Lee MS, Choi JY, Lee SW, Jeong SY, Ernst E. Acupuncture and heart rate variability : A systematic review. Auton Neurosci.
  23. WHO. WHO standard acupuncture point locations in the Western Pacific Region. Manila : World Health Organization. 2008.
  24. Kim Y, Park J, Lee H, Bang H, Park HJ. Content validity of an acupuncture sensation questionnaire. J Altern Complement Med. 2008 ; 14 : 957-63. https://doi.org/10.1089/acm.2007.0565
  25. Min SK, Jon D-I, Lee SH, Ahn CB, Yoo SK. Clinical validity of the domestic EEG and EP mapping system (Neuronics). Sleep Med Psychophysiol. 1997 ; 4 : 96-106.
  26. Shinohara M. Decreasing heart rate and shortening of the arterial pulse propagation time by acupuncture in the spectral analyses. Masui. 1997 ; 46 : 213-21.
  27. Chan J, Briscomb D, Waterhouse E, Cannaby AM. An uncontrolled pilot study of HT7 for 'stress'. Acupunct Med. 2002 ; 20 : 74-7. https://doi.org/10.1136/aim.20.2-3.74
  28. Lin JG, Ho SJ, Lin JC. Effect of acupuncture on cardiopulmonary function. Chin Med J (Engl). 1996 ; 109 : 482-5.
  29. Nordio M, Romanelli F. Efficacy of wrists overnight compression (HT 7 point) on insomniacs : possible role of melatonin? Minerva Med. 2008 ; 99 : 539-47.
  30. Lim S, Ryu YH, Kim ST, Hong MS, Park HJ. Acupuncture increases neuropeptide Y expression in hippocampus of mater nally-separated rats. Neurosci Lett. 2003 ; 343 : 49-52. https://doi.org/10.1016/S0304-3940(03)00317-3
  31. Park HJ, Lim S, Lee HS, Lee HJ, Yoo YM, Kim SA et al. Acupuncture enhances cell proliferation in dentate gyrus of maternally-separated rats. Neurosci Lett. 2002 ; 319 : 153-6. https://doi.org/10.1016/S0304-3940(01)02581-2
  32. Chae Y, Yeom M, Han JH, Park HJ, Hahm DH, Shim I et al. Effect of acupuncture on anxiety-like behavior during nicotine withdrawal and relevant mechanisms. Neurosci Lett. 2008 ; 430 : 98-102. https://doi.org/10.1016/j.neulet.2007.10.026
  33. Kim DH, Yang DH, Kim EJ, Nam DW, Park YC, Park YJ et al. A Study on the Effect of Interaction between Acupuncture at Shinmun (HT7) and Subject's Cold or Heat Tendency on Heart Rate Variability. Journal of Korean Acupuncture and Moxibustion. 2006 ; 23 : 25-38.
  34. Kim DH, Kim JD, Jung. KE, Kim KT, Rhu SR, Jung JC et al. A Study on the Effect of Moxibustion at Shinmun(H7) according to Cold or Heat Tendency. Journal of Korean Acupuncture and Moxibustion. 2004 ; 21 : 135-47.
  35. de Kloet ER, Joels M, Holsboer F. Stress and the brain : from adaptation to disease. Nat Rev Neurosci. 2005 ; 6 : 463-75. https://doi.org/10.1038/nrn1683
  36. Dishman RK, Nakamura Y, Garcia ME, Thompson RW, Dunn AL, Blair SN. Heart rate variability, trait anxiety, and perceived stress among physically fit men and women. Int J Psychophysiol. 2000 ; 37 : 121-33. https://doi.org/10.1016/S0167-8760(00)00085-4
  37. Annie CL, Groer M. Childbirth stress. An immunologic study. J Obstet Gynecol Neonatal Nurs. 1991 ; 20 : 391-7. https://doi.org/10.1111/j.1552-6909.1991.tb01703.x
  38. Koh KB, Park JK, Kim CH, Cho S. Development of the stress response inventory and its application in clinical practice. Psychosom Med. 2001 ; 63 : 668-78. https://doi.org/10.1097/00006842-200107000-00020
  39. Kong J, Gollub R, Huang T, Polich G, Napadow V, Hui K et al. Acupuncture de qi, from qualitative history to quantitative measurement. J Altern Complement Med. 2007 ; 13 : 1059-70. https://doi.org/10.1089/acm.2007.0524
  40. Park H, Park J, Lee H. Does Deqi (needle sensation) exist? Am J Chin Med. 2002 ; 30 : 45-50. https://doi.org/10.1142/S0192415X02000053
  41. MacPherson H, White A, Cummings M, Jobst K, Rose K, Niemtzow R. Standards for reporting interventions in controlled trials of acupuncture : the STRICTA recommendations. Complement Ther Med. 2001 ; 9 : 246-9. https://doi.org/10.1054/ctim.2001.0488
  42. Hui KK, Liu J, Marina O, Napadow V, Haselgrove C, Kwong KK et al. The integrated response of the human cerebro-cerebellar and limbic systems to acupuncture stimulation at ST 36 as evidenced by fMRI. Neuroimage. 2005 ; 27 : 479-96. https://doi.org/10.1016/j.neuroimage.2005.04.037
  43. 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 : 193-205. https://doi.org/10.1002/hbm.20081
  44. Chen SJ, Liu B, Fu WB, Wu SS, Chen J, Ran PC. [A fMRI observation on different cererbral regions activated by acupuncture of Shenmen (HT 7) and Yanglao (SI 6)]. Zhen Ci Yan Jiu. 2008 ; 33 : 267-71.

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