To determine the impact of needling at two depths at the classical acupuncture point Hegu (LI-4) on brain images as recorded by functional magnetic resonance imaging (fMRI) and magneto-encephalography (MEG).
Acupuncture is a treatment modality that is growing in popularity in the UK. In parallel, a number of recent high quality trials have provided evidence of clinical effectiveness, and in some cases cost-effectiveness, for a range of conditions, especially those associated with pain. Despite this growing body of evidence, there are many sceptics who would like “objective” evidence of acupuncture’s impact on biological correlates. One new area of research where such “objective” evidence has now become possible is in the mapping of the effect of acupuncture on regionally specific structures within the brain. Such specific and quantifiable data would extend the evidence base for the mechanisms underlying acupuncture, and potentially contribute to the explanations of its clinical impact.
This project was conducted at the York Neuroimaging Centre (YNIC). In an extension to this project we are also exploring the effect of acupuncture on brain structures with data collected in an MEG scanner. Using overlay techniques, we will explore similarities and differences between the fMRI and MEG data.
Below is an abstract from a paper comparing superficial with deep needling:
Using a 3 Tesla MRI, echo planar imaging data were acquired for seventeen right-handed healthy volunteer participants. Two fMRI scans of acupuncture needling were taken in random order in a block design, one for superficial and one for deep needling on the right hand at the acupuncture point LI-4 (Hegu), with the participant blind to the order. For both scans needle stimulation was used. Brain image analysis tools were used to explore within-group and between-group differences in the blood oxygen level dependent (BOLD) responses.
The study demonstrated marked similarities in BOLD signal responses between superficial and deep needling, with no significant differences in either activations (increases in BOLD signal) or deactivations (decreases in BOLD signal) above the voxel Z score of 2.3 with corrected cluster significance of p=0.05. For both types of needling, deactivations predominated over activations.
These fMRI data suggest that acupuncture needle stimulation at two different depths of needling, superficial and deep, do not elicit significantly different BOLD responses. This data is consistent with the equivalent therapeutic outcomes that are claimed by proponents of Japanese and Chinese styles of acupuncture that utilise superficial and deep needling, respectively.
Hugh MacPherson1, Gary Green2, Angel Nevado2, Mark F Lythgoe3, George Lewith4, Ross Devlin2, Robyn Haselfoot2 and Aziz UR Asghar 2,5
1 Department of Health Sciences, University of York, YO10 5DD
2 York Neuroimaging Centre, University of York, Y10 5DG
3 RCS Unit of Biophysics, UCL Institute of Child Health, University College London, WC1N 3JH
4 Complementary Medicine Research Unit, University of Southampton, SO17 1BJ
5 Hull York Medical School and Department of Biological Sciences, University of Hull, Hull, HU6 7RX
Asghar AUR, Green G, Lythgoe MF, Lewith G, MacPherson H. Acupuncture needling sensation: The neural correlates of deqi using fMRI. Brain
Research. 2010. http://dx.doi.org/10.1016/j.brainres.2009.12.019
MacPherson H, Green G, Nevado A, Lythgoe MF, Lewith G, Devlin R, Haselfoot R, Asghar AUR. Brain imaging of acupuncture: Comparing superficial with deep needling. Neuroscience Letters, 2008 434(1): 144-149.
MacPherson H, Asghar A.Acupuncture needle sensations associated with De Qi: a classification based on expert's ratings. J Alt Comp Medicine. 2006; 12(7): 633-7.