Acupuncture modulates brain neural activity in patients: a systematic review and meta-analysis
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Using fMRI, the acupuncture studies related with modifying disease process in patients still stay in the beginning, whereas the physiological response to acupuncture has been published abundantly. In this study, we reviewed acupuncture studies performed in patient and reported the changes of brain activity using fMRI. Only randomized controlled studies were included. We systemically searched PubMed and EMBASE and extracted data by two independent researchers. We also performed an ALE-meta analysis to investigate significant brain responses of acupuncture. Fifteen studies were finally included in our review. The studies were performed in stroke, carpal tunnel syndrome, migraine, irritable bowel syndrome, lumbar disc herniation, Parkinson’s disease (PD) and mild cognitive impairment. The common changes of brain activity by acupuncture were identified in the sensory system and insular cortex, whereas other brain regions showed heterogeneous activity according to each disease status. Meta-analysis indicated the different brain responses between verum and sham acupuncture were found in the frontal lobe (BA 6) in the brain disorders such as stroke and PD and the parietal lobe (BA 40), insula (BA 13), limbic lobe (BA 23) and occipital lobe (BA 18) in the pain related disease. However, the correlations between the changes of clinical symptoms and brain activities are limited. Some specific changes of brain activities induced by acupuncture can be detective through patient imaging studies. However, it was difficult to draw an obvious conclusion due to the heterogeneity of the diseases and the interventions. Further well-designed patient centered fMRI studies considering clinical points are required.
KeywordsAcupuncture effect Functional magnetic resonance imaging (fMRI) Patient Randomized controlled trials (RCTs) Meta-analysis
This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (NRF-2015R1C1A1A02036676) and the Bio & Medical Technology Development Program of the National Research Foundation (NRF) funded by the Ministry of Science, ICT & Future Planning (NRF-2015M3A9E052338).
This review was conceived and designed by HJP and HL. SYK developed search strategy and conducted the database search. JYP and CJC assessed studies for inclusion, extracted and analyzed the data. JYP prepared the manuscript draft. HL provided guidance on assessing the methodological quality of the included studies. HJP and YC edited and revised the manuscript. All authors approved the final version of the manuscript for publication.
Compliance with Ethical Standards
Conflict of Interest
The authors declare no conflict of interest.
- Cho SY et al (2012) Effectiveness of acupuncture and bee venom acupuncture in idiopathicParkinson’s disease. Parkinsonism Relat Disord 18(8):948–952Google Scholar
- Chu WC et al (2012) Does acupuncture therapy alter activation of neural pathway for pain perception in irritable bowel syndrome?: a comparative study of true and sham acupuncture using functional magnetic resonance imaging. J Neurogastroenterol Motil 18:305–316. doi: 10.5056/jnm.2012.18.3.305 CrossRefPubMedPubMedCentralGoogle Scholar
- Eickhoff SB, Laird AR, Grefkes C, Wang LE, Zilles K, Fox PT (2009) Coordinate-based activation likelihood estimation meta-analysis of neuroimaging data: a random-effects approach based on empirical estimates of spatial uncertainty. Hum Brain Mapp 30:2907–2926. doi: 10.1002/hbm.20718 CrossRefPubMedPubMedCentralGoogle Scholar
- Higgins JP, Green S (eds) (2011) Cochrane handbook for systematic reviews of interventions (Vol. 4). John Wiley & Sons.Google Scholar
- Huang Y, Xiao H, Chen J, Qu S, Zheng Y, Lu Y, Lai X (2011) Needling at the waiguan (SJ5) in healthy limbs deactivated functional brain areas in ischemic stroke patients: a functional magnetic resonance imaging study. Neural Regen Res 6:2829–2833Google Scholar
- Lim SM, Yoo J, Lee E, Kim HJ, Shin S, Han G, Ahn HS (2015) Acupuncture for spasticity after stroke: a systematic review and meta-analysis of randomized controlled trials evidence-based complementary and alternative medicine. eCAM 2015:870398. doi: 10.1155/2015/870398 PubMedPubMedCentralGoogle Scholar
- Qi J, Chen JQ, Huang Y, Lai XS, Tang CZ, Yang JJ, Chen H, Qu SS (2014) Acupuncture at Waiguan (SJ5) and sham points influences activation of functional brain areas of ischemic stroke patients: a functional magnetic resonance imaging study. Neural Regen Res 9:293–300Google Scholar
- Quah-Smith I, Suo C, Williams MA, Sachdev PS (2014) The antidepressant effect of laser acupuncture: a comparison of the resting Brain's default mode network in healthy and depressed subjects during functional magnetic resonance imaging. Med Acupunct 25:124–133. doi: 10.1089/acu.2012.0901 CrossRefGoogle Scholar
- Vickers AJ et al (2012) Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med 172(19):1444-53 doi: 10.1001/archinternmed.2012.3654