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Neural mechanism of acupoint specificity underlying the antiemetic efficacy: an fMRI study.1The First Affiliated Hospital of Xi’An Jiaotong University, Xi’an, People's Republic of China
Synopsis
This paper presents an original research to investigate the underlying neural mechanism on acupoint specificity underlying the antiemetic efficacy. Our findings further suggested that acupuncture at different acupoints may exert distinct modulation effects on the brain activity patterns. Notably, we also may provide preliminary evidence for understanding the gut–brain communication.
Purpose：
Acupuncture is particularly effective for preventing nausea and vomiting after drug treatments and surgery. Furthermore, the antiemetic efficacy of acupuncture, especially the acupoint Neiguan, pericardium 6 (PC6), has been widely used in clinical settings. However, the mechanisms by which acupuncture stimulation at PC6 achieves its therapeutic effects is unclear. We aimed to investigate the activity patterns of different acupoints such as PC6, with the same meridian acupoint PC7 and vision-related acupoint GB37, comparing with the digust-induced group without treatment.Methods and Materials：
Forty- eight subjects were randomly divided into four groups. The digust-induced group was used as a blank control to observe brain signal activation and affective assessments (disgust sensations and anxiety scales) elicted by pictures from the International Affective Picture System (IAPS). Three acupuncture treatment groups performed on different acupoints and experienced the disgust stimuli as conducted in digust-induced group. Psychophysical responses (deqi sensations) were also assessed after acupuncture treatments.Results：
In the comparison of PC6 acupuncture and digust-induced group, disgust sensations showed significant decreased (P＜0.05). By contrast, PC7 group presented significant decrease of anxiety scores compared with digust-induced group (P＜0.05), and GB37 did not produce significant statistical differences on disgust sensations and anxiety scores. Neuroimaging studies showed that PC6 reduce the signal changes in the inferior prefrontal gyrus and vermis. Moreover, there was a less range of signal changes in response to digust stimulation after PC7 acupuncture, mainly deactivations in the parahippocampal. In contrast, GB37 can induce decreased signal changes mainly in the superior occipital gyrus.Conclusions：
The results indicated that PC6 can specifically modulate disgust-induced nausea and vomiting，further suggested by the involvements of the cerebellar-frontal neural circuit. In addition, acupuncture at PC7 produce the affective- process brain area such as parahippocampal, which can be a mechanism underlying its function for mental-related disorders. The brain regions activation after GB37 located at the vision-related cortex (superior occipital gyrus) elucidating the effects of GB37 in vision-related disorders. These findings demonstrated that acupuncture at different acupoints may exert heterogeneous modulatory effects on the brain activity patterns.Acknowledgements
No acknowledgement found.References
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2. Lee A, Done ML. The use of nonpharmacologic techniques to prevent postoperative nausea and vomiting: a meta-analysis. Anesthesia and analgesia. 1999;88(6):1362-1369. 4.
3. Vickers AJ. Can acupuncture have specific effects on health? A systematic review of acupuncture antiemesis trials. Journal of the Royal Society of Medicine. 1996;89(6):303-311. 5.
4. Wang X, Chen Y, Ding M. Estimating Granger causality after stimulus onset: a cautionary note. Neuroimage. 2008;41(3):767-776.
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