Does the Acupoint Specificity Exist? Evidence from Functional Neuroimaging Studies

Ke       Qiu; Tao       Yin; Xiaojuan       Hong; Ruirui       Sun; Zhaoxuan       He; Xiaoyan       Liu; Peihong       Ma; Jie       Yang; Lei       Lan; Zhengjie       Li; Chenjian       Tang; Shirui       Cheng; Fanrong       Liang; Fang       Zeng
doi:10.2174/1573405615666190220113111
Abstract

Background: Using functional neuroimaging techniques to explore the central mechanism of acupoint specificity, the key of acupuncture theory and clinical practice, has attracted increasing attention worldwide. This review aimed to investigate the current status of functional neuroimaging studies on acupoint specificity and explore the potential influencing factors for the expression of acupoint specificity in neuroimaging studies.
Methods: PubMed database was searched from January 1st, 1995 to December 31st, 2016 with the language restriction in English. Data including basic information, methodology and study results were extracted and analyzed from the eligible records.
Results: Seventy-nine studies were finally enrolled. 65.8% of studies were performed in China, 73.4% of studies were conducted with healthy subjects, 77.2% of studies chose manual acupuncture as the intervention, 86.1% of studies focused on the instant efficacy and 89.9% of studies used functional magnetic resonance imaging as scanning technique. The average sample size was 16 per group. The comparison of verum acupoints and sham acupoints were the main body of acupoint specificity researches. 93.7% of studies obtained the positive results and favored the existence of acupoint specificity.
Conclusion: This review affirmed the existence of acupoint specificity and deemed that the acupoint specificity was relative. Multiple factors such as participants, sample size, acupoint combinations, treatment courses, and types of acupoint could influence the expression of acupoint specificity.
Keywords: Acupuncture, acupoint specificity, neuroimaging, fMRI, nonacupoints, functional neuroimaging.
Graphical Abstract

[1] 
Millstine D, Chen CY, Bauer B. Complementary and integrative medicine in the management of headache. BMJ  2017; 357: j1805.
[http://dx.doi.org/10.1136/bmj.j1805] [PMID: 28512119] 
[2] 
Liu BP, Wang YT, Chen SD. Effect of acupuncture on clinical symptoms and laboratory indicators for chronic prostatitis/chronic pelvic pain syndrome: a systematic review and meta-analysis. Int Urol Nephrol  2016; 48(12): 1977-91.
[http://dx.doi.org/10.1007/s11255-016-1403-z] [PMID: 27590134] 
[3] 
Chao GQ, Zhang S. Effectiveness of acupuncture to treat irritable bowel syndrome: a meta-analysis. World J Gastroenterol  2014; 20(7): 1871-7.
[http://dx.doi.org/10.3748/wjg.v20.i7.1871] [PMID: 24587665] 
[4] 
Zhang LL, Chu Q, Wang S, Lai H, Xie BB. Is sham acupuncture as effective as traditional Chinese acupuncture? It’s too early to say. Chin J Integr Med  2016; 22(7): 483-9.
[http://dx.doi.org/10.1007/s11655-016-2458-5] [PMID: 27081001] 
[5] 
Xing JJ, Zeng BY, Li J, Zhuang Y, Liang FR. Acupuncture point specificity. Int Rev Neurobiol  2013; 111: 49-65.
[http://dx.doi.org/10.1016/B978-0-12-411545-3.00003-1] [PMID: 24215917] 
[6] 
Rong PJ, Zhao JJ, Gao JH, et al. Progress of research on specificity of meridian acupoint efficacy. Chin J Integr Med  2013; 19(12): 889-93.
[http://dx.doi.org/10.1007/s11655-013-1651-z] [PMID: 24307308] 
[7] 
Zhao L, Chen J, Li Y, et al. The long-term effect of acupuncture for migraine prophylaxis: a randomized clinical trial. JAMA Intern Med  2017; 177(4): 508-15.
[http://dx.doi.org/10.1001/jamainternmed.2016.9378] [PMID: 28241154] 
[8] 
Liu Z, Liu Y, Xu H, et al. Effect of electroacupuncture on urinary leakage among women with stress urinary incontinence: a randomized clinical trial. JAMA  2017; 317(24): 2493-501.
[http://dx.doi.org/10.1001/jama.2017.7220] [PMID: 28655016] 
[9] 
Hershman DL, Unger JM, Greenlee H, et al. Effect of acupuncture vs. sham acupuncture or waitlist control on joint pain related to aromatase inhibitors among women with early-stage breast cancer: a randomized clinical trial. JAMA  2018; 320(2): 167-76.
[http://dx.doi.org/10.1001/jama.2018.8907] [PMID: 29998338] 
[10] 
Liu Z, Yan S, Wu J, et al. Acupuncture for chronic severe functional constipation: a randomized trial. Ann Intern Med  2016; 165(11): 761-9.
[http://dx.doi.org/10.7326/M15-3118] [PMID: 27618593] 
[11] 
Hinman RS, McCrory P, Pirotta M, et al. Acupuncture for chronic knee pain: a randomized clinical trial. JAMA  2014; 312(13): 1313-22.
[http://dx.doi.org/10.1001/jama.2014.12660] [PMID: 25268438] 
[12] 
Shi GX, Li QQ, Liu CZ, et al. Effect of acupuncture on Deqi traits and pain intensity in primary dysmenorrhea: analysis of data from a larger randomized controlled trial. BMC Complement Altern Med  2014; 14: 69.
[http://dx.doi.org/10.1186/1472-6882-14-69] [PMID: 24555788] 
[13] 
Xu SB, Huang B, Zhang CY, et al. Effectiveness of strengthened stimulation during acupuncture for the treatment of Bell palsy: a randomized controlled trial. CMAJ  2013; 185(6): 473-9.
[http://dx.doi.org/10.1503/cmaj.121108] [PMID: 23439629] 
[14] 
Jang SH, Kim JH, Kim DH, Kwon HG. The vestibulocerebellar tract in the human brain: a diffusion tensor tractography study. Curr Med Imaging  2018; 14(4): 617-20.
[http://dx.doi.org/10.2174/1573405613666170421175932] 
[15] 
Benli SG, Icer S, Gumus K, et al. Neural correlates of default mode network connectivity in children with attention deficit and hyperactivity disorder. Curr Med Imaging Rev  2017; 13(2): 185-94.
[http://dx.doi.org/10.2174/1573405612666160606144408] 
[16] 
Jang SH, Kim DH, Kwon HG. Differences in connectivity between the anterior and mediodorsal nuclei of thalamus in the human brain: diffusion tensor tractography study. Curr Med Imaging Rev  2018; 14(4): 646-50.
[http://dx.doi.org/10.2174/1573405613666170428155635] 
[17] 
Cohen-Adad J. Functional magnetic resonance imaging of the spinal cord: current status and future developments. Semin Ultrasound CT MR  2017; 38(2): 176-86.
[http://dx.doi.org/10.1053/j.sult.2016.07.007] [PMID: 28347420] 
[18] 
Maeda Y, Kim H, Kettner N, et al. Rewiring the primary somatosensory cortex in carpal tunnel syndrome with acupuncture. Brain  2017; 140(4): 914-27.
[http://dx.doi.org/10.1093/brain/awx015] [PMID: 28334999] 
[19] 
Li Z, Zeng F, Yin T, et al. Acupuncture modulates the abnormal brainstem activity in migraine without aura patients. Neuroimage Clin  2017; 15: 367-75.
[http://dx.doi.org/10.1016/j.nicl.2017.05.013] [PMID: 28580293] 
[20] 
Park MS, Sunwoo YY, Jang KS, et al. Changes in brain FDG metabolism induced by acupuncture in healthy volunteers. Acta Radiol  2010; 51(8): 947-52.
[http://dx.doi.org/10.3109/02841851.2010.502541] [PMID: 20735279] 
[21] 
Lai X, Ren J, Lu Y, et al. Effects of acupuncture at HT7 on glucose metabolism in a rat model of Alzheimer’s disease: an 18F-FDG-PET study. Acupunct Med  2016; 34(3): 215-22.
[http://dx.doi.org/10.1136/acupmed-2015-010865] [PMID: 26654890] 
[22] 
Zhao L, Liu J, Zhang F, et al. Effects of long-term acupuncture treatment on resting-state brain activity in migraine patients: a randomized controlled trial on active acupoints and inactive acupoints. PLoS One  2014; 9(6) e99538
[http://dx.doi.org/10.1371/journal.pone.0099538] [PMID: 24915066] 
[23] 
Chen J, Wang J, Huang Y, et al. Modulatory effect of acupuncture at Waiguan (TE5) on the functional connectivity of the central nervous system of patients with ischemic stroke in the left basal ganglia. PLoS One  2014; 9(6) e96777
[http://dx.doi.org/10.1371/journal.pone.0096777] [PMID: 24927275] 
[24] 
Zhao L, Qin W, Liu JX, et al. Two sets of acupoint combination of similar functions engage shared neural representation: a functional magnetic resonance imaging study. Chin J Integr Med  2014; 20(3): 184-93.
[http://dx.doi.org/10.1007/s11655-014-1744-3] [PMID: 24615211] 
[25] 
Usichenko TI, Wesolowski T, Lotze M. Verum and sham acupuncture exert distinct cerebral activation in pain processing areas: a crossover fMRI investigation in healthy volunteers. Brain Imaging Behav  2015; 9(2): 236-44.
[http://dx.doi.org/10.1007/s11682-014-9301-4] [PMID: 24728839] 
[26] 
Cheng H, Yan H, Bai LJ, Wang BG. Exploration of whole brain networks modulated by acupuncture at analgesia acupoint ST36 using scale-specific wavelet correlation analysis. Chin Med J (Engl)  2013; 126(13): 2459-64.
[PMID: 23823818] 
[27] 
Liu J, Nan J, Xiong S, Li G, Qin W, Tian J. Additional evidence for the sustained effect of acupuncture at the vision-related acupuncture point, GB37. Acupunct Med  2013; 31(2): 185-94.
[http://dx.doi.org/10.1136/acupmed-2012-010251] [PMID: 23369811] 
[28] 
Maeda Y, Kettner N, Lee J, et al. Acupuncture evoked response in contralateral somatosensory cortex reflects peripheral nerve pathology of carpal tunnel syndrome. Med Acupunct  2013; 25(4): 275-84.
[http://dx.doi.org/10.1089/acu.2013.0964] [PMID: 24761177] 
[29] 
Maeda Y, Kettner N, Lee J, et al. Acupuncture-evoked response in somatosensory and prefrontal cortices predicts immediate pain reduction in carpal tunnel syndrome. Evid Based Complement Alternat Med  2013; 2013 795906
[http://dx.doi.org/10.1155/2013/795906] [PMID: 23843881] 
[30] 
You Y, Bai L, Dai R, et al. Altered hub configurations within default mode network following acupuncture at ST36: a multimodal investigation combining fMRI and MEG. PLoS One  2013; 8(5) e64509
[http://dx.doi.org/10.1371/journal.pone.0064509] [PMID: 23691237] 
[31] 
Cho SY, Kim M, Sun JJ, et al. A comparison of brain activity between healthy subjects and stroke patients on fMRI by acupuncture stimulation. Chin J Integr Med  2013; 19(4): 269-76.
[http://dx.doi.org/10.1007/s11655-013-1436-4] [PMID: 23546630] 
[32] 
Yang J, Zeng F, Feng Y, et al. A PET-CT study on the specificity of acupoints through acupuncture treatment in migraine patients. BMC Complement Altern Med  2012; 12: 123.
[http://dx.doi.org/10.1186/1472-6882-12-123] [PMID: 22894176] 
[33] 
Huang Y, Tang C, Wang S, et al. Acupuncture regulates the glucose metabolism in cerebral functional regions in chronic stage ischemic stroke patients--a PET-CT cerebral functional imaging study. BMC Neurosci  2012; 13: 75.
[http://dx.doi.org/10.1186/1471-2202-13-75] [PMID: 22738270] 
[34] 
Liu B, Chen J, Wang J, et al. Altered small-world efficiency of brain functional networks in acupuncture at ST36: a functional MRI study. PLoS One  2012; 7(6) e39342
[http://dx.doi.org/10.1371/journal.pone.0039342] [PMID: 22761766] 
[35] 
Chen JR, Li GL, Zhang GF, Huang Y, Wang SX, Lu N. Brain areas involved in acupuncture needling sensation of de qi: a single-photon emission computed tomography (SPECT) study. Acupunct Med  2012; 30(4): 316-23.
[http://dx.doi.org/10.1136/acupmed-2012-010169] [PMID: 23023060] 
[36] 
Napadow V, Lee J, Kim J, et al. Brain correlates of phasic autonomic response to acupuncture stimulation: an event-related fMRI study. Hum Brain Mapp  2013; 34(10): 2592-606.
[http://dx.doi.org/10.1002/hbm.22091] [PMID: 22504841] 
[37] 
Claunch JD, Chan ST, Nixon EE, et al. Commonality and specificity of acupuncture action at three acupoints as evidenced by FMRI. Am J Chin Med  2012; 40(4): 695-712.
[http://dx.doi.org/10.1142/S0192415X12500528] [PMID: 22809025] 
[38] 
Liu H, Xu J, Shan B, et al. Determining the precise cerebral response to acupuncture: an improved FMRI study. PLoS One  2012; 7(11) e49154
[http://dx.doi.org/10.1371/journal.pone.0049154] [PMID: 23152865] 
[39] 
Chen SJ, Meng L, Yan H, et al. Functional organization of complex brain networks modulated by acupuncture at different acupoints belonging to the same anatomic segment. Chin Med J (Engl)  2012; 125(15): 2694-700.
[PMID: 22931977] 
[40] 
Zeng F, Qin W, Ma T, et al. Influence of acupuncture treatment on cerebral activity in functional dyspepsia patients and its relationship with efficacy. Am J Gastroenterol  2012; 107(8): 1236-47.
[http://dx.doi.org/10.1038/ajg.2012.53] [PMID: 22641307] 
[41] 
Zhong C, Bai L, Dai R, et al. Modulatory effects of acupuncture on resting-state networks: a functional MRI study combining independent component analysis and multivariate Granger causality analysis. J Magn Reson Imaging  2012; 35(3): 572-81.
[http://dx.doi.org/10.1002/jmri.22887] [PMID: 22069078] 
[42] 
Ren XJ, Chen HY, Wang BG, et al. Regional homogeneity analysis on acupoint specificity with resting-state functional magnetic resonance imaging. Chin Med J (Engl)  2012; 125(9): 1627-32.
[PMID: 22800833] 
[43] 
Dong M, Qin W, Sun J, et al. Tempo-spatial analysis of vision-related acupoint specificity in the occipital lobe using fMRI: an ICA study. Brain Res  2012; 1436: 34-42.
[http://dx.doi.org/10.1016/j.brainres.2011.11.050] [PMID: 22197696] 
[44] 
Napadow V, Li A, Loggia ML, et al. The brain circuitry mediating antipruritic effects of acupuncture. Cereb Cortex  2014; 24(4): 873-82.
[http://dx.doi.org/10.1093/cercor/bhs363] [PMID: 23222890] 
[45] 
Fang J, Wang X, Liu H, et al. The limbic-prefrontal network modulated by electroacupuncture at CV4 and CV12. Evid Based Complement Alternat Med  2012; 2012 515893
[http://dx.doi.org/10.1155/2012/515893] [PMID: 22291848] 
[46] 
Qin W, Bai L, Dai J, et al. The temporal-spatial encoding of acupuncture effects in the brain. Mol Pain  2011; 7: 19.
[http://dx.doi.org/10.1186/1744-8069-7-19] [PMID: 21429192] 
[47] 
Liu J, Qin W, Guo Q, et al. Divergent neural processes specific to the acute and sustained phases of verum and SHAM acupuncture. J Magn Reson Imaging  2011; 33(1): 33-40.
[http://dx.doi.org/10.1002/jmri.22393] [PMID: 21182118] 
[48] 
Cheng H, Zhang XT, Yan H, et al. Differential temporal neural responses of pain-related regions by acupuncture at acupoint ST36: a magnetoencephalography study. Chin Med J (Engl)  2011; 124(8): 1229-34.
[PMID: 21543002] 
[49] 
Feng Y, Bai L, Zhang W, et al. Investigation of acupoint specificity by whole brain functional connectivity analysis from fMRI data. Conf Proc IEEE Eng Med Biol Soc  2011; 2011: 2784-7.
[PMID: 22254919] 
[50] 
Feng Y, Bai L, Ren Y, et al. Investigation of the large-scale functional brain networks modulated by acupuncture. Magn Reson Imaging  2011; 29(7): 958-65.
[http://dx.doi.org/10.1016/j.mri.2011.04.009] [PMID: 21616623] 
[51] 
Xue T, Bai L, Chen S, et al. Neural specificity of acupuncture stimulation from support vector machine classification analysis. Magn Reson Imaging  2011; 29(7): 943-50.
[http://dx.doi.org/10.1016/j.mri.2011.03.003] [PMID: 21531109] 
[52] 
Liu P, Zhou G, Yang X, et al. Power estimation predicts specific function action of acupuncture: an fMRI study. Magn Reson Imaging  2011; 29(8): 1059-64.
[http://dx.doi.org/10.1016/j.mri.2011.06.002] [PMID: 21849241] 
[53] 
Li G, Yang ES. An fMRI study of acupuncture-induced brain activation of aphasia stroke patients. Complement Ther Med  2011; 19(Suppl. 1): S49-59.
[http://dx.doi.org/10.1016/j.ctim.2010.11.004] [PMID: 21195295] 
[54] 
Liu P, Zhou G, Zhang Y, et al. The hybrid GLM-ICA investigation on the neural mechanism of acupoint ST36: an fMRI study. Neurosci Lett  2010; 479(3): 267-71.
[http://dx.doi.org/10.1016/j.neulet.2010.05.077] [PMID: 20573575] 
[55] 
Quah-Smith I, Sachdev PS, Wen W, Chen X, Williams MA. The brain effects of laser acupuncture in healthy individuals: an FMRI investigation. PLoS One  2010; 5(9) e12619
[http://dx.doi.org/10.1371/journal.pone.0012619] [PMID: 20838644] 
[56] 
Ren Y, Bai L, Feng Y, Tian J, Li K. Investigation of acupoint specificity by functional connectivity analysis based on graph theory. Neurosci Lett  2010; 482(2): 95-100.
[http://dx.doi.org/10.1016/j.neulet.2010.06.091] [PMID: 20619317] 
[57] 
Wu Y, Jin Z, Li K, et al. Functional magnetic resonance imaging activation of the brain in children: real acupoint versus sham acupoint. J Child Neurol  2010; 25(7): 849-55.
[http://dx.doi.org/10.1177/0883073809351314] [PMID: 20595697] 
[58] 
Cho SY, Jahng GH, Park SU, Jung WS, Moon SK, Park JM. fMRI study of effect on brain activity according to stimulation method at LI11, ST36: painful pressure and acupuncture stimulation of same acupoints. J Altern Complement Med  2010; 16(4): 489-95.
[http://dx.doi.org/10.1089/acm.2009.0395] [PMID: 20423217] 
[59] 
Li L, Qin W, Bai L, Tian J. Exploring vision-related acupuncture point specificity with multivoxel pattern analysis. Magn Reson Imaging  2010; 28(3): 380-7.
[http://dx.doi.org/10.1016/j.mri.2009.11.009] [PMID: 20071124] 
[60] 
Bai L, Tian J, Zhong C, et al. Acupuncture modulates temporal neural responses in wide brain networks: evidence from fMRI study. Mol Pain  2010; 6: 73.
[http://dx.doi.org/10.1186/1744-8069-6-73] [PMID: 21044291] 
[61] 
Harris RE, Zubieta JK, Scott DJ, Napadow V, Gracely RH, Clauw DJ. Traditional Chinese acupuncture and placebo (sham) acupuncture are differentiated by their effects on mu-opioid receptors (MORs). Neuroimage  2009; 47(3): 1077-85.
[http://dx.doi.org/10.1016/j.neuroimage.2009.05.083] [PMID: 19501658] 
[62] 
Bai L, Qin W, Tian J, et al. Time-varied characteristics of acupuncture effects in fMRI studies. Hum Brain Mapp  2009; 30(11): 3445-60.
[http://dx.doi.org/10.1002/hbm.20769] [PMID: 19350547] 
[63] 
Napadow V, Dhond R, Park K, et al. Time-variant fMRI activity in the brainstem and higher structures in response to acupuncture. Neuroimage  2009; 47(1): 289-301.
[http://dx.doi.org/10.1016/j.neuroimage.2009.03.060] [PMID: 19345268] 
[64] 
Ho TJ, Duann JR, Chen CM, et al. Temporally shifted hemodynamic response model helps to extract acupuncture-induced functional magnetic resonance imaging blood oxygenation-level dependent activities. Chin Med J (Engl)  2009; 122(7): 823-9.
[PMID: 19493397] 
[65] 
Liu P, Zhang Y, Zhou G, et al. Partial correlation investigation on the default mode network involved in acupuncture: an fMRI study. Neurosci Lett  2009; 462(3): 183-7.
[http://dx.doi.org/10.1016/j.neulet.2009.07.015] [PMID: 19595739] 
[66] 
Zhang Y, Qin W, Liu P, et al. An fMRI study of acupuncture using independent component analysis. Neurosci Lett  2009; 449(1): 6-9.
[http://dx.doi.org/10.1016/j.neulet.2008.10.071] [PMID: 18977409] 
[67] 
Kong J, Kaptchuk TJ, Webb JM, et al. Functional neuroanatomical investigation of vision-related acupuncture point specificity--a multisession fMRI study. Hum Brain Mapp  2009; 30(1): 38-46.
[http://dx.doi.org/10.1002/hbm.20481] [PMID: 17990299] 
[68] 
Liu P, Qin W, Zhang Y, et al. Combining spatial and temporal information to explore function-guide action of acupuncture using fMRI. J Magn Reson Imaging  2009; 30(1): 41-6.
[http://dx.doi.org/10.1002/jmri.21805] [PMID: 19557845] 
[69] 
Bai L, Qin W, Tian J, et al. Acupuncture modulates spontaneous activities in the anticorrelated resting brain networks. Brain Res  2009; 1279: 37-49.
[http://dx.doi.org/10.1016/j.brainres.2009.04.056] [PMID: 19427842] 
[70] 
Park SU, Shin AS, Jahng 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  2009; 15(11): 1193-200.
[http://dx.doi.org/10.1089/acm.2008.0602] [PMID: 19922250] 
[71] 
Fang J, Jin Z, Wang Y, et al. The salient characteristics of the central effects of acupuncture needling: limbic-paralimbic-neocortical network modulation. Hum Brain Mapp  2009; 30(4): 1196-206.
[http://dx.doi.org/10.1002/hbm.20583] [PMID: 18571795] 
[72] 
Li L, Liu H, Li YZ, et al. The human brain response to acupuncture on same-meridian acupoints: evidence from an fMRI study. J Altern Complement Med  2008; 14(6): 673-8.
[http://dx.doi.org/10.1089/acm.2008.0036] [PMID: 18684074] 
[73] 
Deng G, Hou BL, Holodny AI, Cassileth BR. Functional magnetic resonance imaging (fMRI) changes and saliva production associated with acupuncture at LI-2 acupuncture point: a randomized controlled study. BMC Complement Altern Med  2008; 8(1): 37.
[http://dx.doi.org/10.1186/1472-6882-8-37] [PMID: 18606019] 
[74] 
Qin W, Tian J, Bai L, et al. FMRI connectivity analysis of acupuncture effects on an amygdala-associated brain network. Mol Pain  2008; 4: 55.
[http://dx.doi.org/10.1186/1744-8069-4-55] [PMID: 19014532] 
[75] 
Kong J, Gollub RL, Webb JM, Kong JT, Vangel MG, Kwong K. Test-retest study of fMRI signal change evoked by electroacupuncture stimulation. Neuroimage  2007; 34(3): 1171-81.
[http://dx.doi.org/10.1016/j.neuroimage.2006.10.019] [PMID: 17157035] 
[76] 
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(4): 1080-91.
[http://dx.doi.org/10.1016/j.neuroimage.2005.08.066] [PMID: 16325429] 
[77] 
Napadow V, Dhond RP, Purdon P, et al. Correlating acupuncture FMRI in the human brainstem with heart rate variability. Conf Proc IEEE Eng Med Biol Soc  2005; 2005: 4496-9.
[http://dx.doi.org/10.1109/IEMBS.2005.1615466] [PMID: 17281236] 
[78] 
Yan B, Li K, Xu J, et al. Acupoint-specific fMRI patterns in human brain. Neurosci Lett  2005; 383(3): 236-40.
[http://dx.doi.org/10.1016/j.neulet.2005.04.021] [PMID: 15876491] 
[79] 
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.
[http://dx.doi.org/10.1007/s00234-003-1125-7] [PMID: 15103431] 
[80] 
Liu WC, Feldman SC, Cook DB, et al. fMRI study of acupuncture-induced periaqueductal gray activity in humans. Neuroreport  2004; 15(12): 1937-40.
[http://dx.doi.org/10.1097/00001756-200408260-00021] [PMID: 15305141] 
[81] 
Zhang WT, Jin Z, Luo F, Zhang L, Zeng YW, Han JS. Evidence from brain imaging with fMRI supporting functional specificity of acupoints in humans. Neurosci Lett  2004; 354(1): 50-3.
[http://dx.doi.org/10.1016/j.neulet.2003.09.080] [PMID: 14698480] 
[82] 
Litscher G, Rachbauer D, Ropele S, et al. Acupuncture using laser needles modulates brain function: first evidence from functional transcranial Doppler sonography and functional magnetic resonance imaging. Lasers Med Sci  2004; 19(1): 6-11.
[http://dx.doi.org/10.1007/s10103-004-0291-0] [PMID: 15316852] 
[83] 
Li G, Liu HL, Cheung RT, et al. An fMRI study comparing brain activation between word generation and electrical stimulation of language-implicated acupoints. Hum Brain Mapp  2003; 18(3): 233-8.
[http://dx.doi.org/10.1002/hbm.10098] [PMID: 12599282] 
[84] 
Cho ZH, Chung SC, Jones JP, et al. New findings of the correlation between acupoints and corresponding brain cortices using functional MRI. Proc Natl Acad Sci USA  1998; 95(5): 2670-3.
[http://dx.doi.org/10.1073/pnas.95.5.2670] [PMID: 9482945] 
[85] 
Zhu B, Wang Y, Zhang G, et al. Acupuncture at KI3 in healthy volunteers induces specific cortical functional activity: an fMRI study. BMC Complement Altern Med  2015; 15: 361.
[http://dx.doi.org/10.1186/s12906-015-0881-3] [PMID: 26467429] 
[86] 
Chen X, Zhang H, Zou Y. A functional magnetic resonance imaging study on the effect of acupuncture at GB34 (Yanglingquan) on motor-related network in hemiplegic patients. Brain Res  2015; 1601: 64-72.
[http://dx.doi.org/10.1016/j.brainres.2015.01.011] [PMID: 25601007] 
[87] 
Yang M, Yang J, Zeng F, et al. Electroacupuncture stimulation at sub-specific acupoint and non-acupoint induced distinct brain glucose metabolism change in migraineurs: a PET-CT study. J Transl Med  2014; 12: 351.
[http://dx.doi.org/10.1186/s12967-014-0351-6] [PMID: 25496446] 
[88] 
Chen X, Spaeth RB, Retzepi K, Ott D, Kong J. Acupuncture modulates cortical thickness and functional connectivity in knee osteoarthritis patients. Sci Rep  2014; 4: 6482.
[http://dx.doi.org/10.1038/srep06482] [PMID: 25258037] 
[89] 
Leung A, Zhao Y, Shukla S. The effect of acupuncture needle combination on central pain processing--an fMRI study. Mol Pain  2014; 10: 23.
[http://dx.doi.org/10.1186/1744-8069-10-23] [PMID: 24667015] 
[90] 
Quirico PE, Allais G, Ferrando M, et al. Effects of the acupoints PC 6 Neiguan and LR 3 Taichong on cerebral blood flow in normal subjects and in migraine patients. Neurol Sci  2014; 35(Suppl. 1): 129-33.
[http://dx.doi.org/10.1007/s10072-014-1754-0] [PMID: 24867849] 
[91] 
Li Z, Liu M, Lan L, et al. Altered periaqueductal gray resting state functional connectivity in migraine and the modulation effect of treatment. Sci Rep  2016; 6: 20298.
[http://dx.doi.org/10.1038/srep20298] [PMID: 26839078] 
[92] 
Zheng Y, Zhang J, Wang Y, et al. Acupuncture decreases blood pressure related to hypothalamus functional connectivity with frontal lobe, cerebellum, and insula: a study of instantaneous and short-term acupuncture treatment in essential hypertension. Evid Based Complement Alternat Med  2016; 2016 6908710
[http://dx.doi.org/10.1155/2016/6908710] [PMID: 27688791] 
[93] 
Li Z, Lan L, Zeng F, et al. The altered right frontoparietal network functional connectivity in migraine and the modulation effect of treatment. Cephalalgia  2017; 37(2): 161-76.
[http://dx.doi.org/10.1177/0333102416641665] [PMID: 27053062] 
[94] 
Liu L, Wu Y, Zheng J, et al. Cerebral activation effects of acupuncture using Zusanli (ST36) and Yanglingquan (GB34) points based on Regional Homogeneity indices: A resting-state fMRI study. J XRay Sci Technol  2016; 24(2): 297-308.
[http://dx.doi.org/10.3233/XST-160557] [PMID: 27002910] 
[95] 
Deng D, Duan G, Liao H, et al. Changes in regional brain homogeneity induced by electro-acupuncture stimulation at the baihui acupoint in healthy subjects: a functional magnetic resonance imaging study. J Altern Complement Med  2016; 22(10): 794-9.
[http://dx.doi.org/10.1089/acm.2015.0286] [PMID: 27438091] 
[96] 
Xiao J, Zhang H, Chang JL, et al. Effects of electro-acupuncture at Tongli (HT 5) and Xuanzhong (GB 39) acupoints from functional magnetic resonance imaging evidence. Chin J Integr Med  2016; 22(11): 846-54.
[http://dx.doi.org/10.1007/s11655-015-1971-2] [PMID: 26129898] 
[97] 
Zhang J, Zheng Y, Wang Y, et al. Evidence of a synergistic effect of acupoint combination: a resting-state functional magnetic resonance imaging study. J Altern Complement Med  2016; 22(10): 800-9.
[http://dx.doi.org/10.1089/acm.2016.0016] [PMID: 27548054] 
[98] 
Chen X, Spaeth RB, Freeman SG, et al. The modulation effect of longitudinal acupuncture on resting state functional connectivity in knee osteoarthritis patients. Mol Pain  2015; 11: 67.
[http://dx.doi.org/10.1186/s12990-015-0071-9] [PMID: 26511911] 
[99] 
Wik G, Huang Y, Zeng T, et al. Waiguan stimulation may kindle anticorrelated brain networks: functional magnetic resonance imaging data revisited. J Acupunct Meridian Stud  2016; 9(1): 22-5.
[http://dx.doi.org/10.1016/j.jams.2015.11.035] [PMID: 26896073] 
[100] 
Egorova N, Gollub RL, Kong J. Repeated verum but not placebo acupuncture normalizes connectivity in brain regions dysregulated in chronic pain. Neuroimage Clin  2015; 9: 430-5.
[http://dx.doi.org/10.1016/j.nicl.2015.09.012] [PMID: 26594625] 
[101] 
Longhurst JC. Defining meridians: a modern basis of understanding. J Acupunct Meridian Stud  2010; 3(2): 67-74.
[http://dx.doi.org/10.1016/S2005-2901(10)60014-3] [PMID: 20633518] 
[102] 
Scheffold BE, Hsieh CL, Litscher G. Neuroimaging and neuromonitoring effects of electro and manual acupuncture on the central nervous system: a literature review and analysis. Evid Based Complement Alternat Med  2015; 2015 641742
[http://dx.doi.org/10.1155/2015/641742] [PMID: 26339269] 
[103] 
He T, Zhu W, Du SQ, et al. Neural mechanisms of acupuncture as revealed by fMRI studies. Auton Neurosci  2015; 190: 1-9.
[http://dx.doi.org/10.1016/j.autneu.2015.03.006] [PMID: 25900479] 
[104] 
Gollub RL, Kirsch I, Maleki N, et al. A functional neuroimaging study of expectancy effects on pain response in patients with knee osteoarthritis. J Pain  2018; 19(5): 515-27.
[http://dx.doi.org/10.1016/j.jpain.2017.12.260] [PMID: 29325883] 
[105] 
Lewith GT, White PJ, Pariente J. Investigating acupuncture using brain imaging techniques: the current state of play. Evid Based Complement Alternat Med  2005; 2(3): 315-9.
[http://dx.doi.org/10.1093/ecam/neh110] [PMID: 16136210] 
[106] 
Dhond RP, Kettner N, Napadow V. Do the neural correlates of acupuncture and placebo effects differ? Pain  2007; 128(1-2): 8-12.
[http://dx.doi.org/10.1016/j.pain.2007.01.001] [PMID: 17267130] 
[107] 
Campbell A. Point specificity of acupuncture in the light of recent clinical and imaging studies. Acupunct Med  2006; 24(3): 118-22.
[http://dx.doi.org/10.1136/aim.24.3.118] [PMID: 17013358] 
[108] 
Huang W, Pach D, Napadow V, et al. Characterizing acupuncture stimuli using brain imaging with FMRI--a systematic review and meta-analysis of the literature. PLoS One  2012; 7(4) e32960
[http://dx.doi.org/10.1371/journal.pone.0032960] [PMID: 22496739] 
[109] 
Cai RL, Shen GM, Wang H, Guan YY. Brain functional connectivity network studies of acupuncture: a systematic review on resting-state fMRI. J Integr Med  2018; 16(1): 26-33.
[http://dx.doi.org/10.1016/j.joim.2017.12.002] [PMID: 29397089] 
[110] 
Bosch P, van den Noort M, Staudte H, Lim S. Schizophrenia and depression: a systematic review of the effectiveness and the working mechanisms behind acupuncture. Explore (NY)  2015; 11(4): 281-91.
[http://dx.doi.org/10.1016/j.explore.2015.04.004] [PMID: 26007331] 
[111] 
Button KS, Ioannidis JP, Mokrysz C, et al. Power failure: why small sample size undermines the reliability of neuroscience. Nat Rev Neurosci  2013; 14(5): 365-76.
[http://dx.doi.org/10.1038/nrn3475] [PMID: 23571845] 
[112] 
Schnack HG, Kahn RS. Detecting neuroimaging biomarkers for psychiatric disorders: sample size matters. Front Psychiatry  2016; 7: 50.
[http://dx.doi.org/10.3389/fpsyt.2016.00050] [PMID: 27064972] 
[113] 
Desmond JE, Glover GH. Estimating sample size in functional MRI (fMRI) neuroimaging studies: statistical power analyses. J Neurosci Methods  2002; 118(2): 115-28.
[http://dx.doi.org/10.1016/S0165-0270(02)00121-8] [PMID: 12204303] 
[114] 
Poldrack RA. The future of fMRI in cognitive neuroscience. Neuroimage  2012; 62(2): 1216-20.
[http://dx.doi.org/10.1016/j.neuroimage.2011.08.007] [PMID: 21856431] 
[115] 
Mersov AM, Crane DE, Chappell MA, Black SE, MacIntosh BJ. Estimating the sample size required to detect an arterial spin labelling magnetic resonance imaging perfusion abnormality in voxel-wise group analyses. J Neurosci Methods  2015; 245: 169-77.
[http://dx.doi.org/10.1016/j.jneumeth.2015.02.017] [PMID: 25749568] 
[116] 
Pajula J, Tohka J. How many is enough? Effect of sample size in inter-subject correlation analysis of fMRI. Comput Intell Neurosci  2016; 2016 2094601
[http://dx.doi.org/10.1155/2016/2094601] [PMID: 26884746] 
[117] 
Lin YJ, Kung YY, Kuo WJ, et al. Effect of acupuncture ‘dose’ on modulation of the default mode network of the brain. Acupunct Med  2016; 34(6): 425-32.
[http://dx.doi.org/10.1136/acupmed-2016-011071] [PMID: 27841974] 
[118] 
Zhang C, Wen Y, Fan XN, et al. Therapeutic effects of different durations of acupuncture on rats with middle cerebral artery occlusion. Neural Regen Res  2015; 10(1): 159-64.
[http://dx.doi.org/10.4103/1673-5374.150727] [PMID: 25788938] 
Rights & Permissions Print Cite
Article Metrics
12
1
Journal Information
For Authors
For Editors
For Reviewers
Explore Articles
For Visitors
DOI https://dx.doi.org/10.2174/1573405615666190220113111	Print ISSN 1573-4056
Publisher Name Bentham Science Publisher	Online ISSN 1875-6603
Current Medical Imaging

Does the Acupoint Specificity Exist? Evidence from Functional Neuroimaging Studies

Abstract Play Pause

Graphical Abstract

Related Books

Related Articles

Abstract
