Effect of ST 36-ST 41 Electro-acupuncture on Regional Cerebral Blood Flow in Normal Volunteers Evaluated by $^{99m}Tc$-ECD SPECT

족삼리-해계 전침치료가 정상인의 국소 뇌혈류에 미치는 영향 -Brain SPECT와 SPM을 이용하여-

  • Moon, Sang-Kwan (Dept. of Cardiovascular and Neurologic Diseases (Steroke, Center), College of Oriental Medicine, Kyung Hee Univ.) ;
  • Min, In-Kyu (Dept. of Cardiovascular and Neurologic Diseases (Steroke, Center), College of Oriental Medicine, Kyung Hee Univ.) ;
  • Park, Sung-Uk (Dept. of Cardiovascular and Neurologic Diseases (Steroke, Center), College of Oriental Medicine, Kyung Hee Univ.) ;
  • Jung, Woo-Sang (Dept. of Cardiovascular and Neurologic Diseases (Steroke, Center), College of Oriental Medicine, Kyung Hee Univ.) ;
  • Park, Jung-Mee (Dept. of Cardiovascular and Neurologic Diseases (Steroke, Center), College of Oriental Medicine, Kyung Hee Univ.) ;
  • Ko, Chang-Nam (Dept. of Cardiovascular and Neurologic Diseases (Steroke, Center), College of Oriental Medicine, Kyung Hee Univ.) ;
  • Cho, Ki-Ho (Dept. of Cardiovascular and Neurologic Diseases (Steroke, Center), College of Oriental Medicine, Kyung Hee Univ.) ;
  • Bae, Hyung-Sup (Dept. of Cardiovascular and Neurologic Diseases (Steroke, Center), College of Oriental Medicine, Kyung Hee Univ.) ;
  • Kim, Young-Suk (Dept. of Cardiovascular and Neurologic Diseases (Steroke, Center), College of Oriental Medicine, Kyung Hee Univ.) ;
  • Kim, Deok-Yoon (Dept. of Nuclear Medicine, College of Medicine, Kyung Hee Univ.)
  • 문상관 (경희대학교 한의과대학 제2내과학교실) ;
  • 민인규 (경희대학교 한의과대학 제2내과학교실) ;
  • 박성욱 (경희대학교 한의과대학 제2내과학교실) ;
  • 정우상 (경희대학교 한의과대학 제2내과학교실) ;
  • 박정미 (경희대학교 한의과대학 제2내과학교실) ;
  • 고창남 (경희대학교 한의과대학 제2내과학교실) ;
  • 조기호 (경희대학교 한의과대학 제2내과학교실) ;
  • 배형섭 (경희대학교 한의과대학 제2내과학교실) ;
  • 김영석 (경희대학교 한의과대학 제2내과학교실) ;
  • 김덕윤 (경희대학교 의과대학 핵의학교실)
  • Received : 2009.08.12
  • Accepted : 2009.10.14
  • Published : 2010.01.30

Abstract

Objectives: So far it has been reported that acupuncture increases cerebral blood supply and stimulates the functional activity of brain nerve cells. Previous studies have demonstrated that frequently used electro-acupuncture (EA) therapies for stroke increased regional cerebral blood flow (rCBF) in normal volunteers. Though ST 36-ST 41 EA is another prevailing therapy for stroke, there had been no report about its effect on rCBF. This study was to evaluate the effect of ST 36-ST 41 EA on rCBF in normal volunteers using single photon emission computed tomography (SPECT) and statistical parametric mapping (SPM). Methods: In the resting state, $^{99m}Tc$-ECD brain SPECT scans were performed on 10 normal volunteers (5 males, 5 female, mean age $23.6{\pm}0.5$ years). On the other study day, 7 days after the resting examination, 15 minutesEA were applied at ST 36 and ST 41 on the right side of the subjects. Immediately after ST36-ST41 EA, the second SPECT images were obtained in the same manner as the resting state. Significant increases and decreases of rCBF after EA were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by SPM with a threshold of p = 0.01, uncorrected (extent threshold: k=100 voxels). Results: EA applied at the right ST36-ST41 significantly increased rCBF in the right inferior parietal lobule (Brodmann area [BA] 40), right retrosubicular area (BA 48), left inferior parietal lobule (BA 40), left middle temporal gyrus (BA 21), left fusiform gyrus (BA 37), left inferior parietal lobule (BA 39), left inferior temporal gyrus (BA 20), and left somatosensory association cortex (BA 7). However, right ST36-ST41 EA significantly decreased rCBF in the right parahippocampal gyrus (BA 35), right cerebellum, left frontopolar area (BA 10), left orbitofrontal area (BA 11), left dorsolateral prefrontal cortex (BA 9), and left dorsal anterior cingulate cortex (BA 32). Conclusions: These results demonstrate that rightST36-ST41 EA increased rCBF prominently in both inferior parietal lobule (BA 40) and right retrosubicular area (BA 48), which suggest that there be correlation between specific EA and corresponding rCBF.

Keywords

References

  1. Kim YS, Moon SK, Park SU, Han CH. Intergrated clinical approach to stroke, Seoul, Jeongdam publishing company, 2007:367.
  2. Lo YL, Cue SL, Fook-Chong S. The effect of acupuncture on motor cortex excitability and plasticity. Neuroscience Letters. 2005;384:145-149. https://doi.org/10.1016/j.neulet.2005.04.083
  3. 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. https://doi.org/10.1093/ecam/neh110
  4. Hui KKS, Liu J, Makris N, Gollub RL, Chen AJW, Moore CI, et al. Acupuncture modulates the limbic system and subcortical gray structures of the human brain: evidence from fMRI studies in normal subjects. Human Brain Mapping 2000; 9:13-25. https://doi.org/10.1002/(SICI)1097-0193(2000)9:1<13::AID-HBM2>3.0.CO;2-F
  5. Yoo SS, Teh EK, Blinder RA, Jolesz FA. Modulation of cerebellar activities by acupuncture stimulation:evidence from fMRI study. Neuro- Image 2004;22:932- 940.
  6. Wu MT, Sheen JM, Chuang KH, Yang P, Chin SL, Tsai CY, et al. Neuronal Specificity of Acupuncture Response: A fMRI Study with Electroacupuncture. NeuroImage 2002;16:1028-1037. https://doi.org/10.1006/nimg.2002.1145
  7. Napadow V, Makris N, Liu J, Kettner NW, Kwong KK, Hui KKS. Effects of Electroacupuncture versus Manual Acupuncture on the Human Brain as Measured by fMRI. Human Brain Mapping 2005;24:193-205. https://doi.org/10.1002/hbm.20081
  8. Hui KKS, 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;27:479-496. https://doi.org/10.1016/j.neuroimage.2005.04.037
  9. Hsieh JC, Tu CH, Chen FP, Chen MC, Yeh TC, Cheng HC, et al. Activation of the hypothalamus characterizes the acupuncture stimulation at the analgesic point in human: a positron emission tomography study. Neurosci Lett 2001;307(2): 105-8. https://doi.org/10.1016/S0304-3940(01)01952-8
  10. Song HC, Bum HS, Kang HJ, Ahn SK, Kim SM, Jeong HJ, et al. Effect of acupuncture on regional cerebral blood flow at acupoints GV 20, GV 26, LI 4, ST 36, SP 6 evaluated by Tc-99m ECD brain SPECT. J Korean Nuclear Medicine and Molecular Imaging 2000;34(6):456-459.
  11. Moon SK, Kim YS, Park SU, Jung WS, Ko CN, Cho KH, et al. The Effect of LI4-LI11 electrical acupuncture at unaffected limb on cerebral blood flow in ischemic stroke patients using SPECT. J Korean Acupuncture and Moxibustion 2004;21 (1):111-118.
  12. Ryu JM, Moon SK, Kim YS, Park SU, Jung WS, Ko CN, et al. Effect of LI4-LI11 Electro-acupuncture on Regional Cerebral Blood Flow Evaluated by Tc-99m ECD Brain SPECT. J Korean Oriental Med 2006;27(2):276-283.
  13. Han JA, Moon SK, Park SU, Jung WS, Ko CN, Cho KH, et al. Effect of GB 34-GB 39 electroacupuncture on regional cerebral blood flow in stroke patients and normal volunteers evaluated by 99mTc-ECD SPECT. J Korean Oriental Med 2006;27(3):197-210.
  14. Lee JD, Chon JS, Jeong HK, Kim HJ, Yun M, Kim DY, et al. The cerebrovascular response to traditional acupuncture after stroke. Neuroradiology 2003;45:780-784. https://doi.org/10.1007/s00234-003-1080-3
  15. Moon SK, Jeong DW, Kim YS, Park SU, Jung WS, Park JM, et al. Effect of LI4-LI11 Transcutaneous electrical nerve stimulation on regional cerebral blood flow in healthy human using SPECT and statistical parametric mapping. J Korean Oriental Med 2008;29(4):205-212.
  16. MacPherson H, Green G, Nevado A, Lythgoe MF, Lewith G, Devlin R, et al. Brain imaging of acupuncture: Comparing superficial with deep needling. Neuroscience Letters 2008;434:144- 149. https://doi.org/10.1016/j.neulet.2008.01.058
  17. Lee HY, Lee DS, Paeng JC, Oh CW, Cho MJ, Chung JK, et al. The efficacy of Quantitative Analysis of Basal/Acetazolamide SPECT Using SPM and Statistical Probabilistic Brain Atlas in Patients with Internal Carotid Artery Stenosis. Korean J Nucl Med 2002;36(6):357-367.
  18. Lee JS, Lee DS, Lee SK, Nam HW, Kim SK, Park KS, et al. Functional Brain Mapping Using H215O Positron Emission Tomography ( II ): Mapping of Human Working Memory. Korean J Nucl Med 1998;32(3):238-249.
  19. Jeong DW, Min IK, Moon SK, Park SU, Jung WS, Park JM, et al. A literatual study on the acupuncture and moxibustion for hemiparesis of stroke in Euibujipsung. Korean J of Joongpoong 2006;7(1):34-39.
  20. Lee DW. Study of cerebrovascular reactivity in dementia of Alzheimer's type using Diamox SPECT. MS dissetation, Seoul National Univ. College of Medicine. 2000.
  21. Kang HJ, Kang EJ, Lee JS, Yeo JS, Kim JY, Lee DS, et al. Relationship between Brain Perfusion SPECT and MNSK Score in Dementia of Alzheimer's Type - A statistical Parametric Mapping Analysis. Korean J Nucl Med 2002;36: 91-101.
  22. Stefanovic B, Warnking JM, Pike GB. Hemodynamic and metabolic responses to neuronal inhibition. NeuroImage 2004;22:771-778 https://doi.org/10.1016/j.neuroimage.2004.01.036