PARIS - Many Western studies of the effects of acupuncture seem to be missing the point, looking for on-or-off effects caused by inserting the long needles used in this traditional Chinese medical practice. Repeatedly inserting needles to force a stimulation that can be seen immediately does not correspond to the technique developed more than 3,000 years, and this has limited research.
Acupuncture is a branch of traditional Chinese medicine that has been practiced for thousands of years in China and the Far East, but studying its effects has proved difficult.By shifting methods to align with expected longer term, or cascading, effects, new studies using functional MRI (fMRI) are demonstrating functional specificity for acupuncture through dynamic reconfiguration of complex neural networks. These results are creating a field for exploration that on one hand may provide an evidence-based practice for acupuncture, and on the other hand may open a greater understanding of neuronally mediated effects that can be measured by fMRI.
In his presentation during the session about Chinese radiology at the annual congress of the French Radiology Society (SFR), les Journées Françaises de Radiologie (JFR), Jie Tian, PhD, a professor in the Institute of Automation at the Chinese Academy of Sciences in Beijing, traced a history of frustration for practitioners of acupuncture.
For 10 years, no one was able to reproduce the selective changes in cortical fMRI following insertion of needles at acupuncture points that were published by Zang-Hee Cho from the University of California, Irvine in 1998 and again in 2002 in the Journal of Alternative and Complementary Medicine (August 2002, Vol. 8:4, pp. 399-401). There were also compelling patient experiences, including the near-complete recovery from an inoperable brain stem hemorrhage thanks to intensive acupuncture described by Ruth Lycke in her 2001 book, Out of the Darkness into the Light. To this point, fMRI studies employed a "block design" built on a stimulation-response model with the assumption that the signal should immediately fall back to its prestimuli condition after stimulation, he explained to JFR attendees.
The breakthrough came with a new framework considering that the peripheral acupoint-brain interaction may engage complex neural substrates and that acupuncture's long-lasting effects may include multidimensional physiological as well as psychological responses. The issue became how to study these effects.
Tian is co-author of the study, "The temporal-spatial encoding of acupuncture effects in the brain," published in March in Molecular Pain that shows functional specificity in which both the needling sensation of acupuncture and the following neural cascades contribute to an overall effect through dynamic reconfiguration of complex neural networks (23 March 2011, 7:19).
A complex network analysis tested the hypothesis that acupuncture stimulation at an acupoint would induce corresponding activity changes in one or more intrinsic or resting state brain networks. A dynamic encoding system was constructed with a hub at the posterior cingulate cortex and precuneus and results indicate an encoding/decoding function that may interact with distinct brain networks when different visual or nonvisual acupoints are stimulated.
Tian suggested the results open new methods for the design and interpretation of a range of neuroimaging studies. His main research interests include medical image processing and analysis, pattern recognition, and biomatics, and he is a winner of the 2010 National Award for Technological Invention for his work in small animal multimodality optical molecular imaging.
