Neuroimaging and Neuromonitoring Effects of Electro and Manual Acupuncture on the Central Nervous System: A Literature Review and Analysis

Table 2

PET studies on the effect of MA and EA.

Author	Year	Title	Objective	Outcomes
Biella et al. [24]	2001	Acupuncture produces central activations in pain regions	Investigation of cerebral blood flow (CBF) changes after MA at ST36 (bil) and LU5 (bil) versus two nearby NAPs (bil)	Verum acupuncture but not sham acupuncture activated the left anterior cingulus, the insulae bilaterally, the cerebellum bilaterally, the left superior frontal gyrus, and the right medial and inferior frontal gyri.
Dougherty et al. [35]	2008	A combined 11C diprenorphine PET study and fMRI study of acupuncture analgesia	Investigation of changes in binding of opioid agonists and changes of heat pain after MA versus Streitberger sham acupuncture at LI4 (r)	In comparison to Streitberger acupuncture, they observed significant changes during verum acupuncture in the medial and lateral pain networks, such as opioid-binding decreases (associated with greater endogenous opioid release) in the right OFC, left medial PFC, right insula, and right thalamus, as well as binding increases in the bilateral insula, right medial PFC/ACC, left OFC, and right brainstem. An overlap of results between fMRI signals and 11C diprenorphine blood pressure changes was only exhibited in the right medial OFC.
Hsieh et al. [17]	2001	Activation of the hypothalamus characterizes the acupuncture stimulation at the analgesic point in human: A positron emission tomography study	Investigation of point specific CBF changes during MA at LI4 (r) versus nearby NAP	In comparison to acupuncture at a NAP, only MA at LI4 elicited activation of the regional CBF (rCBF) in the areas of the hypothalamus with extension to midbrain, the insula, the ACC, and the cerebellum. In addition, a further comparison of needling with deqi contrasted with minimal manipulation acupuncture and showed activation in the hypothalamus and the cerebellum. The activation by deqi in the hypothalamus extended to the midbrain/brain stem when contrasted with the brain at rest. Minimal stimulation activated neither the hypothalamus nor the insula when compared with rest situation.
Lai et al. [36]	2009	A cerebral functional imaging study by positron emission tomography in healthy volunteers receiving true or sham acupuncture needling	Investigation of CBF changes during MA versus Streitberger needle versus overt blunt needling at TH5 (r)	For MA in comparison with overt blunt needling, more brain areas (BA7, 13, 18, 19, 21, 22, 27, 38, 40, 42, and 45) were activated, whereas, in comparison with Streitberger-like sham acupuncture, slightly less MA activation was found in the areas of BA13 and 42. During Streitberger-like sham acupuncture the areas BA4, 6, 7, 19, 22, and 41 showed activation.
Schlünzen et al. [37]	2007	Acupuncture of LI-4 in anesthetized healthy humans decreases cerebral blood flow in the putamen measured with positron emission tomography	Investigation of CBF changes during MA at LI4 (r) versus nearby NAP in anesthetized participants	Their results showed a decrease in CBF in the right medial frontal gyrus and in the left putamen for verum acupuncture. Acupuncture at a nearby NAP only caused a decrease of CBF in the right medial frontal gyrus.