A PET Study On Glucose Metabolism In Migraineurs' Brain Associated With Electroacupuncture At Acupoints Of Shao Yang Meridian

OBJECTIVE:To observe changes of glucose metabolism in migraineurs'brain associated with electroacupuncture stimulation at special points of ShaoYang meridian. To investigate the characteristic that central neurons respond to XunJingQuXue, and discuss the neurophysiological modulation mechanism of effects of stimulating at acupoints.METHORDS:The participants include 8 healthy volunteers and 30 migraineurs. Assigned migraineurs into 3 groups randomly, they are ShaoYang point group, non-point group and migraine group. Electroacupuncture was used to treat migraine in former two groups. The ShaoYang points we stimulated are Fengchi(GB20),Waiguan(SJ5), Yanglingquan(GB34), the non-points are 3 spots locate at upper and lower limb.The instant analgesia effect of electroacupunture were observed and the glucose metabolism signals were recorded by ¹⁸F-FDG PET scanner. The participants in migraine group and the healthy ones reserved PET scan without electroacupuncture. The functional neuroimaging of glucose metabolism were analysed by Statistical Parameter Mapping (SPM) software.RESULTS:1.The visual analoge scale(VAS)of the headache descented in all three groups after PET scan, the analgesia effect of point electroacupuncture group was better than non-point group and the group without treating (P<0.05).2.The activation areas of migraine include ipsilateral brainstem(pons and midbrain). bilateral anterior and posterior lobes of celebellum, fusiform gyrus and lingual gyrus of ipsilateral occipital lobe,bilateral parahippocampus and parts of temporal lobe. The deactivate areas include prefrontal cortex, orbitofrantal cortex (BA1147), right anterior cingulate cortex (BA24,25), bilateral parietal lobe and temporal lobe.3. In the comparison of migraine group, ShaoYang points electroacupuncture stimuation elicited right insula (BA44,45), anterior cingulate gyrus, there were decreaced areas of cerebral metabolism in bilateral cerebellum, right parahippocampus, basal ganglia and somatosensory-motor cortex (BA3,6,40). The change of functional neuroimage has the trend of returning to normal state.4. Non-points electroacupuncture stimulation elicited activate areas in limbic system structures included bilateral parahippocampus and posterior cingulate cortex, bilateral supramarginal gyrus, inferior parietal lobe(BA40), bilateral frontal lobe(BA4.6), temporal lobe.fusiform gyrus, cuneus and precuneus lobe. Reduction in cerebral metabolism was seen in anterior and posterior lobe of cerebellum, prefrontal lobe, parahippocampus gyrus and contralateral temporal lobe. There are distinct activation areas on parietal Iobe and occipital lobe (BA5,7,18,19) and deactivation areas in prefrontal cortex in contrast to healthy ones.·CONCLUSIONS:1. Electroacupuncture stimulation at ShaoYang points to treat migraine showed comparatively special characteristics of cerebral neuronal responses. 2. The special cerebral pathway of network maybe includes brainstem-thalamus-basal ganglia-insula-limic system-cortex, through which to modulate acupoints'analgesia effects.3. A certain of regions of limbic system such as anterior cingulate and hippocampus maybe involved in the modulation network of analgesia of acupuncture,but not special to respond to point stimulation.