A Systematic Review Of The Effects Of FMRI On Brain Function Activity

Background:Deqi is one of the key points in the clinical efficacy of acupuncture treatment and also a hot spot in acupuncture research in recent years.The importance of deqi and it’s characteristic that being difficult to grasp require us to explore the mechanism of deqi with relatively objective indicators.Researchers at home and abroad have carried out a large number of objectified studies of deqi based on central brain activity.Among them,fMRI has been applied in the objective study of deqi most widely because of its advantages of non-invasive,non-radiation and high spatial resolution.In order to systematically summarize the research progress of deqi based on fMRI,we present a systematic review.Using the method of voxel meta-analysis,we evaluated the effect of deqi on brain function effects and summed up the activited/deactivated pattern of brain function effects induced by deqi.Study 1Background:The objective research of deqi in the past ten years,especially the fMRI study of deqi,is summarized and analyzed.The relationship between the acupuncture effect and the central reaction was also discussed theoretically,we think exploring the central effect of acupuncture is important for acupuncture research.It is preliminarily considered that it is necessary and feasible to carry out a systematic review of the effects of deqi on brain functional activities based on fMRI technology.Objective:To evaluate the influence of deqi on brain function effects after acupuncture compared with non-deqi state after acupuncture.Method:We searched the following 10 electronic databases:CNKI,CBM,VIP,the Wanfang Database,MEDLINE,CENTRAL,CINAHL,AMED,Embase,PsycINFO and 5 clinical trial registration platform.The time is from building of the library to January 2018.The trials comparing different brain function effects in deqi group with non-deqi group that employed fMRI technology were collected.The SDM(Seed-based d Mapping)software will be used for voxel meta analysis when the outcome contains MNI or Talairach space coordinates of the activated/deactivated brain regions.Results:4612 articles wereretrieved,andfour trials involving 79 subjects were included.Voxel meta analysis was conducted using SDM software with four studies involved,the result shows that there are more activated brain regions in Right supramarginal gyrus,Left median network,Left postcentral gyrus,etc in deqi state than non-deqi state.However,due to the large heterogeneity between the trials,the activated brain regions shown in the results were not representative.Conclusion:The initial point of view is that brain function effects is different between deqi and non-deqi state.There do have more activation brian areas in the deqi condition compared to non-deqi condition,and the degree is stronger.The specific activated brain regions after acupuncture needs further confirmed by more high quality studies.This review protocol is registered in PROSPERO:CRD42016043209.Study 2Background:Based on the experience and limitations of the first system review,it is planned to carry out the second systematic review of the changes in the brain functional activity owing to deqi after acupuncturing a particular acupoint,and the effect of deqiin the central level will be further discussed.As Zusanli is a common acupoint in clinical and research of acupuncture,and there are many deqi studies based on fMRIon Zusanli.Therefore,the second systematic review selected Zusanli as the study point to evaluate the functional activity changes of brain after deqi than in the relative resting state at Zusanli.Objective:To evaluate the influence of deqi after acupuncturing at Zusanli on brain function effects compared with resting state.Methods:We searched the following 10 electronic databases and 5 clinical trial registration platform.The time is from building of the library to January 2018.The clinical trial literatures that used fMRI as the observation index and compared the effects of deqi on brain function activity were collected systematically.The outcome index should include the MNI or Talairach coordinates of the activated/deactivated brain regions.The voxel meta-analysis is carried out with the SDM(Seed-based d Mapping)software.Results:10 literatures involving 185 subjects were included.Six of the literatures are in Chinese and four are in English.Mean analysis results show that five brain regions after acupuncture were more active:right inferior frontal gyrus、orbital part(BA 47),right median cingulate/paracingulate gyri(BA 24),left rolandic operculum(BA 48),right supramarginal gyrus(BA 40)and rght pons.There were 5 brain regions deactivated than the resting state after deqi:right middle occipital gyrus(BA 18),left paracentral lobule,right cerebellum、crus I(BA 19),left middle occipital gyrus(BA 19)and left lingual gyrus(BA 27).Jackknife sensitivity analysis shows that the results are stable.Conclusion:The authorpreliminarily consider that there is a significant difference in the activity of the brain after deqi compared to resting state.The activated/deactivated brain areas were mainly concentrated on the brain regions that relevant to somatosensory and movement,balance,emotion regulation,memory and so on,whichmay have correlations with the acupoint function of Zusanli.