Engineering, 2013, 5, 545-548
http://dx.doi.org/10.4236/eng.2013.510B112 Published Online October 2013 (http://www.scirp.org/journal/eng)
The Research on Acupuncture Anesthesia Based on fMRI
Jijun Tong1*, Jin Liu1, Yingying Lv2, Huade Chen2
1College of Information, Zhejiang Sci-Tech University, Hangzhou, Zhejiang
2The Third Clinical Medicine College, Zhejiang University of Traditional Chinese Medicine, Hangzhou, Zhejiang
Received 2013
ABSTRACT
Pain is one of the most important sensations in daily life, and the traditional Chinese medicine such as acupuncture has
shown great potential in pain relief. The principle research of acupuncture anesthesia has been the focus of modern
science. In this paper the noninvasive brain imaging technique fMRI (functional magnetic reso nance imaging) was used.
Eight volunteers were enrolled and received pain stimulation, and the brain response under TEAS (transcutaneous elec-
trical acupoint stimulation) and manual needle stimulation were observed. The research finds pain has specific sensation
region and the acupuncture anesthesia is realized through modulating the corresponding brain function region, but the
manual needle has wider brai n r e sponse region tha n TE A S.
Keywords: Acupuncture; Anesthesia; fMRI
1. Introduction
Pain is one of the most important sensations in daily life.
Pain perception is much more complicated than any other
human perceptions. Much research results in many fields
have shown that pain is not only physical experience but
also closely related to many other factors such as physi-
ology, social background, cultural differences and mental
state [1]. The official definition of pain by the Interna-
tional Association for the Study of Pain (IASP) consists
of three elements: 1) it is associated with “injury” and
“threat of injury”; 2) it is an “unpleasant” and “emotional”
experience; and 3) it is “subjective” [2]. Since the Inter-
national Association for the Study of Pain was founded
in 1974, the research on pain developed steadily. But up
to present the research and control on pain is still quite
deficient. In contemporary medicine, acupuncture is con-
sidered an important adjuvant treatment and has attracted
more and more attention. Especially in anesthesia, acu-
puncture was used more widely. Acupuncture was first
successfully used in surgical analgesia in the 1950s [3].
In recent decades multidisciplinary experts explore the
principle of acupuncture analgesia from the multi-level
(from molecular and cellular level into gene level) and
multiple perspectives (nerve, body fluids, meridian) [4].
The research of mechanism of acupuncture analgesia
has become more and more important. The Traditional
Chinese Medicine is difficult to explain many acupunc-
ture phenomenons, so the use of modern medical tech-
nical in acupuncture treatment has become the research
focus in recent years, especially the various noninvasive
brain imaging technologies and their application in illu-
strating the cerebral mechanism of acupuncture anesthe-
sia. It is a huge progress in revealing the scientific es-
sence of acupuncture therapy effect [5-8]. These tech-
niques mainly include Electroencephalograph (EEG),
Magnetoencephalograph (MEG), Positron Emission To-
mography (PET), Functional Magnetic Resonance Im-
aging (fMRI) and s o on.
The paper applies Functional Magnetic Resonance
Imaging to study brain activity changes in the different
stimulation modes in LI.4 (Hegu acupoint). From a new
aspect to discusses the analgesic effect in different acu-
puncture stimulation modes, to provide the visible and
objective criterion for clinical application of acupuncture
analgesia.
2. Methods
2.1. Subjects
Eight healthy volunteers were enrolled in the experiment
(four male and four female), they are right handed, 22 -
28 years old. All volunteers were students in the univer-
sity, none of them had neurological or psychological dis-
orders and they were not taking medicine. All volunteers
were informed and received acupuncture treatment,
signed an informed consent of this experiment. The vo-
lunteers had no fMRI contraindications, such as metal
prosthet i c l i mbs, joint, heart pacemakers, etc.
*Corresponding a uthor.

J. J. TONG ET AL.
546
2.2. Experiment Materials
1) Acupuncture needle (contain gold 75%), length 40
mm, diameter 0.32 mm, Suzhou Hua Tuo factory pro-
duction. Remove the metal wire which wrapped around
the needl e s handle;
2) 75% alcohol, disinfection cotton-wool, medical pa-
per tape;
3) Siemens 1.5 T Magneton Sonata. Provided by Ra-
diology Department of the Second Hospital affiliated
Zhejiang University;
4) Black eye shade, rubber ear plugs.
2.3. Protocol of the Experiment
Each participant should attend two experiments, after
given the pain stimulation we use electrical stimulation
and manual needle stimulation in LI.4 (Hegu acupoint).
The two stimulations were given by random. For elimi-
nate other factors disturbance, the time of interv al of this
two experiments is a week for the same volunteer.
In the experiment we use 75% alcohol cotton to disin-
fect acupoint, let the volunteers on the operation stage,
using black eye shade and rubber ear plugs to cover eyes
and ears. Using a magnetic resonance special mat padded
the occipital and then using a pair of special sponge pad
plug the each side of head and fixed the head.
This experiment process was shown in Figure 1. Ac-
cording to the acupuncture program this experiment di-
vided into four stages. The first 3 min as B phase (resting
phase) and the pain stimulation last for 2 min as P phase
(pain phase), after 10 min acupuncture as S phase (sti-
mulate phase), the last 3 min after needle as PO phase
(resting phase 2). The whole process lasts for 18 min.
All subjects received pain stimulation by injection 3.5
ml mixture of herb medicine (angelica, a clinic medicine
used widely in China) and Vit.B12 (2:1) in the subjects’
left shoulder , the depth w a s about 2.5 cm.
2.4. The Experiment Stimulating Patterns
Acupuncture pattern: 1) Manual needle sti mulation, which
was operated by my professional doctor; 2) TEAS sti-
mulation: Transcutaneous electric acupoint stimulation
(HANS: Han’s acupoint nerve stimulator, Model LH202H
TEAS) was used. The stimulation frequency of TEAS
was 2/100 Hz and the intensity was 3 - 8 mA, according
to the standard to cause muscle shiver. Stimulation pat-
terns were shown in Figure 2.
2.5. The Pain of VAS Score Record
Visual Analog Scale (VAS) for all volunteers, records
Baseline(3 min) Pain(2 min) TEAS(Needle)(1 0 min) Post(3 min)
Figure 1. The process of experiment.
Figure 2. The acupuncture patterning of experiment ((A)
TEAS; (B) Manual needle).
every volunteer’s pain score after give injection stimula-
tion and after treatment.
2.6. fMRI Data Processin g
fMRI techno logy is based on brain activity caused by the
change of physiological or metabolic changes. It is very
sensitive to the blood flow and the blood oxygen level.
The spatial resolution is only a few millimeters and time
resolution is also a few seconds [9]. The statistical para-
meter mapping (SPM) was used for brain imaging data
processing [10-13].
3. Results
3.1. The VAS Score
The VAS score of each experiment was recorded. The
VAS of the manual needle group (Mean ± SD) was 5.73
± 2.28, after Manual needle stimulation treatment was
1.63 ± 1.11, The VAS of TEAS group was 5.15 ± 1.84,
after transcutanclus electrical acupoint stimulation the
VAS was 1.1 3 ± 0.48. The VAS values of the two groups
were significantly decreased after acupuncture treatment,
as shown in Table 1.
3.2. The Analyses of the Activated Brain
Functional Areas
After the pain stimulation and acupuncture treatment
(manual needle and TEAS) the corresponding brain areas
would be activated. The definition of activated areas:
mor e than 5 voxels (body element) activation, confidence
level is 0.05.
1) The activated brain functional areas after the pain
stimulation
According to the Broadmann partition, when the body
received the pain stimulation the activated brain areas
mainly distributed in: 1) the first somatosensory cortex of
postcentral gyrus (BA 3, 1 and 2) and postcentral gyrus
(BA 40), precentral gyrus, paracentral lobule; 2) the post
nodules of thalamus and left thalamus; 3) the right ven-
tral lateral nucleus and the right side of the ventral post-
erolateral nucleus; 4) bilateral superior temporal gyrus
(BA 38) and transverse temporal gyri; 5) bilateral supe-
rior temporal gyrus, middle frontal gyrus, inferior frontal

J. J. TONG ET AL.
547
Table 1. The vas value of the two groups.
Experiment group After pain stimulation
(Mean ± SD) After treatment (Mean ± SD)
Manual needle group 5.73 ± 2.28 1.63 ± 1.11
TESA group 5.15 ± 1.84 1.13 ± 0.48
gyrus and medial frontal gyrus; 6) bilateral suboccipital
back, occipital visual cor tex (BA 18 and 19), the right of
superior occipital gyrus; 7) caudate nucleus; 8) the right
of lenticular nucleus, the right of red nucleus; 9) lateral
globus pallidus, geniculate body, corpus callosum. Acti-
vated areas were shown in Figure 3.
2) The activated brain functional areas after Manual
needle stimulation
Figure 4 shows the activated brain functional areas
after the needle stimulation on LI.4 (Hegu acupoint). 1)
central vault gyri and the left of vault gyri; 2) precentral
gyrus and the left of postcentral gyrus; 3) angular gyrus,
the corpus callosum and inferior corpus callosum; 4)
bilateral cingulated gyrus, the left of caudate nucleus and
the left of fusiform gyrus; 5) the left of superior temporal
gyrus, the left of transverse temporal gyri and supramar-
ginal gyrus; 6) the left of parietal lobe, inferior parietal
lobule and the left of precuneus; 7) the left of hippocam-
pus and hippocampal gyrus, the left of lingual gyrus,
uvula, the right of middle occipital gyrus and the right of
pulvinar thalami; 8) the right of BA partition 11, 13, 28,
34, 43, the left of BA partition 3, 7, 19, 30, 31, 36, 41,
44.
3) The acti v ated brain functio nal areas after TEAS
After the TEAS treatment the brain activated area
mainly distributed in: 1) the right side of the main bila-
teral occipital lobe visual cortex (BA19); 2) the left of
precuneus; 3) the left of superior parietal lobule; 4) the
right of BA partition BA 30, 31, and 34. As it was shown
in Figure 5.
4. Discussions
In this paper we established the pain model in healthy
people and used the blood oxygen levels dependence
functional MRI (magnetic resonance imaging) technolo-
gy to observe the brain functional areas activation after
the TEAS and manual needle stimulation in LI.4 (Hegu
acupoint). The paper explored the neurological basis of
meridian contact and communication and the principles
of acupuncture treatment to investigate the mechanism of
acupuncture analgesia.
In the experiments we found after stimulation of all
volunteers’ pain perceptions and response activities al-
most involve the whole brain, including part of thalamus,
hypothalamus, reticular formation of brain stem, limbic
system, cerebral cortex and other parts. After manual
needle stimul a tion on LI.4 (Hegu acup oint), t he activated
Figure 3. The fMRI of brain functional areas activation
after pain stimulation.
Figure 4. The fMRI of brain functional areas activation
after needle stimulation hegu acupoint.
Figure 5. The fMRI of brain functional areas activation
after transcutanclus electrical acupoint stimulation.
brain function area is mainly distributed in: precentral
gyrus, the left of inferior corpus callosum, the right of
thalamus, middle occipital gyrus, the right of cingulate
gyrus, the left of caudate nucleus, fusiform gyrus, hippo-

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548
campus, the left of superior temporal gyrus, middle tem-
poral gyrus, supramarginal gyrus, angular gyrus, left of
the superior parietal lobule and inferior parietal lobule.
But after the TEAS on LI.4 (Hegu acupoint), the acti-
vated brain functional area is mainly distributed in: the
right side of the main bilateral occipital lobe visual cor-
tex (BA19), anterior cingulated, hippocampal gyrus, left
of the precuneus and the BA partition of 30, 31, 34. Ma-
nual needle stimulation and transcutaneous electrical sti-
mulation of acupuncture analgesia through activate the
multiple brain areas related pain modulation and then to
realize, but manual needle stimulation activation area is
wider than TEAS, and the degree of activate is stronger.
5. Conclusion
Studies have shown that acupuncture (manual needle
stimulation and TEAS) is an effective means in pain re-
lief. Acupuncture analgesia mainly through activating the
multiple brain areas related pain modulation, but the ac-
tivated brain functional area is different between TEAS
and manual needle stimulation. Transcutaneou s electrical
acupoint stimulation mainly activated the right side of
the cerebral cortex-based, while the ordinary manual need-
le stimulation activated the wider areas.
6. Acknowledgements
The research was supported by the Natural Science
Foundation of Zhejiang Province. The authors would like
to appreciate their thanks to them.
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