手针与电针调制边缘叶-旁边缘叶-新皮层网络.ppt

1、手针与电针调制边缘叶-旁边缘叶-新皮层网络传统望诊技术传统望诊技术-Traditional InspectionTelescope 望远镜望远镜Microscope 显微镜显微镜 X-Ray Body 人体透视人体透视现代望诊技术现代望诊技术-Modern Tech for InspectionThe transparent image of Body4RADIOLOGY TOOLS-Instruments5 X-RAY DSA CT gamma camera MRI Modern Imaging Techniques in TCM Clinical practice and Research

2、现代影像技术在针刺机制研究中的应用现代影像技术在针刺机制研究中的应用针刺为具有针刺为具有3000年历史的我国传统体表刺激治年历史的我国传统体表刺激治疗方法，其脑效应不清，适合疗方法，其脑效应不清，适合fMRI研究。研究。1994-2009，共发表各种文章，共发表各种文章700余篇，主要在余篇，主要在中国、美国、韩国、德国、日本；中国、美国、韩国、德国、日本；SCI论文论文140余篇，余篇，40篇左右有较高的学术价值。篇左右有较高的学术价值。Huang W.J.,park K.et al Plos One 20126 针刺穴位针刺穴位fMRI脑效应研究脑效应研究经过近二十年的国内外经过近二十年的

3、国内外fMRI针刺研究针刺研究探索，对针灸脑机理产生了新的认识探索，对针灸脑机理产生了新的认识，初步形成了新的多学科边缘研究领，初步形成了新的多学科边缘研究领域。域。SCI 论文论文 140余篇余篇：HBM，NeuroImage，Journal of Neuroscience PNAS -Hui et al HBM 2000 Neuroimage 2005 -Cho et al PNAS 1998，2006 -Wu et al Radiology 1999-Kong et al Journal of Neuroscience 2009 Basic Questions 基本问题 Do Manua

4、l and Electro acupuncture modulate the relative specific brain network?手针、电针脑效应有何特点，有何不同？8 Hypothesis 假说假说The Salient Characteristics of the Central Effects of Acupuncture Needling:Limbic-Paralimbic-Neocortical Network Modulation 针刺捻针的显著特征：调制边缘叶-旁边缘叶-新皮层网络 Manual and Electro acupuncture modulating t

5、he relative specific brain network 电针和手针各有特点9 First experiment -Manual acupuncture 实 验 一 -手针脑效应研究10The Salient Characteristics of the Central Effectsof Acupuncture Needling:Limbic-Paralimbic-Neocortical Network Modulation 捻针的显著特征：调制边缘叶捻针的显著特征：调制边缘叶-旁边缘叶旁边缘叶-新皮层网络新皮层网络 Fang Jiliang,Hui KKS et al.Huma

6、n Brain mapping 2009 MethodsMethodsSubjects:Healthy adult volunteers,right-handed,N=10Acupoints:LV3,LV2,ST44,Sham 3rd metatarsal spaceManual acu:needle rotation,even motion,160/minParadigm:Block Design R1,2,3,4 Needle in place Current Off,S1,2,3 EA Current On 30s.6 min fMRI:1.5 T GE Signa MRI EPI:TE

7、 30ms,TR 2500ms,slice thickness 3.0/0.5 mm,41 Slices,paralleled by AC-PC line Data analysis:SPM2Interview for sensations after each procedureLV3LV2ST44ShamLVST Needling sensation Intensity 四穴位四穴位 捻针针感强度比较捻针针感强度比较 T-test Aching *LV3 vs.LV2 p 0.25,P 0.25,P 0.25,P 0.05The Limbic-Prefrontal Network Modu

8、lated by Electro-acupuncture at CV4 and CV12Jiliang Fang,XiaolingWang,Hesheng Liu,YinWang,Kehua Zhou,Yang Hong,Jun Liu,LeiWang,Chao Xue,Ming Song,Baoyan Liu,and Bing ZhuEvidence Based Complementary and Alternative Medicine Epub 2012.22728 Discussion 讨讨 论论29Limbic paralimbic Neocortical 网络网络 边缘叶边缘叶-旁

9、边缘叶旁边缘叶-新皮层网络新皮层网络Adapted from Carpenter M.B.Core Text of Neuroanatomy,4th Ed.F FParahippocampusAmygdalaAmygdalaCingulate CortexHippocampusSeptal NMPFCHypFennixMPCMPFCMFC BA11,10,25ACC BA24/32 MPC BA7 pCC BA31Amgy,Hipp,Hypotha Para-HP弓状纤维束弓状纤维束Uncinate B扣带纤维束扣带纤维束Cingulum B扣带纤维束扣带纤维束Cingulum BManual

10、 acupuncture modulatingLimbic-paralimbic-neocortical network（LPNN）1 frontal pole 2 VMPFC 3 pregen cingulate 4 subgen cingulate5 post cingulate 6 hypothalamus 7 cerebellar vermis8 substantia nigra 9 reticular formation29864357Signal decreaseThe Generalized Integrated Signal Decrease Response in the L

11、imbic-paralimbic-neocortical system Courtesy by Dr.Kathleen Hui111Electro acupuncture modulating Limbic-prefrontal network电针调制边缘叶电针调制边缘叶-前额叶网络前额叶网络MFC BA11,10,25ACC BA24/32Amgy,Hipp,Hypotha Para-HP弓状纤维束弓状纤维束Uncinate B Neural Circuitry of Mood 情感调制神经环路情感调制神经环路 Adapted from Carpenter M.B.Core Text of

12、Neuroanatomy,4th Ed.References for LPNNGroup in Martinos center MGH,Harvard medical School（1994-2009）Hui 2000,2005,2009Wu 1999,2002Napadow 2005These results support the LPNN modulation 35 手针调制脑网络既往研究手针调制脑网络既往研究Hui et al Human Brain Mapping 2000,Neuroimaging 2005,Brain Research 2009 METHODS Subjects:

13、48 healthy adults,acupuncture-nave,F/M,20-55 y.o.Acupuncture:manual rotation 60/min at right LI4,ST36,LV3 on same subjectParadigms:M1,M2 needle manipulation,R1,R2,R3 needle in place Control:tactile stimulation with 0.55 von Frey filamentInterview for sensations after each procedure:grouping of datas

14、ets into deqi and mixed(deqi mixed with sharp pain)Courtesy by Dr.Kathleen HuiS ST36,right runs=73,subjects=43 LV3,right runs=63,subjects=37 LI4.right runs=64,subjects=37 1.BA10,24,32,11,25,3.C.vermis 6.BA20,21,227.BA10,24,328.PH,BA18Acupuncture Deqi 针刺得气效应针刺得气效应 2.BA7,314.brainstem 5.amyg.PH 9.BA19

15、p.000110-2410-610-610-24p +|x=2x=2x=2y=-6y=-6y=-1z=3 z=3z=3345 MTL 6789 1 AMC2 PMC3 合谷合谷 足三里足三里 太冲太冲Hui,Fang,Brain Research 2009Courtesy by Dr.Kathleen HuipP 0.001RAX 6-2-10-18-26-341232 Hippocampus,right 10-2410-1210-1210-240+Task-negative Network CCA:Acupuncture deqi P 0.005.Courtesy by Dr.Kathlee

16、n Hui Wu et al 1999 Radiology40 Napadow 2005 HBM41 LPNN (Hui,et al 2000,2005,2009 Fang et al 2009)LPNN(MPFC-Limbic)(Fang 2012)DMN Overlap networkbetween LPNN in acupuncture and DMN of resting brain (Biswal 1997Buckner et al,2006)Resting Brain Manual Acu Electro Acu The are different effects between

17、manual and electro acupuncture at the Brain LPNN.手针调制：手针调制：边缘叶边缘叶-旁边缘叶旁边缘叶-新皮层网络新皮层网络电针调制：边缘叶电针调制：边缘叶-前额叶皮层网络前额叶皮层网络 It is overlapped with the functional circuits associated with emotional and cognitive regulation.针刺调制的脑网络与脑情绪及认知调节明显相关针刺调制的脑网络与脑情绪及认知调节明显相关 The antipain,antianxiety,and other modulato

18、ry effects of acupuncture may be mediated by this intrinsic neural system.针刺可能通过此脑内在网络产生抗焦虑、止痛及其他治针刺可能通过此脑内在网络产生抗焦虑、止痛及其他治疗效应。疗效应。Conclusion44 Acknowledge Our Brain Imaging Research Team in China：王寅，王寅，王小玲，刘军，洪洋，周科华，王雷，薛超，林王小玲，刘军，洪洋，周科华，王雷，薛超，林诗智诗智,石凤祥，汪平石凤祥，汪平宋明，蒋田仔宋明，蒋田仔刘保延，朱兵刘保延，朱兵 Martinos cente

19、r MGH Harvard Medical School USA：Kathleen Hui，Hesheng Liu，Kenneth K Kwong，Phoebe S T Chen，Erika Nikson，Jing Liu，Nikos Markris,Vitaly Napadow Grants fMRI study on Neuromechanism of Acupuncture 1.美国国立卫生研究院（美国国立卫生研究院（NIH）课题）课题 2005-2009 针刺不同穴位脑中枢效应的针刺不同穴位脑中枢效应的fMRI研究研究 PI:Central Effects of Acupuncture

20、:Acupoint Specificity(NIH/NCCAM)F05-AT003022-01-04)(2005.12-2009.12)2.国家自然基金课题国家自然基金课题 2009-2011 针刺调制脑边缘叶旁边缘叶新皮层环路的针刺调制脑边缘叶旁边缘叶新皮层环路的fMRI研究研究 PI:Acupuncture modulating the limbic-paralimbic-neocortical circuit(NSFC:30870668)（2009.1-2011.12）3.国家中医药管理局中医药留学回国人员课题国家中医药管理局中医药留学回国人员课题 2004-2005 针刺正常人太冲穴针刺正常人太冲穴 及其临近穴及其临近穴 的脑功能成像的脑功能成像 Hi，Everyone，CooperationRadiologist 影像专家影像专家 Experts in TCM中医针灸中医针灸临床科研临床科研专家专家