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BMC Complementary Medicine and Therapies
Published in: BMC Complementary Medicine and Therapies 1/2014

Open Access 01-12-2014 | Research article

Acupuncture on GB34 activates the precentral gyrus and prefrontal cortex in Parkinson’s disease

Authors: Sujung Yeo, Il-Hwan Choe, Maurits van den Noort, Peggy Bosch, Geon-Ho Jahng, Bruce Rosen, Sung-Hoon Kim, Sabina Lim

Published in: BMC Complementary Medicine and Therapies | Issue 1/2014

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Abstract

Background

Acupuncture is increasingly used as an additional treatment for patients with Parkinson’s disease (PD).

Methods

In this functional magnetic resonance imaging study, brain activation in response to acupuncture in a group of 12 patients with PD was compared with a group of 12 healthy participants. Acupuncture was conducted on a specific acupoint, the right GB 34 (Yanglingquan), which is a frequently used acupoint for motor function treatment in the oriental medical field.

Results

Acupuncture stimulation on this acupoint activates the prefrontal cortex, precentral gyrus, and putamen in patients with PD; areas that are known to be impaired in patients with PD. Compared with healthy participants, patients with PD showed significantly higher brain activity in the prefrontal cortex and precentral gyrus, especially visible in the left hemisphere.

Conclusions

The neuroimaging results of our study suggest that in future acupuncture research; the prefrontal cortex as well as the precentral gyrus should be treated for symptoms of Parkinson’s disease and that GB 34 seems to be a suitable acupoint. Moreover, acupuncture evoked different brain activations in patients with Parkinson’s disease than in healthy participants in our study, stressing the importance of conducting acupuncture studies on both healthy participants as well as patients within the same study, in order to detect acupuncture efficacy.

Trial registration

KCT0001122 at cris.nih.go.kr (registration date: 20140530)
Appendix
Available only for authorised users
Literature
1.
Pecci C, Rivas MJ, Moretti CM, Raina G, Ramirez CZ, Diaz S, Uribe Roca C, Micheli FE: Use of complementary and alternative therapies in outpatients with Parkinson’s disease in Argentina. Mov Disord. 2010, 25 (13): 2094-2098. 10.1002/mds.23235.CrossRefPubMed
2.
Denman M: ACP Journal Club. Review: evidence for the effectiveness of acupuncture for pain is mixed. Ann Intern Med. 2011, 155 (4): JC2-JC6.CrossRefPubMed
3.
Fang JL, Krings T, Weidemann J, Meister IG, Thron A: Functional MRI in healthy subjects during acupuncture: different effects of needle rotation in real and false acupoints. Neuroradiology. 2004, 46 (5): 359-362. 10.1007/s00234-003-1125-7.CrossRefPubMed
4.
Lee MS, Shin BC, Kong JC, Ernst E: Effectiveness of acupuncture for Parkinson’s disease: a systematic review. Mov Disord. 2008, 23 (11): 1505-1515. 10.1002/mds.21993.CrossRefPubMed
5.
Liu B, Chen J, Wang J, Liu X, Duan X, Shang X, Long Y, Chen Z, Li X, Huang Y, He Y: Altered small-world efficiency of brain functional networks in acupuncture at ST36: a functional MRI study. PLoS One. 2012, 7 (6): e39342-10.1371/journal.pone.0039342.CrossRefPubMedPubMedCentral
6.
Yeo S, Choi YG, Hong YM, Lim S: Neuroprotective changes of thalamic degeneration-related gene expression by acupuncture in an MPTP mouse model of parkinsonism: microarray analysis. Gene. 2013, 515 (2): 329-338. 10.1016/j.gene.2012.12.002.CrossRefPubMed
7.
Campbell A: Point specificity of acupuncture in the light of recent clinical and imaging studies. Acupunct Med. 2006, 24 (3): 118-122. 10.1136/aim.24.3.118.CrossRefPubMed
8.
Chae Y, Park HJ, Hahm DH, Hong M, Ha E, Park HK, Lee H: fMRI review on brain responses to acupuncture: the limitations and possibilities in traditional Korean acupuncture. Neurol Res. 2007, 29 (Suppl 1): S42-S48.CrossRefPubMed
9.
Dhond RP, Kettner N, Napadow V: Neuroimaging acupuncture effects in the human brain. J Altern Complement Med. 2007, 13 (6): 603-616. 10.1089/acm.2007.7040.CrossRefPubMed
10.
Kaptchuk TJ: Acupuncture: theory, efficacy, and practice. Ann Intern Med. 2002, 136 (5): 374-383. 10.7326/0003-4819-136-5-200203050-00010.CrossRefPubMed
11.
Lewith GT, White PJ, Kaptchuk TJ: Developing a research strategy for acupuncture. Clin J Pain. 2006, 22 (7): 632-638. 10.1097/01.ajp.0000210908.42299.1a.CrossRefPubMed
12.
Chae Y, Lee H, Kim H, Sohn H, Park JH, Park HJ: The neural substrates of verum acupuncture compared to non-penetrating placebo needle: an fMRI study. Neurosci Lett. 2009, 450 (2): 80-84. 10.1016/j.neulet.2008.11.048.CrossRefPubMed
13.
Kong J, Kaptchuk TJ, Polich G, Kirsch I, Vangel M, Zyloney C, Rosen B, Gollub R: Expectancy and treatment interactions: a dissociation between acupuncture analgesia and expectancy evoked placebo analgesia. Neuroimage. 2009, 45 (3): 940-949. 10.1016/j.neuroimage.2008.12.025.CrossRefPubMed
14.
Wu MT, Sheen JM, Chuang KH, Yang P, Chin SL, Tsai CY, Chen CJ, Liao JR, Lai PH, Chu KA, Pan HB, Yang CF: Neuronal specificity of acupuncture response: a fMRI study with electroacupuncture. Neuroimage. 2002, 16 (4): 1028-1037. 10.1006/nimg.2002.1145.CrossRefPubMed
15.
Wu Y, Jin Z, Li K, Lu ZL, Wong V, Han TL, Zheng H, Caspi O, Liu G, Zeng YW, Zou LP: Functional magnetic resonance imaging activation of the brain in children: real acupoint versus sham acupoint. J Child Neurol. 2010, 25 (7): 849-855. 10.1177/0883073809351314.CrossRefPubMed
16.
Chau AC, Fai Cheung RT, Jiang X, Au-Yeung PK, Li LS: An fMRI study showing the effect of acupuncture in chronic stage stroke patients with aphasia. J Acupunct Meridian Stud. 2010, 3 (1): 53-57. 10.1016/S2005-2901(10)60009-X.CrossRefPubMed
17.
Li G, Jack CR, Yang ES: An fMRI study of somatosensory-implicated acupuncture points in stable somatosensory stroke patients. J Magn Reson Imaging. 2006, 24 (5): 1018-1024. 10.1002/jmri.20702.CrossRefPubMed
18.
Zhou Y, Jin J: Effect of acupuncture given at the HT 7, ST 36, ST 40 and KI 3 acupoints on various parts of the brains of Alzheimer’ s disease patients. Acupunct Electrother Res. 2008, 33 (1–2): 9-17.CrossRefPubMed
19.
Shulman LM, Wen X, Weiner WJ, Bateman D, Minagar A, Duncan R, Konefal J: Acupuncture therapy for the symptoms of Parkinson’s disease. Mov Disord. 2002, 17 (4): 799-802. 10.1002/mds.10134.CrossRefPubMed
20.
Wu T, Long X, Zang Y, Wang L, Hallett M, Li K, Chan P: Regional homogeneity changes in patients with Parkinson’s disease. Hum Brain Mapp. 2009, 30 (5): 1502-1510. 10.1002/hbm.20622.CrossRefPubMed
21.
DeLong MR: Primate models of movement disorders of basal ganglia origin. Trends Neurosci. 1990, 13 (7): 281-285. 10.1016/0166-2236(90)90110-V.CrossRefPubMed
22.
Albin RL, Young AB, Penney JB: The functional anatomy of basal ganglia disorders. Trends Neurosci. 1989, 12 (10): 366-375. 10.1016/0166-2236(89)90074-X.CrossRefPubMed
23.
24.
Chung V, Liu L, Bian Z, Zhao Z, Leuk Fong W, Kum WF, Gao J, Li M: Efficacy and safety of herbal medicines for idiopathic Parkinson’s disease: a systematic review. Mov Disord. 2006, 21 (10): 1709-1715. 10.1002/mds.21008.CrossRefPubMed
25.
Kim SR, Lee TY, Kim MS, Lee MC, Chung SJ: Use of complementary and alternative medicine by Korean patients with Parkinson’s disease. Clin Neurol Neurosurg. 2009, 111 (2): 156-160. 10.1016/j.clineuro.2008.09.011.CrossRefPubMed
26.
Klein PJ, Rivers L: Taiji for individuals with Parkinson disease and their support partners: a program evaluation. J Neurol Phys Ther. 2006, 30 (1): 22-27. 10.1097/01.NPT.0000282146.18446.f1.CrossRefPubMed
27.
Tan LC, Lau PN, Jamora RD, Chan ES: Use of complementary therapies in patients with Parkinson’s disease in Singapore. Mov Disord. 2006, 21 (1): 86-89. 10.1002/mds.20662.CrossRefPubMed
28.
Rajendran PR, Thompson RE, Reich SG: The use of alternative therapies by patients with Parkinson’s disease. Neurology. 2001, 57 (5): 790-794. 10.1212/WNL.57.5.790.CrossRefPubMed
29.
Liang XB, Liu XY, Li FQ, Luo Y, Lu J, Zhang WM, Wang XM, Han JS: Long-term high-frequency electro-acupuncture stimulation prevents neuronal degeneration and up-regulates BDNF mRNA in the substantia nigra and ventral tegmental area following medial forebrain bundle axotomy. Brain Res Mol Brain Res. 2002, 108 (1–2): 51-59.CrossRefPubMed
30.
Kim SN, Doo AR, Park JY, Choo HJ, Shim I, Park JJ, Chae Y, Lee B, Lee H, Park HJ: Combined treatment with acupuncture reduces effective dose and alleviates adverse effect of l-dopa by normalizing Parkinson’s disease-induced neurochemical imbalance. Brain Res. 2014, 1544: 33-44.CrossRefPubMed
31.
Wang H, Liang X, Wang X, Luo D, Jia J: Electro-acupuncture stimulation improves spontaneous locomotor hyperactivity in MPTP intoxicated mice. PLoS One. 2013, 8 (5): e64403-10.1371/journal.pone.0064403.CrossRefPubMedPubMedCentral
32.
Lam YC, Kum WF, Durairajan SS, Lu JH, Man SC, Xu M, Zhang XF, Huang XZ, Li M: Efficacy and safety of acupuncture for idiopathic Parkinson’s disease: a systematic review. J Altern Complement Med. 2008, 14 (6): 663-671. 10.1089/acm.2007.0011.CrossRefPubMed
33.
Zhuang X, Wang L: Acupuncture treatment of Parkinson’s disease–a report of 29 cases. J Tradit Chin Med. 2000, 20 (4): 265-267.PubMed
34.
Yeo S, Lim S, Choe IH, Choi YG, Chung KC, Jahng GH, Kim SH: Acupuncture stimulation on GB34 activates neural responses associated with Parkinson’s disease. CNS Neurosci Ther. 2012, 18 (9): 781-790. 10.1111/j.1755-5949.2012.00363.x.CrossRefPubMed
35.
Choi YG, Yeo S, Hong YM, Lim S: Neuroprotective changes of striatal degeneration-related gene expression by acupuncture in an MPTP mouse model of Parkinsonism: microarray analysis. Cell Mol Neurobiol. 2011, 31 (3): 377-391. 10.1007/s10571-010-9629-2.CrossRefPubMed
36.
Jeon S, Kim YJ, Kim ST, Moon W, Chae Y, Kang M, Chung MY, Lee H, Hong MS, Chung JH, Joh TH, Park HJ: Proteomic analysis of the neuroprotective mechanisms of acupuncture treatment in a Parkinson’s disease mouse model. Proteomics. 2008, 8 (22): 4822-4832. 10.1002/pmic.200700955.CrossRefPubMed
37.
Tinaz S, Schendan HE, Stern CE: Fronto-striatal deficit in Parkinson’s disease during semantic event sequencing. Neurobiol Aging. 2008, 29 (3): 397-407. 10.1016/j.neurobiolaging.2006.10.025.CrossRefPubMed
38.
Yu H, Sternad D, Corcos DM, Vaillancourt DE: Role of hyperactive cerebellum and motor cortex in Parkinson’s disease. Neuroimage. 2007, 35 (1): 222-233. 10.1016/j.neuroimage.2006.11.047.CrossRefPubMedPubMedCentral
39.
Lewis MM, Slagle CG, Smith AB, Truong Y, Bai P, McKeown MJ, Mailman RB, Belger A, Huang X: Task specific influences of Parkinson’s disease on the striato-thalamo-cortical and cerebello-thalamo-cortical motor circuitries. Neuroscience. 2007, 147 (1): 224-235. 10.1016/j.neuroscience.2007.04.006.CrossRefPubMedPubMedCentral
40.
Silberstein P, Kuhn AA, Kupsch A, Trottenberg T, Krauss JK, Wohrle JC, Mazzone P, Insola A, Di Lazzaro V, Oliviero A, Aziz T, Brown P: Patterning of globus pallidus local field potentials differs between Parkinson’s disease and dystonia. Brain. 2003, 126 (Pt 12): 2597-2608.CrossRefPubMed
41.
van Eimeren T, Monchi O, Ballanger B, Strafella AP: Dysfunction of the default mode network in Parkinson disease: a functional magnetic resonance imaging study. Arch Neurol. 2009, 66 (7): 877-883.CrossRefPubMedPubMedCentral
42.
Hoehn MM, Yahr MD: Parkinsonism: onset, progression and mortality. Neurology. 1967, 17 (5): 427-442. 10.1212/WNL.17.5.427.CrossRefPubMed
43.
Fahn S, Elton R, Members of the UPDRS Development Committee: Unified Parkinson's disease rating scale. Recent Developments in Parkinson's Disease. Volume 2. Edited by: Fahn S, Marsden CD, Calne DB, Goldstein M. 1987, Florham Park, New Jersey: Macmillan Health Care Information, 153-163. 293-304
44.
Oldfield RC: The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia. 1971, 9 (1): 97-113. 10.1016/0028-3932(71)90067-4.CrossRefPubMed
45.
MacPherson H, Altman DG, Hammerschlag R, Youping L, Taixiang W, White A, Moher D: Revised STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA): extending the CONSORT statement. PLoS Med. 2010, 7 (6): e1000261-10.1371/journal.pmed.1000261.CrossRefPubMedPubMedCentral
46.
Park HJ, Lim S, Joo WS, Yin CS, Lee HS, Lee HJ, Seo JC, Leem K, Son YS, Kim YJ, Kim CJ, Kim YS, Chung JH: Acupuncture prevents 6-hydroxydopamine-induced neuronal death in the nigrostriatal dopaminergic system in the rat Parkinson’s disease model. Exp Neurol. 2003, 180 (1): 93-98. 10.1016/S0014-4886(02)00031-6.CrossRefPubMed
47.
Chae Y, Lee H, Kim H, Kim CH, Chang DI, Kim KM, Park HJ: Parsing brain activity associated with acupuncture treatment in Parkinson’s diseases. Mov Disord. 2009, 24 (12): 1794-1802. 10.1002/mds.22673.CrossRefPubMed
48.
Dhond RP, Yeh C, Park K, Kettner N, Napadow V: Acupuncture modulates resting state connectivity in default and sensorimotor brain networks. Pain. 2008, 136 (3): 407-418. 10.1016/j.pain.2008.01.011.CrossRefPubMedPubMedCentral
49.
van den Noort M, Specht K, Rimol LM, Ersland L, Hugdahl K: A new verbal reports fMRI dichotic listening paradigm for studies of hemispheric asymmetry. Neuroimage. 2008, 40 (2): 902-911. 10.1016/j.neuroimage.2007.11.051.CrossRefPubMed
50.
Cho B, Yang J, Kim S, Yang DW, Park M, Chey J: The validity and reliability of a Computerized Dementia Screening Test developed in Korea. J Neurol Sci. 2002, 203–204: 109-114.CrossRefPubMed
51.
Beck AT, Steer RA: Internal consistencies of the original and revised Beck Depression Inventory. J Clin Psychol. 1984, 40 (6): 1365-1367. 10.1002/1097-4679(198411)40:6<1365::AID-JCLP2270400615>3.0.CO;2-D.CrossRefPubMed
52.
Mezer A, Yovel Y, Pasternak O, Gorfine T, Assaf Y: Cluster analysis of resting-state fMRI time series. Neuroimage. 2009, 45 (4): 1117-1125. 10.1016/j.neuroimage.2008.12.015.CrossRefPubMed
53.
Binkofski F, Fink GR, Geyer S, Buccino G, Gruber O, Shah NJ, Taylor JG, Seitz RJ, Zilles K, Freund HJ: Neural activity in human primary motor cortex areas 4a and 4p is modulated differentially by attention to action. J Neurophysiol. 2002, 88 (1): 514-519.PubMed
54.
DeLong MR, Alexander GE, Georgopoulos AP, Crutcher MD, Mitchell SJ, Richardson RT: Role of basal ganglia in limb movements. Hum Neurobiol. 1984, 2 (4): 235-244.PubMed
55.
Alexander GE, Crutcher MD: Preparation for movement: neural representations of intended direction in three motor areas of the monkey. J Neurophysiol. 1990, 64 (1): 133-150.PubMed
56.
Marchand WR, Lee JN, Thatcher JW, Hsu EW, Rashkin E, Suchy Y, Chelune G, Starr J, Barbera SS: Putamen coactivation during motor task execution. Neuroreport. 2008, 19 (9): 957-960. 10.1097/WNR.0b013e328302c873.CrossRefPubMed
57.
Helmich RC, Derikx LC, Bakker M, Scheeringa R, Bloem BR, Toni I: Spatial remapping of cortico-striatal connectivity in Parkinson’s disease. Cereb Cortex. 2010, 20 (5): 1175-1186. 10.1093/cercor/bhp178.CrossRefPubMed
58.
Kang JM, Park HJ, Choi YG, Choe IH, Park JH, Kim YS, Lim S: Acupuncture inhibits microglial activation and inflammatory events in the MPTP-induced mouse model. Brain Res. 2007, 1131 (1): 211-219.CrossRefPubMed
59.
Na BJ, Jahng GH, Park SU, Jung WS, Moon SK, Park JM, Bae HS: An fMRI study of neuronal specificity of an acupoint: electroacupuncture stimulation of Yanglingquan (GB34) and its sham point. Neurosci Lett. 2009, 464 (1): 1-5. 10.1016/j.neulet.2009.08.009.CrossRefPubMed
60.
Jeun SS, Kim JS, Kim BS, Park SD, Lim EC, Choi GS, Choe BY: Acupuncture stimulation for motor cortex activities: a 3 T fMRI study. Am J Chin Med. 2005, 33 (4): 573-578. 10.1142/S0192415X0500317X.CrossRefPubMed
61.
Baglio F, Blasi V, Falini A, Farina E, Mantovani F, Olivotto F, Scotti G, Nemni R, Bozzali M: Functional brain changes in early Parkinson’s disease during motor response and motor inhibition. Neurobiol Aging. 2011, 32 (1): 115-124. 10.1016/j.neurobiolaging.2008.12.009.CrossRefPubMed
62.
Palomar FJ, Diaz-Corrales F, Carrillo F, Fernandez-del-Olmo M, Koch G, Mir P: Sensory perception changes induced by transcranial magnetic stimulation over the primary somatosensory cortex in Parkinson’s disease. Mov Disord. 2011, 26 (11): 2058-2064. 10.1002/mds.23779.CrossRefPubMed
63.
Sabatini U, Boulanouar K, Fabre N, Martin F, Carel C, Colonnese C, Bozzao L, Berry I, Montastruc JL, Chollet F, Rascol O: Cortical motor reorganization in akinetic patients with Parkinson’s disease: a functional MRI study. Brain. 2000, 123 (Pt 2): 394-403.CrossRefPubMed
64.
Katschnig P, Schwingenschuh P, Jehna M, Svehlik M, Petrovic K, Ropele S, Zwick EB, Ott E, Fazekas F, Schmidt R, Enzinger C: Altered functional organization of the motor system related to ankle movements in Parkinson’s disease: insights from functional MRI. J Neural Transm. 2011, 118 (5): 783-793. 10.1007/s00702-011-0621-x.CrossRefPubMed
65.
Jahanshahi M, Jenkins IH, Brown RG, Marsden CD, Passingham RE, Brooks DJ: Self-initiated versus externally triggered movements. I. An investigation using measurement of regional cerebral blood flow with PET and movement-related potentials in normal and Parkinson’s disease subjects. Brain. 1995, 118 (Pt 4): 913-933.CrossRefPubMed
66.
Miller EK, Freedman DJ, Wallis JD: The prefrontal cortex: categories, concepts and cognition. Philos Trans R Soc Lond B Biol Sci. 2002, 357 (1424): 1123-1136. 10.1098/rstb.2002.1099.CrossRefPubMedPubMedCentral
67.
Levy R, Volle E: The prefrontal cortex: composer and conductor of voluntary behaviors. Rev Neurol (Paris). 2009, 165 Spec No 3: F159-F177.
68.
Carpenter AF, Georgopoulos AP, Pellizzer G: Motor cortical encoding of serial order in a context-recall task. Science. 1999, 283 (5408): 1752-1757. 10.1126/science.283.5408.1752.CrossRefPubMed
69.
Crowe DA, Chafee MV, Averbeck BB, Georgopoulos AP: Participation of primary motor cortical neurons in a distributed network during maze solution: representation of spatial parameters and time-course comparison with parietal area 7a. Exp Brain Res. 2004, 158 (1): 28-34.CrossRefPubMed
70.
Georgopoulos AP, Lurito JT, Petrides M, Schwartz AB, Massey JT: Mental rotation of the neuronal population vector. Science. 1989, 243 (4888): 234-236. 10.1126/science.2911737.CrossRefPubMed
Metadata
Title
Acupuncture on GB34 activates the precentral gyrus and prefrontal cortex in Parkinson’s disease
Authors
Sujung Yeo
Il-Hwan Choe
Maurits van den Noort
Peggy Bosch
Geon-Ho Jahng
Bruce Rosen
Sung-Hoon Kim
Sabina Lim
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Complementary Medicine and Therapies / Issue 1/2014
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/1472-6882-14-336

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