Influence of acupuncture treatment on cerebral activity in functional dyspepsia patients and its relationship with efficacy.
OBJECTIVE
Acupuncture is a commonly used therapy for treating functional dyspepsia (FD), although the mechanism remains unclear. The objectives of this study were to investigate the differences in cerebral glycometabolism changes evoked by acupuncture and sham acupuncture and to explore the possible correlations between brain responses and clinical efficacy.


METHODS
In all, 72 FD patients were randomly assigned to receive either acupuncture or sham acupuncture treatment for 4 weeks. Ten patients in each group were randomly selected for fluorine-18 fluorodeoxyglucose positron emission tomography computed tomography scans to detect cerebral glycometabolism changes. The Nepean Dyspepsia Index (NDI) and Symptom Index of Dyspepsia (SID) were used to evaluate the therapeutic effect.


RESULTS
(i) The clinical data showed that after treatment the decrease in SID score in the acupuncture group was significantly greater than that in the sham acupuncture group (P<0.05). The increase in NDI score between the two groups did not differ (P>0.05), and only the improvement in NDI score in the acupuncture group was clinically significant. (ii) The neuroimaging data indicated that after treatment the acupuncture group showed extensive deactivation in cerebral activities compared with the sham acupuncture group. In the acupuncture group, the deactivations of the brainstem, anterior cingulate cortex (ACC), insula, thalamus, and hypothalamus were nearly all related to the decrease in SID score and the increase in NDI score (P<0.05, corrected). In the sham acupuncture group, the deactivations of the brainstem and thalamus tended to be associated with the increase in NDI score (P<0.1, corrected).


CONCLUSIONS
Acupuncture and sham acupuncture have relatively different clinical efficacy and brain responses. Acupuncture treatment more significantly improves the symptoms and quality of life of FD patients. The more remarkable modulation on the homeostatic afferent network, including the insula, ACC, and hypothalamus, might be the specific mechanism of acupuncture.
Acupunture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Sichuan, China.
Fang
F
Zeng
Wei
W
Qin
Tingting
T
Ma
Jinbo
J
Sun
Yong
Y
Tang
Kai
K
Yuan
Ying
Y
Li
Jixin
J
Liu
Xuguang
X
Liu
Wenzhong
W
Song
Lei
L
Lan
Mailan
M
Liu
Shuguang
S
Yu
Xin
X
Gao
Jie
J
Tian
Fanrong
F
Liang
D015670:Acupuncture Therapy; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism*; D004415:Dyspepsia / Q000000981:diagnostic imaging / Q000378:metabolism / Q000628:therapy*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008297:Male; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005947:Glucose