title: Evidence of a Synergistic Effect of Acupoint Combination: A Resting-State Functional Magnetic Resonance Imaging Study.
abstract: OBJECTIVE
  This study aimed to find evidence of a synergistic effect of acupoint combinations by analyzing different brain regions activated after acupuncture at different acupoint combinations.
  
  
  METHODS
  A total of 57 healthy subjects were randomly distributed into three groups: LR3 plus KI3 acupoints, LR3 plus sham acupoint, or LR3 alone. They underwent a magnetic resonance imaging scan before and after acupuncture. The amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) values of different brain regions were analyzed to observe changes in brain function.
  
  
  RESULTS
  ALFF and ReHo produced an activated area in the cerebellum posterior lobe after acupuncture at LR3 plus KI3 acupoints versus LR3 alone. ALFF and ReHo revealed altered activity in Brodmann area 10 (BA10), BA18, and brainstem pons after acupuncture at LR3 plus sham acupoint compared with at LR3 alone. A comparison of acupuncture at LR3 plus KI3 acupoints with LR3 plus sham acupoint demonstrated an increase in BA6 of ALFF and a downregulation of ReHo.
  
  
  CONCLUSIONS
  The increased number of brain regions with altered brain activity after acupuncture at acupoint combinations versus a single acupoint are evidence of the synergistic effect of acupoint combinations. BA6 was significantly activated after acupuncture at LR3 plus KI3 acupoints compared with at LR3 plus sham acupoint, suggesting that BA6 is the specific region of synergistic effect of acupoint combinations of LR3 plus KI3 acupoints. Affected brain regions were different between acupuncture at LR3 plus sham acupoint and LR3 alone, which indicates that the sham acupoint may have some psychological effect. However, the specific mechanism of acupoint combinations requires further research.
authors.affiliation: 1 School of Traditional Chinese Medicine, Southern Medical University , Guangzhou, China .
authors.forename: Jiping
authors.initials: J
authors.lastname: Zhang
authors.affiliation: 1 School of Traditional Chinese Medicine, Southern Medical University , Guangzhou, China .
authors.forename: Yu
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: 1 School of Traditional Chinese Medicine, Southern Medical University , Guangzhou, China .
authors.forename: Yanjie
authors.initials: Y
authors.lastname: Wang
authors.affiliation: 1 School of Traditional Chinese Medicine, Southern Medical University , Guangzhou, China .
authors.forename: Shanshan
authors.initials: S
authors.lastname: Qu
authors.affiliation: 1 School of Traditional Chinese Medicine, Southern Medical University , Guangzhou, China .
authors.forename: Shaoqun
authors.initials: S
authors.lastname: Zhang
authors.affiliation: 1 School of Traditional Chinese Medicine, Southern Medical University , Guangzhou, China .
authors.forename: Chunxiao
authors.initials: C
authors.lastname: Wu
authors.affiliation: 2 Department of Rehabilitation Medicine, Third Affiliated Hospital of Southern Medical University , Guangzhou, China .
authors.forename: Junqi
authors.initials: J
authors.lastname: Chen
authors.affiliation: 3 Department of Traditional Chinese Medicine, Zhujiang Hospital of Southern Medical University , Guangdong, China .
authors.forename: Huailiang
authors.initials: H
authors.lastname: Ouyang
authors.affiliation: 4 Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine , Guangzhou, China .
authors.forename: Chunzhi
authors.initials: C
authors.lastname: Tang
authors.affiliation: 1 School of Traditional Chinese Medicine, Southern Medical University , Guangzhou, China .
authors.forename: Yong
authors.initials: Y
authors.lastname: Huang
mesh_terms: D015669:Acupuncture Points; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging* / Q000502:physiology*; D005260:Female; D005528:Foot / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D055815:Young Adult
keywords: MRI; acupoints combination; acupuncture; synergistic effect