A Narrative Review of Neuroimaging Studies in Acupuncture for Migraine.

Acupuncture has been widely used as an alternative and complementary therapy for migraine. With the development of neuroimaging techniques, the central mechanism of acupuncture for migraine has gained increasing attention. This review aimed to analyze the study design and main findings of neuroimaging studies of acupuncture for migraine to provide the reference for future research. The original studies were collected and screened in three English databases (PubMed, Embase, and Cochrane Library) and four Chinese databases (Chinese National Knowledge Infrastructure, Chinese Biomedical Literature database, the Chongqing VIP database, and Wanfang database). As a result, a total of 28 articles were included. Functional magnetic resonance imaging was the most used neuroimaging technique to explore the cerebral activities of acupuncture for migraine. This review manifested that acupuncture could elicit cerebral responses on patients with migraine, different from sham acupuncture. The results indicated that the pain systems, including the medial pain pathway, lateral pain pathway, and descending pain modulatory system, participated in the modulation of the cerebral activities of migraine by acupuncture.

Aberrant functional brain network dynamics in patients with functional constipation.

The aberrant static functional connectivity of brain network has been widely investigated in patients with functional constipation (FCon). However, the dynamics of brain functional connectivity in FCon patients remained unknown. This study aimed to detect the brain dynamics of functional connectivity states and network topological organizations of FCon patients and investigate the correlations of the aberrant brain dynamics with symptom severity. Eighty-three FCon patients and 80 healthy subjects (HS) were included in data analysis. The spatial group independent component analysis, sliding-window approach, k-means clustering, and graph-theoretic analysis were applied to investigate the dynamic temporal properties and coupling patterns of functional connectivity states, as well as the time-variation of network topological organizations in FCon patients. Four reoccurring functional connectivity states were identified in k-means clustering analysis. Compared to HS, FCon patients manifested the lower occurrence rate and mean dwell time in the state with a complex connection between default mode network and cognitive control network, as well as the aberrant anterior insula-cortical coupling patterns in this state, which were significantly correlated with the symptom severity. The graph-theoretic analysis demonstrated that FCon patients had higher sample entropy at the nodal efficiency of anterior insula than HS. The current findings provided dynamic perspectives for understanding the brain connectome of FCon and laid the foundation for the potential treatment of FCon based on brain connectomics.

[Review on characteristics of acupuncture-activated network regulatory effect based on brain connectomics].

The network analysis method based on brain connectomics is an important entry point to explore the working mechanism of brain and is also the current trend of researches on acupuncture stimulation-induced changes of neuroimages. We, in the present review, summarized the common network analysis methods for exploring the underlying mechanisms of brain network-mediated regulatory effects of acupuncture interventions. Moreover, combining the current research development and our team's previous research findings, we extracted the characteristics of targeting, conditionity and dynamic of regulatory effects of acupuncture-activated brain network, and put forward our prospects about the future research from the aspects of new scanning modes (for instance, multimodal data acquisition of magnetic resonance, electroencephalogram, near infrared spectrum, etc.), network analysis (such as Granger causality analysis, complex network measures, whole-brain connectivity dynamics tracking, high-order resting-state functional connectivity analysis, etc.) and experimental research paradigms (for example, introduce of transcranial magnetic stimulation induced transient changes of brain functional activity, machine learning approach, etc.).

Machine Learning in Neuroimaging: A New Approach to Understand Acupuncture for Neuroplasticity.

The effects of acupuncture facilitating neural plasticity for treating diseases have been identified by clinical and experimental studies. In the last two decades, the application of neuroimaging techniques in acupuncture research provided visualized evidence for acupuncture promoting neuroplasticity. Recently, the integration of machine learning (ML) and neuroimaging techniques becomes a focus in neuroscience and brings a new and promising approach to understand the facilitation of acupuncture on neuroplasticity at the individual level. This review is aimed at providing an overview of this rapidly growing field by introducing the commonly used ML algorithms in neuroimaging studies briefly and analyzing the characteristics of the acupuncture studies based on ML and neuroimaging, so as to provide references for future research.

Effect and cerebral mechanism of acupuncture treatment for functional constipation: study protocol for a randomized controlled clinical trial.

BACKGROUND: Acupuncture is effective in functional constipation (FC) treatment, but the central mechanism has not been well investigated. This trial will combine functional magnetic resonance imaging (fMRI) and positron emission tomography-computed tomography (PET-CT) to investigate the potential central mechanism of acupuncture treatment for FC. METHODS: This is a multimodal neuroimaging randomized controlled trial. In total, 140 FC patients will be randomly allocated into four groups: the verum acupuncture group; the sham acupuncture group; the PEG 4000 group; and the waiting-list group. This trial will include a two-week baseline period and a two-week treatment period. Patients will receive 10 sessions of acupuncture, sham acupuncture, PEG 4000, or no intervention during the treatment period. The stool diary, Cleveland Constipation Score (CCS), Patient Assessment of Constipation Symptom (PAC-SYM), and Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QoL) will be used to assess the clinical efficacy of different interventions. The MRI and PET-CT scans will be performed to detect cerebral functional changes in 15 patients in each group at baseline and at the end of treatment/waiting. Multimodal imaging data will be associated with clinical data to investigate possible correlation between brain activity changes elicited by different interventions and symptoms improvement. DISCUSSION: We hypothesize that acupuncture can treat FC through normalizing the pathological alteration of the cerebral activity. The results of this trial will allow us to re-testify the therapeutic effects of acupuncture treating for FC and to investigate the potential central mechanism of acupuncture treatment for FC from direct (cerebral glucose metabolism) and indirect (contrast of oxyhemoglobin and deoxyhemoglobin) approaches. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1800016658 . Registered on 14 June 2018.

[Research progress of percutaneous 360 degree axial lumbar interbody fusion technique].

OBJECTIVE: To review the feature, biomechanics, and clinical application of percutaneous 360 degree axial lumbar interbody fusion (AxiaLIF) technique. METHODS: Recent literature on investigation and application of percutaneous 360 degree AxiaLIF technique was reviewed. RESULTS: Percutaneous 360 degree AxiaLIF technique mainly contained operative approach, axial technique, and posterior fixation. It was obviously different from other lumbar interbody fusion techniques due to its capability of maintaining the integrity of the bilateral facet joints, the anterior/posterior longitudinal ligament, and the annulus fibrosus. Three-dimensional AxiaLIF Rod provided axial support and firmly fixation, thereby relieving stenosis of lumbar intervertebral foramen and restoring the intervertebral disc height and the whole height and physiological curvature of the lumbar spine. The recovery of the intervertebral disc height could restore the folded or crumpled flavum, the posterior longitudinal ligament, and the herniated annulus, resulting in the improvement of stenosis symptoms of nerve root canal or central vertebral canal. CONCLUSION: Percutaneous 360 degree AxiaLIF technique achieves satisfying therapeutic effects, although it has fairly narrow indication and needs long-term follow-up observation.