Abstract
Deqi is taken as an indispensable requirement to achieve acupuncture efficacy. This study aimed to explore the central influence of deqi on the efficacy of acupuncture for functional dyspepsia (FD). 70 FD patients were randomized to receive 20 sessions’ acupuncture treatment with (n = 35) and without deqi (n = 35). In each group, 25 FD patients randomly selected underwent functional magnetic resonance imaging (fMRI) scans before and after treatment. After group re-division according to deqi response, changes of amygdala subregions-based resting-state functional connectivity (rsFC) were compared between the acupuncture with and without obvious deqi group. The clinical changes of the Nepean Dyspepsia Symptom Index (NDSI) measuring FD symptoms were also used to further assess the correlation with amygdala subregions rsFC in FD patients. The decrease in the NDSI scores (pre-pos) in the obvious deqi group was significantly greater than that in the acupuncture without obvious deqi group (p < 0.05). Compared to the without obvious deqi group, the obvious deqi group showed significantly decreased the left basolateral amygdala (BLA) rsFC with bilateral insular (INS), putamen and middle/posterior cingulate cortex (MCC/PCC), right pallidum and hippocampus (HIPP) after treatment. The changed NDSI scores(pre-post) of all 41 FD patients was significantly positively correlated with their Fisher’s transformed z value of the left BLA rsFC with left INS (r = 0.376, FDR corrected p = 0.015), and rsFC with right HIPP (r = 0.394, FDR corrected p = 0.015). The changed NDSI scores(pre-post) of the obvious deqi group was significantly negatively correlated with their Fisher’s transformed z value of the right centromedial amygdala (CMA) rsFC with left medial prefrontal cortex (mPFC) (r = −0.463, p = 0.035). The results tested the hypothesis that the advantage of deqi on efficacy is related to affecting the BLA and CMA rsFC. It suggested that deqi might influence the abnormal rsFC within the salience network (SN), and participate in the adaptive modulation of disrupted relationship between the SN and default mode network (DMN).
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- FD:
-
functional dyspepsia
- fMRI:
-
functional magnetic resonance imaging
- rsFC:
-
resting-state functional connectivity
- NDSI:
-
the Nepean Dyspepsia Symptom Index
- BLA:
-
the basolateral amygdala subregions
- INS:
-
insular cortex
- MCC:
-
middle cingulate cortex
- PCC:
-
posterior cingulate cortex
- HIPP:
-
hippocampus
- FDR:
-
false discovery rate
- CMA:
-
the centromedial amygdala subregions
- mPFC:
-
medial prefrontal cortex
- SN:
-
the salience network
- DMN:
-
the default mode network
- FGID:
-
functional gastrointestinal disorder
- QOL:
-
quality of life
- HS:
-
healthy subjects
- TCM:
-
Traditional Chinese Medicine
- PDS:
-
Postprandial Distress Syndrome
- EPS:
-
Epigastric Pain Syndrome
- SAS:
-
Zung Self-Rating Anxiety Scale
- SDS:
-
Zung Self-Rating Depression Scale
- C-MASS:
-
Chinese version of modified Massachusetts General Hospital Acupuncture Sensation Scale
- VAS:
-
Visual Analogue Scale
- BOLD-fMRI:
-
Blood oxygenation level dependent fMRI
- RCTs:
-
Randomized Controlled Trials
- mean ± SD:
-
Means and standard deviations
- SPM:
-
statistical parametric mapping
- MNI:
-
Montreal Neurological Institute
- FWHM:
-
full-width at half maximum
- ROIs:
-
Regions of Interests
- MPM:
-
Maximum Probabilistic Map
- SFA:
-
the Superficial Amygdala
- OFC:
-
orbital frontal cortex
- PrG:
-
precentral gyrus
- PoG:
-
postcentral gyrus
- ACC:
-
anterior cingulate cortex
- MTG:
-
middle temporal gyrus
- PET-CT:
-
Positron Emission Tomography-Computed Tomography
References
Abdi, H., Tayefi, M., Moallem, S. R., Zhao, B., Fayaz, M., Ardabili, H. M., Razavi, A. A., Darbandi, M., Darbandi, S., Abbasi, P., Ferns, G. A., & Ghayour-Mobarhan, M. (2017). Abdominal and auricular acupuncture reduces blood pressure in hypertensive patients. Complementary Therapies in Medicine, 31, 20–26. https://doi.org/10.1016/j.ctim.2017.01.003.
Adam, B., Liebregts, T., Saadat-Gilani, K., Vinson, B., & Holtmann, G. (2005). Validation of the gastrointestinal symptom score for the assessment of symptoms in patients with functional dyspepsia. Alimentary Pharmacology & Therapeutics, 22(4), 357–363. https://doi.org/10.1111/j.1365-2036.2005.02572.x.
Andresen, V., Bach, D. R., Poellinger, A., Tsrouya, C., Stroh, A., Foerschler, A., Georgiewa, P., Zimmer, C., & Mönnikes, H. (2005). Brain activation responses to subliminal or supraliminal rectal stimuli and to auditory stimuli in irritable bowel syndrome. Neurogastroenterology and Motility, 17(6), 827–837. https://doi.org/10.1111/j.1365-2982.2005.00720.x.
Aro, P., Talley, N. J., Johansson, S. E., Agreus, L., & Ronkainen, J. (2015). Anxiety is linked to new-onset dyspepsia in the Swedish population: A 10-year follow-up study. Gastroenterology, 148(5), 928–937. https://doi.org/10.1053/j.gastro.2015.01.039.
Asghar, A. U., Green, G., Lythgoe, M. F., Lewith, G., & MacPherson, H. (2010). Acupuncture needling sensation: The neural correlates of deqi using fMRI. Brain Research, 1315, 111–118. https://doi.org/10.1016/j.brainres.2009.12.019.
Aziz, Q., Schnitzler, A., & Enck, P. (2000). Functional neuroimaging of visceral sensation. Journal of Clinical Neurophysiology, 17(6), 604–612.
Balderston, N. L., Schultz, D. H., Hopkins, L., & Helmstetter, F. J. (2015). Functionally distinct amygdala subregions identified using DTI and high-resolution fMRI. Social Cognitive and Affective Neuroscience, 10(12), 1615–1622. https://doi.org/10.1093/scan/nsv055.
Brewer, J. A., Worhunsky, P. D., Gray, J. R., Tang, Y. Y., Weber, J., & Kober, H. (2011). Meditation experience is associated with differences in default mode network activity and connectivity. Proceedings of the National Academy of Sciences of the United States of America, 108(50), 20254–20259. https://doi.org/10.1073/pnas.1112029108.
Desmond, J. E., & Glover, G. H. (2002). Estimating sample size in functional MRI (fMRI) neuroimaging studies: Statistical power analyses. Journal of Neuroscience Methods, 118(2), 115–128. https://doi.org/10.1016/s0165-0270(02)00121-8.
Fang, J., Jin, Z., Wang, Y., Li, K., Kong, J., Nixon, E. E., Zeng, Y., Ren, Y., Tong, H., Wang, Y., Wang, P., & Hui, K. K. (2009). The salient characteristics of the central effects of acupuncture needling: Limbic-paralimbic-neocortical network modulation. Human Brain Mapping, 30(4), 1196–1206. https://doi.org/10.1002/hbm.20583.
Fox, M. D., Snyder, A. Z., Vincent, J. L., Corbetta, M., Van Essen, D. C., & Raichle, M. E. (2005). The human brain is intrinsically organized into dynamic, anticorrelated functional networks. Proceedings of the National Academy of Sciences of the United States of America, 102(27), 9673–9678. https://doi.org/10.1073/pnas.0504136102.
Ghoshal, U. C., Singh, R., Chang, F. Y., Hou, X., Wong, B. C., & Kachintorn, U. (2011). Epidemiology of uninvestigated and functional dyspepsia in Asia: Facts and fiction. Journal of Neurogastroenterology and Motility, 17(3), 235–244. https://doi.org/10.5056/jnm.2011.17.3.235.
Gusnard, D. A., Akbudak, E., Shulman, G. L., & Raichle, M. E. (2001). Medial prefrontal cortex and self-referential mental activity: Relation to a default mode of brain function. Proceedings of the National Academy of Sciences of the United States of America, 98(7), 4259–4264. https://doi.org/10.1073/pnas.071043098.
He, Y., Xu, T., Zhang, W., & Zuo, X. N. (2016). Lifespan anxiety is reflected in human amygdala cortical connectivity. Human Brain Mapping, 37(3), 1178–1193. https://doi.org/10.1002/hbm.23094.
Ho, L. F., Lin, Z. X., Leung, A. W. N., Chen, L., Zhang, H., Ng, B. F. L., Ziea, E. T. C., & Guo, Y. (2017). Efficacy of abdominal acupuncture for neck pain: A randomized controlled trial. PLoS One, 12(7), e0181360. https://doi.org/10.1371/journal.pone.0181360.
Hui, K. K., Liu, J., Marina, O., Napadow, V., Haselgrove, C., Kwong, K. K., et al. (2005). The integrated response of the human cerebro-cerebellar and limbic systems to acupuncture stimulation at ST 36 as evidenced by fMRI. Neuroimage, 27(3), 479–496. https://doi.org/10.1016/j.neuroimage.2005.04.037.
Hui, K. K., Marina, O., Liu, J., Rosen, B. R., & Kwong, K. K. (2010). Acupuncture, the limbic system, and the anticorrelated networks of the brain. Autonomic Neuroscience, 157(1–2), 81–90. https://doi.org/10.1016/j.autneu.2010.03.022.
Jin, L. M., Qin, C. J., Lan, L., Sun, J. B., Zeng, F., Zhu, Y. Q., Yu, S. G., Yin, H. Y., & Tang, Y. (2014). Local anesthesia at ST36 to reveal responding brain areas to deqi. Evidence-based Complementary and Alternative Medicine, 2014, 987365. https://doi.org/10.1155/2014/987365.
Kano, M., Dupont, P., Aziz, Q., & Fukudo, S. (2018). Understanding Neurogastroenterology from neuroimaging perspective: A comprehensive review of functional and structural brain imaging in functional gastrointestinal disorders. Journal of Neurogastroenterology and Motility, 24(4), 512–527. https://doi.org/10.5056/jnm18072.
Ko, S. J., Kuo, B., Kim, S. K., Lee, H., Kim, J., Han, G., Kim, J., Kim, S. Y., Jang, S., Son, J., Kim, M., Lee, H., Yeo, I., Joo, K. R., & Park, J. W. (2016). Individualized acupuncture for symptom relief in functional dyspepsia: A randomized controlled trial. Journal of Alternative and Complementary Medicine, 22(12), 997–1006. https://doi.org/10.1089/acm.2016.0208.
Kong, J., Gollub, R., Huang, T., Polich, G., Napadow, V., Hui, K., Vangel, M., Rosen, B., & Kaptchuk, T. J. (2007). Acupuncture de qi, from qualitative history to quantitative measurement. Journal of Alternative and Complementary Medicine, 13(10), 1059–1070. https://doi.org/10.1089/acm.2007.0524.
Ladabaum, U., Minoshima, S., Hasler, W. L., Cross, D., Chey, W. D., & Owyang, C. (2001). Gastric distention correlates with activation of multiple cortical and subcortical regions. Gastroenterology, 120(2), 369–376. https://doi.org/10.1053/gast.2001.21201.
Lalitha, V., Pal, G. K., Pal, P., Parija, S. C., & Murugaiyan, S. B. (2016). Gender difference in the role of Posterodorsal amygdala on the regulation of food intake, adiposity and immunological responses in albino Wistar rats. Annals of Neurosciences, 23(1), 6–12. https://doi.org/10.1159/000443550.
Lee, I. S., Wang, H., Chae, Y., Preissl, H., & Enck, P. (2016). Functional neuroimaging studies in functional dyspepsia patients: A systematic review. Neurogastroenterology and Motility, 28(6), 793–805. https://doi.org/10.1111/nmo.12793.
Li, H., Liu, H., Liu, C., Shi, G., Zhou, W., Zhao, C., et al. (2014). Effect of "Deqi" during the study of needling "Wang's Jiaji" Acupoints treating spasticity after stroke. Evidence-based Complementary and Alternative Medicine, 2014, 715351. https://doi.org/10.1155/2014/715351.
Li, M. K., Li, Y. J., Zhang, G. F., Chen, J. Q., Zhang, J. P., Qi, J., Huang, Y., Lai, X. S., & Tang, C. Z. (2015). Acupuncture for ischemic stroke: Cerebellar activation may be a central mechanism following Deqi. Neural Regeneration Research, 10(12), 1997–2003. https://doi.org/10.4103/1673-5374.172318.
Li, M., Yuan, H., Wang, P., Xin, S., Hao, J., Liu, M., Li, J., Yu, M., & Zhang, X. (2017). Influences of De Qi induced by acupuncture on immediate and accumulated analgesic effects in patients with knee osteoarthritis: Study protocol for a randomized controlled trial. Trials, 18(1), 251. https://doi.org/10.1186/s13063-017-1975-7.
Liu, S., Zhou, W., Ruan, X., Li, R., Lee, T., Weng, X., Hu, J., & Yang, G. (2007). Activation of the hypothalamus characterizes the response to acupuncture stimulation in heroin addicts. Neuroscience Letters, 421(3), 203–208. https://doi.org/10.1016/j.neulet.2007.04.078.
Liu, J., Mu, J., Liu, Q., Dun, W., Zhang, M., & Tian, J. (2017). Brain structural properties predict psychologically mediated hypoalgesia in an 8-week sham acupuncture treatment for migraine. Human Brain Mapping, 38(9), 4386–4397. https://doi.org/10.1002/hbm.23667.
Liu, J., Mu, J., Chen, T., Zhang, M., & Tian, J. (2019). White matter tract microstructure of the mPFC-amygdala predicts interindividual differences in placebo response related to treatment in migraine patients. Human Brain Mapping, 40(1), 284–292. https://doi.org/10.1002/hbm.24372.
Ma, T., Zeng, F., Li, Y., Wang, C. M., Tian, X., Yu, S., Zhao, L., Wu, X., Yang, M., Wang, D., & Liang, F. (2015). Which subtype of functional dyspepsia patients responses better to acupuncture? A retrospective analysis of a randomized controlled trial. Forschende Komplementärmedizin, 22(2), 94–100. https://doi.org/10.1159/000380983.
Mahadeva, S., & Ford, A. C. (2016). Clinical and epidemiological differences in functional dyspepsia between the east and the west. Neurogastroenterology and Motility, 28(2), 167–174. https://doi.org/10.1111/nmo.12657.
Mayer, E. A., Naliboff, B., Lee, O., Munakata, J., & Chang, L. (1999). Review article: Gender-related differences in functional gastrointestinal disorders. Alimentary Pharmacology & Therapeutics, 13(Suppl 2), 65–69.
Menon, V. K. (2019). Mechanically relevant anatomy of the Axis vertebra and its relation to Hangman's fracture: An illustrated essay. Neurospine, 16(2), 223–230. https://doi.org/10.14245/ns.1938140.070.
Nan, J., Liu, J., Li, G., Xiong, S., Yan, X., Yin, Q., Zeng, F., von Deneen, K., Liang, F., Gong, Q., Qin, W., & Tian, J. (2013). Whole-brain functional connectivity identification of functional dyspepsia. PLoS One, 8(6), e65870. https://doi.org/10.1371/journal.pone.0065870.
Nan, J., Liu, J., Mu, J., Dun, W., Zhang, M., Gong, Q., Qin, W., Tian, J., Liang, F., & Zeng, F. (2015). Brain-based correlations between psychological factors and functional dyspepsia. Journal of Neurogastroenterology and Motility, 21(1), 103–110. https://doi.org/10.5056/jnm14096.
Napadow, V., Kettner, N., Liu, J., Li, M., Kwong, K. K., Vangel, M., Makris, N., Audette, J., & Hui, K. K. (2007). Hypothalamus and amygdala response to acupuncture stimuli in carpal tunnel syndrome. Pain, 130(3), 254–266. https://doi.org/10.1016/j.pain.2006.12.003.
Northoff, G., Heinzel, A., de Greck, M., Bermpohl, F., Dobrowolny, H., & Panksepp, J. (2006). Self-referential processing in our brain--a meta-analysis of imaging studies on the self. Neuroimage, 31(1), 440–457. https://doi.org/10.1016/j.neuroimage.2005.12.002.
Pang, B., Jiang, T., Du, Y. H., Li, J., Li, B., Hu, Y. C., et al. (2016). Acupuncture for functional dyspepsia: What strength does it have? A systematic review and meta-analysis of randomized controlled trials. Evidence-based Complementary and Alternative Medicine, 2016, 3862916. https://doi.org/10.1155/2016/3862916.
Pariente, J., White, P., Frackowiak, R. S., & Lewith, G. (2005). Expectancy and belief modulate the neuronal substrates of pain treated by acupuncture. Neuroimage, 25(4), 1161–1167. https://doi.org/10.1016/j.neuroimage.2005.01.016.
Qin, W., Tian, J., Bai, L., Pan, X., Yang, L., Chen, P., Dai, J., Ai, L., Zhao, B., Gong, Q., Wang, W., von Deneen, K., & Liu, Y. (2008). FMRI connectivity analysis of acupuncture effects on an amygdala-associated brain network. Molecular Pain, 4, 55. https://doi.org/10.1186/1744-8069-4-55.
Qiu, K., Jing, M., Sun, R., Yang, J., Liu, X., He, Z., Yin, S., Lan, Y., Cheng, S., Gao, F., Liang, F., & Zeng, F. (2016). The status of the quality control in acupuncture-neuroimaging studies. Evidence-based Complementary and Alternative Medicine, 2016, 3685785. https://doi.org/10.1155/2016/3685785.
Shi, G. X., Yang, X. M., Liu, C. Z., & Wang, L. P. (2012). Factors contributing to therapeutic effects evaluated in acupuncture clinical trials. Trials, 13, 42. https://doi.org/10.1186/1745-6215-13-42.
Shi, G. X., Li, Q. Q., Liu, C. Z., Zhu, J., Wang, L. P., Wang, J., Han, L. L., Guan, L. P., & Wu, M. M. (2014). Effect of acupuncture on Deqi traits and pain intensity in primary dysmenorrhea: Analysis of data from a larger randomized controlled trial. BMC Complementary and Alternative Medicine, 14, 69. https://doi.org/10.1186/1472-6882-14-69.
Spaeth, R. B., Camhi, S., Hashmi, J. A., Vangel, M., Wasan, A. D., Edwards, R. R., Gollub, R. L., & Kong, J. (2013). A longitudinal study of the reliability of acupuncture deqi sensations in knee osteoarthritis. Evidence-based Complementary and Alternative Medicine, 2013, 204259. https://doi.org/10.1155/2013/204259.
Sun, R., Hong, X., Guo, J., Yin, S., Feng, P., Lan, L., Lei, D., Liu, X., Suo, X., Yin, T., Zhang, T., Huang, L., Gao, F., Gong, Q., Liang, F., & Zeng, F. (2018). The central mechanism of acupuncture treatment with a long-lasting effect for functional dyspepsia: Study protocol for a randomized controlled trial. Trials, 19(1), 373. https://doi.org/10.1186/s13063-018-2742-0.
Swanson, L. W. (2003). The amygdala and its place in the cerebral hemisphere. Annals of the New York Academy of Sciences, 985, 174–184. https://doi.org/10.1111/j.1749-6632.2003.tb07081.x.
Tack, J., & Talley, N. J. (2013). Functional dyspepsia--symptoms, definitions and validity of the Rome III criteria. Nature Reviews. Gastroenterology & Hepatology, 10(3), 134–141. https://doi.org/10.1038/nrgastro.2013.14.
Takahashi, T. (2006). Acupuncture for functional gastrointestinal disorders. Journal of Gastroenterology, 41(5), 408–417. https://doi.org/10.1007/s00535-006-1773-6.
Talley, N. J. (2017). Functional dyspepsia: Advances in diagnosis and therapy. Gut and Liver, 11(3), 349–357. https://doi.org/10.5009/gnl16055.
Talley, N. J., Locke 3rd, G. R., Lahr, B. D., Zinsmeister, A. R., Tougas, G., Ligozio, G., et al. (2006). Functional dyspepsia, delayed gastric emptying, and impaired quality of life. Gut, 55(7), 933–939. https://doi.org/10.1136/gut.2005.078634.
Tian, X. P., Li, Y., Liang, F. R., Sun, G. J., Yan, J., Chang, X. R., Ma, T. T., Yu, S. Y., & Yang, X. G. (2009). Translation and validation of the Nepean dyspepsia index for functional dyspepsia in China. World Journal of Gastroenterology, 15(25), 3173–3177. https://doi.org/10.3748/wjg.15.3173.
Van Oudenhove, L., Coen, S. J., & Aziz, Q. (2007). Functional brain imaging of gastrointestinal sensation in health and disease. World Journal of Gastroenterology, 13(25), 3438–3445. https://doi.org/10.3748/wjg.v13.i25.3438.
Van Oudenhove, L., Vandenberghe, J., Dupont, P., Geeraerts, B., Vos, R., Dirix, S., et al. (2010a). Abnormal regional brain activity during rest and (anticipated) gastric distension in functional dyspepsia and the role of anxiety: A H(2)(15)O-PET study. The American Journal of Gastroenterology, 105(4), 913–924. https://doi.org/10.1038/ajg.2010.39.
Van Oudenhove, L., Vandenberghe, J., Dupont, P., Geeraerts, B., Vos, R., Dirix, S., et al. (2010b). Regional brain activity in functional dyspepsia: A H(2)(15)O-PET study on the role of gastric sensitivity and abuse history. Gastroenterology, 139(1), 36–47. https://doi.org/10.1053/j.gastro.2010.04.015.
Vandenbergh, J., Dupont, P., Fischler, B., Bormans, G., Persoons, P., Janssens, J., & Tack, J. (2005). Regional brain activation during proximal stomach distention in humans: A positron emission tomography study. Gastroenterology, 128(3), 564–573. https://doi.org/10.1053/j.gastro.2004.11.054.
Vanner, S., Greenwood-Van Meerveld, B., Mawe, G., Shea-Donohue, T., Verdu, E. F., Wood, J., et al. (2016). Fundamentals of neurogastroenterology: Basic Science. Gastroenterology. https://doi.org/10.1053/j.gastro.2016.02.018.
Wang, G. J., Tomasi, D., Backus, W., Wang, R., Telang, F., Geliebter, A., Korner, J., Bauman, A., Fowler, J. S., Thanos, P. K., & Volkow, N. D. (2008). Gastric distention activates satiety circuitry in the human brain. Neuroimage, 39(4), 1824–1831. https://doi.org/10.1016/j.neuroimage.2007.11.008.
Wang, X., Wang, Z., Liu, J., Chen, J., Liu, X., Nie, G., Byun, J. S., Liang, Y., Park, J., Huang, R., Liu, M., Liu, B., & Kong, J. (2016). Repeated acupuncture treatments modulate amygdala resting state functional connectivity of depressive patients. NeuroImage: Clinical, 12, 746–752. https://doi.org/10.1016/j.nicl.2016.07.011.
Whitfield-Gabrieli, S., & Nieto-Castanon, A. (2012). Conn: A functional connectivity toolbox for correlated and anticorrelated brain networks. Brain Connectivity, 2(3), 125–141. https://doi.org/10.1089/brain.2012.0073.
Wilder-Smith, C. H., Schindler, D., Lovblad, K., Redmond, S. M., & Nirkko, A. (2004). Brain functional magnetic resonance imaging of rectal pain and activation of endogenous inhibitory mechanisms in irritable bowel syndrome patient subgroups and healthy controls. Gut, 53(11), 1595–1601. https://doi.org/10.1136/gut.2003.028514.
Xu, S., Hou, X., Zha, H., Gao, Z., Zhang, Y., & Chen, J. D. (2006). Electroacupuncture accelerates solid gastric emptying and improves dyspeptic symptoms in patients with functional dyspepsia. Digestive Diseases and Sciences, 51(12), 2154–2159. https://doi.org/10.1007/s10620-006-9412-x.
Yang, X. Y., Shi, G. X., Li, Q. Q., Zhang, Z. H., Xu, Q., & Liu, C. Z. (2013). Characterization of deqi sensation and acupuncture effect. Evidence-based Complementary and Alternative Medicine, 2013, 319734. https://doi.org/10.1155/2013/319734.
Yin, X., Gou, M., Xu, J., Dong, B., Yin, P., Masquelin, F., Wu, J., Lao, L., & Xu, S. (2017). Efficacy and safety of acupuncture treatment on primary insomnia: A randomized controlled trial. Sleep Medicine, 37, 193–200. https://doi.org/10.1016/j.sleep.2017.02.012.
Yu, D. T., Jones, A. Y., & Pang, M. Y. (2012). Development and validation of the Chinese version of the Massachusetts General Hospital acupuncture sensation scale: An exploratory and methodological study. Acupuncture in Medicine, 30(3), 214–221. https://doi.org/10.1136/acupmed-2012-010145.
Zeng, F., Qin, W., Liang, F., Liu, J., Tang, Y., Liu, X., Yuan, K., Yu, S., Song, W., Liu, M., Lan, L., Gao, X., Liu, Y., & Tian, J. (2011). Abnormal resting brain activity in patients with functional dyspepsia is related to symptom severity. Gastroenterology, 141(2), 499–506. https://doi.org/10.1053/j.gastro.2011.05.003.
Zeng, F., Qin, W., Ma, T., Sun, J., Tang, Y., Yuan, K., Li, Y., Liu, J., Liu, X., Song, W., Lan, L., Liu, M., Yu, S., Gao, X., Tian, J., & Liang, F. (2012). Influence of acupuncture treatment on cerebral activity in functional dyspepsia patients and its relationship with efficacy. The American Journal of Gastroenterology, 107(8), 1236–1247. https://doi.org/10.1038/ajg.2012.53.
Zeng, F., Lan, L., Tang, Y., Liu, M., Liu, X., Song, W., Li, Y., Qin, W., Sun, J., Yu, S., Gao, X., Tian, J., & Liang, F. (2015). Cerebral responses to puncturing at different acupoints for treating meal-related functional dyspepsia. Neurogastroenterology and Motility, 27(4), 559–568. https://doi.org/10.1111/nmo.12532.
Zeng, F., Sun, R., He, Z., Chen, Y., Lei, D., Yin, T., et al. (2019). Altered functional connectivity of the amygdala and sex differences in functional dyspepsia. Clinical and Translational Gastroenterology, 10(6), e00046. https://doi.org/10.14309/ctg.0000000000000046.
Zhao, L., Chen, J., Li, Y., Sun, X., Chang, X., Zheng, H., Gong, B., Huang, Y., Yang, M., Wu, X., Li, X., & Liang, F. (2017). The long-term effect of acupuncture for migraine prophylaxis: A randomized clinical trial. JAMA Internal Medicine, 177(4), 508–515. https://doi.org/10.1001/jamainternmed.2016.9378.
Zhou, W., & Benharash, P. (2014). Significance of "Deqi" response in acupuncture treatment: Myth or reality. Journal of Acupuncture and Meridian Studies, 7(4), 186–189. https://doi.org/10.1016/j.jams.2014.02.008.
Zhou, G., Qin, W., Zeng, F., Liu, P., Yang, X., von Deneen, K. M., et al. (2013). White-matter microstructural changes in functional dyspepsia: A diffusion tensor imaging study. The American Journal of Gastroenterology, 108(2), 260–269. https://doi.org/10.1038/ajg.2012.405.
Zung, W. W. (1965). A SELF-RATING DEPRESSION SCALE. Archives of General Psychiatry, 12, 63–70. https://doi.org/10.1001/archpsyc.1965.01720310065008.
Zung, W. W. (1971). A rating instrument for anxiety disorders. Psychosomatics, 12(6), 371–379. https://doi.org/10.1016/s0033-3182(71)71479-0.
Acknowledgements
We were grateful to Dr. Peiming Feng, Dr. Tingting Ma and Prof. Jie Wu for the patient recruitment, Dr. Baiwan Zhou, PhD. for MRI data acquisition and interpretation, Liangsheng Zhang for language and grammar editing.
Funding
This study was supported by grants from the National Natural Science Foundation of Outstanding Youth Fund in China (NO.81622052), National Natural Science Foundation of China (NO.81473602), the major program of the National Natural Science Foundation of China (NO.81590950), the Ten Thousand Talent Program (W02020595) and Youth Science and Technology Innovative Team of Sichuan Province (2019JDTD0011).
Author information
Authors and Affiliations
Contributions
Fang Zeng, Fanrong Liang, Ruirui Sun, Zhaoxuan He and Peihong Ma designed the study; Ruirui Sun, Zhaoxuan He and Peihong Ma drafted the manuscript; Tao Yin, Xiaoyan Liu and Yuzhu Qu recruited participants and performed the clinical measurement; Jin Lu and Shuai Yin completed the acupuncture procedure; Tingting Zhang and Liuyang Huang collected the clinical data; Xueling Suo, Du Lei and Qiyong Gong designed the fMRI scan and collected images; Ruirui Sun did the data analysis. All authors discussed, read, revised the manuscript, and all approved the publication of this paper.
Corresponding authors
Ethics declarations
Conflict of interest
The authors have declared that no conflict of interest exists.
Ethical approval
This study protocol has been approved by the institutional review boards and ethics committees of the 1st Teaching Hospital of Chengdu University of TCM with the ethical approval identifier 2015KL-002. This study has been registered in the Chinese Clinical Trial Registry, ChiCTR-IOR-15006523. This trial follows the principles of the Declaration of Helsinki (Version Edinburgh 2000). Only patients signed the informed consent form will be included. In addition, all researchers were trained and signed a pledge to protect the confidentiality of study participants.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Sun, R., He, Z., Ma, P. et al. The participation of basolateral amygdala in the efficacy of acupuncture with deqi treating for functional dyspepsia. Brain Imaging and Behavior 15, 216–230 (2021). https://doi.org/10.1007/s11682-019-00249-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11682-019-00249-7