Somatosensory Stimulation With XNKQ Acupuncture Modulates Functional Connectivity of Motor Areas

Till Nierhaus, Yinghui Chang, Bin Liu, Xuemin Shi, Ming Yi, Claudia M Witt, Daniel Pach, Till Nierhaus, Yinghui Chang, Bin Liu, Xuemin Shi, Ming Yi, Claudia M Witt, Daniel Pach

Abstract

Xingnao Kaiqiao (XNKQ) acupuncture is an acupuncture technique used for stroke patients. In 24 healthy volunteers, we applied this complex acupuncture intervention, which consists of a manual needle-stimulation on five acupuncture points (DU26 unilaterally, PC6, and SP6 bilaterally). XNKQ was compared to three control conditions: (1) insertion of needles on the XNKQ acupuncture points without stimulation, (2) manual needle-stimulation on five nearby non-acupuncture points, and (3) insertion of needles on the non-acupuncture points without stimulation. In a within-subject design, we investigated functional connectivity changes in resting-state functional magnetic resonance imaging (fMRI) by means of the data-driven eigenvector centrality (EC) approach. With a 2 × 2 factorial within-subjects design with two-factor stimulation (stimulation vs. non-stimulation) and location (acupuncture points vs. non-acupuncture points), we found decreased EC in the precuneus after needle-stimulation (stimulation<non-stimulation), whereas the factor location showed no statistically significant EC differences. XNKQ acupuncture compared with needle-stimulation on non-acupuncture points showed decreased EC primarily in subcortical structures such as the caudate nucleus, subthalamic nucleus, and red nucleus. Post-hoc seed-based analysis revealed that the decrease in EC was mainly driven by reduced temporal correlation to primary sensorimotor cortices. The comparison of XNKQ acupuncture with the other two (non-stimulation) interventions showed no significant differences in EC. Our findings support the importance of the stimulation component of the acupuncture intervention and hint toward the modulation of functional connectivity by XNKQ acupuncture, especially in areas involved in motor function. As a next step, similar mechanisms should be validated in stroke patients suffering from motor deficits. ClinicalTrials.gov ID: NCT02453906.

Keywords: acupuncture; centrality; functional connectivity; precuneus; red nucleus; resting-state fMRI; stroke.

Figures

Figure 1
Figure 1
Acupuncture points and respective control points.
Figure 2
Figure 2
Comparison of ECM values for the factor “stimulation.” Whole brain analysis for the contrast [stimulation vs. non-stimulation] shows decreased centrality for the stimulation conditions. Monte Carlo simulation with AlphaSim was used to identify significant clusters at pFWE X = −5, Y = −78, Z = 42. LH, left hemisphere.
Figure 3
Figure 3
Comparison of the two stimulation conditions. Effect on functional connectivity for the contrast [XNKQ vs. “non-acupuncture point with stimulation” (npws)]. (A) Data-driven ECM analysis shows decreased centrality for XNKQ, mainly in subcortical regions. Monte Carlo simulation with AlphaSim was used to identify significant clusters at pFWE < 0.05 (family-wise error (FWE) correction for multiple comparisons). Red circle (Red Nucleus) and yellow circle (Subthalamic Nucleus) indicate areas that were used for seed-based correlation analyses. MNI slice coordinates X = –8, Y = –22, Z = –18. (B) Seed-based functional connectivity with seed in Red Nucleus. Whole brain analysis shows for XNKQ decreased temporal correlation of the seed-region (red) with primary sensorimotor areas (voxel-wise FWE correction at pFWE < 0.05). MNI slice coordinates X = 41, Y = –22, Z = 51. (C) Seed-based functional connectivity with seed in Subthalamic Nucleus. Whole brain analysis shows for XNKQ decreased temporal correlation of the seed-region (yellow) with left primary sensorimotor areas (voxel-wise FWE correction at pFWE < 0.05). MNI slice coordinates X = –40, Y = –20, Z = 48. LH, left hemisphere.

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