fMRI를 이용하여 수지굴신운동(手指屈伸運動)과 조해(照海)(KI₆) 자침(刺鍼)에 의(依)한 대뇌운동피질(大腦運動皮質)의 활성변화(活性變化)에 관(關)한 비교(比較) 연구(硏究)

The New Finding on BOLD Response of Motor Acupoint KI₆(照海) by fMRI

Introduction : Recent studies Suggested that there is a strong correlation between acupuncture stimulation and its related cortical activation. Anther study showed that either positive or negative BOLD effects could be observed depending on anatomical structure in acupuncture stimulation. In ttis study, we investigated a new acupoint $KI_6$ (照海), which was known as motor-related acupoint and obtained an evidence that the stimulation of $KI_6$ resulted in either negative or positive BOLD response to stimulation. Methods & Results : 1. Subjects and paradigms : Two separate stimulation paradigms were performed on five healthy (aged 22-23 yrs) in this study. First, the paradigm of acupuncture stimulation was that the acupuncture needle was inserted in acupoints $KI_6$, which is located in lateral side of the foot and then continuously twisted(補瀉를 除外한 捻轉法) for 70 seconds for 10 cycles of activation. During rest period (70 seconds), the needle was completed removed from acupoint. Total 60 cycles were performed and 10 images were obtained per cycle. Second, nonacupoint was randomly selected and the same paradigm was performed as acupoint stimulation. The stimulation protocol comprised 10 cycles of alternating. activation and rest (10 images per cycle). Total 60 cycles were performed and each cycle take about 1.5 sec for motor task. Subjects take an at least 15 minutes break before starting anther paradigm. 2. fMRI mapping : Multi-slice functional images were obtained on a 1.5T Magnetom Vision MRI scanner (Simens Medical, Erlangen, Germany) equipped with high performance whole-body gradients. The BOLD T2 * - weighted images were acquired with acho planar imaging sequence (TR = 1.2 sec, TE = 60 msec, and flip angle = $90_{\circ}$). The other sequence parameter are : FOV = 210 mm, matrix=$64{\times}128$ or $64{\times}64$, slice number=10 and slice thickness = 5 or 8 mm. the anatomic images were obtained with Spin-echo T1-weighted images. The resulting images were then anaiyzed with STIMULATE (CMRR, U. of Minnesota) to generate functional maps using a student T-test (p < 0.005) and cluster analysis. Both positive and negative response were evaluated. Conclusions : We have observed the activation of the motor cortex by stimulating motor-related acupoint ($KI_6$). Among five subjects, negative BOLD response was shown in four and positive response in one. All subjects showed positive response to conventional finger flexion-extension task. To understand the detailed mechanisms of correlation between acupuncture stimulation and BOLD fMRI changes and two typs of response, further study strongly required.