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      Different Brain Activation after Acupuncture at Combined Acupoints and Single Acupoint in Hypertension Patients: An Rs-fMRI Study Based on ReHo Analysis

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          Abstract

          Background

          Acupuncture is proved to be effective on hypertension by numerous studies and resting-state functional magnetic resonance imaging (Rs-fMRI) is a widely used technique to study its mechanism. Along with lower blood pressure, patients with hypertension receiving acupuncture also presented improvement in function of cognition, emotion, language, sematic sensation, and so on. This study was a primary study to explore the acting path of acupuncture at combined acupoints in stimulated brain areas related to such functions.

          Methods

          In this research, regional homogeneity (ReHo) was applied to analyze the Rs-fMRI image data of brain activities after acupuncture at LR3, KI3, and LR3+KI3 and to compare the differences of functional brain activities between stimulating combined acupoints and single acupoint under pathological conditions. A total of thirty hypertension patients underwent Rs-fMRI scanning before acupuncture treatment and then were randomly divided into three groups following random number table, the LR3 group (3 males and 7 females), the KI3 group (3 males and 7 females), and the LR3+ KI3 group (4 males and 6 females) for needling, respectively. When the 30-min treatment finished, they received a further Rs-fMRI scanning. The Rs-fMRI data before and after the acupuncture treatment were analyzed through ReHo.

          Results

          Compared with preacupuncture, respectively, ReHo values increased in Brodmann areas (BAs) 3, 18, and 40 and decreased in BAs 7 and 31 in LR3+ KI3 group. However, ReHo values only decreased in BA7 of KI3 group while the results showed no significant difference of brain regions in LR3 group between pre- and postacupuncture. Compared with LR3 group, LR3+KI3 group exhibited decreased ReHo values in BAs 7, 9, and 31. Meanwhile, compared with KI3 group, LR3+KI3 group exhibited increased ReHo values in the BAs 2, 18, 30, and 40 and decreased ReHo values in BA13.

          Conclusion

          Combined acupoints of LR3 and KI3 could act on wider brain areas than the sum of single acupoints, whose functions include emotional processing, cognition, somatic sensation, spatial orientation, language production, and vision.

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          Most cited references38

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          Emotional arousal and activation of the visual cortex: an fMRI analysis.

          Functional activity in the visual cortex was assessed using functional magnetic resonance imaging technology while participants viewed a series of pleasant, neutral, or unpleasant pictures. Coronal images at four different locations in the occipital cortex were acquired during each of eight 12-s picture presentation periods (on) and 12-s interpicture interval (off). The extent of functional activation was larger in the right than the left hemisphere and larger in the occipital than in the occipitoparietal regions during processing of all picture contents compared with the interpicture intervals. More importantly, functional activity was significantly greater in all sampled brain regions when processing emotional (pleasant or unpleasant) pictures than when processing neutral stimuli. In Experiment 2, a hypothesis that these differences were an artifact of differential eye movements was ruled out. Whereas both emotional and neutral pictures produced activity centered on the calcarine fissure (Area 17), only emotional pictures also produced sizable clusters bilaterally in the occipital gyrus, in the right fusiform gyrus, and in the right inferior and superior parietal lobules.
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            Hypertension and cognitive dysfunction in elderly: blood pressure management for this global burden

            Arterial hypertension and stroke are strong independent risk factors for the development of cognitive impairment and dementia. Persistently elevated blood pressure (BP) is known to impair cognitive function, however onset of new cognitive decline is common following a large and multiple mini strokes. Among various forms of dementia the most prevalent include Alzheimer’s disease (AD) and vascular dementia (VaD) which often present with similar clinical symptoms and challenging diagnosis. While hypertension is the most important modifiable vascular risk factor with antihypertensive therapy reducing the risk of stroke and potentially slowing cognitive decline, optimal BP levels for maintaining an ideal age-related mental performance are yet to be established. Cognition has improved following the use of at least one representative agent of the major drug classes with further neuroprotection with renin angiotensin inhibitors and calcium channel blockers in the hypertensive elderly. However, a reduction in BP may worsen cerebral perfusion causing an increased risk of CV complications due to the J-curve phenomenon. Given the uncertainties and conflicting results from randomized trials regarding the hypertension management in the elderly, particularly octogenarians, antihypertensive approaches are primarily based on expert opinion. Herein, we summarize available data linking arterial hypertension to cognitive decline and antihypertensive approach with potential benefits in improving cognitive function in elderly hypertensive patients.
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              Modulatory effects of acupuncture on brain networks in mild cognitive impairment patients

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                Author and article information

                Contributors
                Journal
                Evid Based Complement Alternat Med
                Evid Based Complement Alternat Med
                ECAM
                Evidence-based Complementary and Alternative Medicine : eCAM
                Hindawi
                1741-427X
                1741-4288
                2019
                3 January 2019
                3 January 2019
                : 2019
                : 5262896
                Affiliations
                1School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province 510515, China
                2Weinan Vocational and Technical College, Weinan, Shaanxi Province 714026, China
                3School of Chinese Medicine, LKS Faculty of Medicine, HKU, Hong Kong
                4Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province 510405, China
                Author notes

                Academic Editor: Morry Silberstein

                Author information
                http://orcid.org/0000-0002-9967-2450
                http://orcid.org/0000-0003-3127-578X
                http://orcid.org/0000-0003-2652-8586
                Article
                10.1155/2019/5262896
                6335668
                30719061
                54f12c31-72ec-499a-bc20-949671abf49a
                Copyright © 2019 Jiping Zhang et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 September 2018
                : 2 December 2018
                : 17 December 2018
                Funding
                Funded by: National Key Basic Research and Development Project (973 Program)
                Award ID: 2012CB518504
                Funded by: School-level Scientific Research Project of Weinan Vocational and Technical College
                Award ID: WZYZ201706
                Categories
                Research Article

                Complementary & Alternative medicine
                Complementary & Alternative medicine

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