Most of the work on the scientific validation of acupuncture has concentrated on the analgesic properties of acupuncture. There are naturally occurring chemicals like endorphins and enkephalins that act as natural pain modulators that have been shown to change and increase with acupuncture. However acupuncture's effects are greater than mere analgesia suggesting other pathways/mechanisms are involved. Since 1950 there have been a number of significant discoveries that closely correspond to ancient acupuncture concepts. Acupoints are special and different from surrounding skin. Their activity can be measured electrically both before and after stimulation.   MRI Evidence of Acupuncture   Debra Gordon THE ORANGE COUNTY REGISTER 25-Dec-1998 Friday IRVINE -- What started with a walk up a Korean mountain in the wrong shoes may end up demystifying an ancient Oriental medicine -- and providing new insights into how our brains work. University of California Irvine professor and physicist Zang-Hee Cho slipped on that walk five years ago, injuring his back so severely that by the time he got off the plane in Los Angeles he could barely move. Acupuncture melted the pain and spurred Cho to use modern technology -- a functional MRI machine -- to explore old medicine. The results, published last spring in the Proceedings of the National Academy of Sciences, one of the world's premier scientific journals, showed a direct correlation between acupuncture and the brain, the first time any effect in the brain has ever been demonstrated. Cho's experiment may have demonstrated something else, too: a scientific explanation for two key Eastern medical concepts: the circulation of Qi (pronounced chee), a subtle, vivifying energy that relieves disease and pain, and Yin and Yang, the ever-present, complementary forces of nature. Doubts at first When his family first suggested acupuncture for his back pain, Cho was skeptical. He is a member of the highly respected National Academy of Science, the inventor of an early version of the Positron Emission Tomograph, or PET scan, and a pioneer of the MRI scanner, both of which have revolutionized our ability to see into the body and brain. To him, acupuncture was voodoo medicine. But much to his surprise, the $40, 15-minute procedure worked. Three years later, while on sabbatical in Korea, a bastion of Oriental medicine, he felt his curiosity about acupuncture growing, slipping into his thoughts like needles slipped through the skin. At the time, he was conducting MRI studies showing how visual stimulation is revealed in the brain. He flashed lights into people's eyes, took MRIs, then analyzed the brightly colored scans, which showed increases in blood flow in parts of the brain. He could do the same thing using acupuncture instead of bright lights. He recruited 12 volunteers for the experiment, which studied the relationship between an acupoint and the visual cortex in the brain. Vision-related acupoints lie along the Urinary Bladder Channel. The name alone gave Cho doubts about it having anything to do with the brain, but, ever the scientist, he wouldn't give in to his skepticism without proof. He secured the volunteers' heads in a special coil to prevent movement. First he flashed a light in their eyes to get the standard response in the visual cortex of the brain. Then an acupuncturist "needled" a site in their little toe, called BL67,used to treat eye diseases. Then Cho compared the two MRIs. They were nearly identical. Stimulation of the vision-related acupoint showed the same reaction in the brain as stimulation of the eye. Cho noticed something else. When he did a series of MRIs, alternately flashing and shutting off the light, and graphed the results, two distinct patterns emerged. Four participants showed an increasing flow of blood to the cortex; eight showed a decreasing flow. He repeated the experiments several times. Same results. It was as if the two groups were opposites of each other. And indeed, they were. This was the mysterious Yin and Yang so elemental to Oriental medicine, yet still a mystery to Western medicine, Cho decided. The two types tend to correlate to the Western type A and B personalities, he said. Yang, or Type A, tends to have a hasty or positive attitude, a high heart rate and warm body. Yin, or type B, tends to have a lower heart rate, cold extremities and cautious and often negative attitudes. Regulating Yin and Yang What Cho thought happened was that stimulating the acupoints provoked an opposite effect: increasing blood flow in the Yins brains, decreasing it in Yangs'. But still Cho didn't understand how it all worked. What was the connection between the tip of the little toe and the visual cortex? Easy, said the UCI neuroscientist he asked: The nerves in the foot connect to the central nervous system, which connects to a part of the brain that includes the visual cortex. As the acupuncture signal passes to the brain via nerves, it possibly stimulates the hypothalamus, the "executive center" of the brain, responsible for the production and release of hundreds of neurochemicals, Cho said. These neurochemicals, together with the autonomic nervous system, Cho said, may have some effect on vision-related disorders. Perhaps, he suggested, they are Qi. With 1,500 acupoints on the body, Cho says, he has a long way to go with his research. But he's hooked now. He's applying to the National Institutes of Health's Office of Alternative Medicine for a $12 million grant to continue his research. Not only could it lead to more understanding of how acupuncture works --and thus greater acceptance of it by the Western medical establishment, he said, but it may enable scientists to use MRI to explore areas of the brain they weren't previously able to reach. With acupuncture, for instance, they could stimulate digestive acupoints and watch the effect in the brain; it would be more difficult to do that any other way. One of the studies cited by the NIH was conducted by Abass Alavi, M.D., chief of nuclear medicine at the University of Pennsylvania Medical Center, who showed that acupuncture affects the flow of blood in the brain. He used SPECT (single photon emission computed tomography) to view the brains of four people with pain and five pain-free people who served as the control group. Dr. Alavi found that after acupuncture needles were inserted, all of the patients had increased blood flow to the thalamus, the area of the brain that relays pain and other sensory messages. Because the brains of the pain-free group showed the same reactions as those with pain, the changes in blood flow couldn't be attributed to placebo. "We've used acupuncture at the Mayo Pain Clinic since 1974," says Lee A. Nauss, M.D., an emeritus anesthesiologist at Mayo Clinic, Rochester, Minn. "If patients don't respond to the types of treatment that usually work best — medication and nerve blocks — then we consider acupuncture. Often in those circumstances, it is quite beneficial." Blood Flow in Brain Shows Acupuncture Relieves Pain CHICAGO (Reuters) - Acupuncture relieves pain and a scan of brain activity proves it, researchers said on Wednesday. Doctors at the University of Medicine and Dentistry of New Jersey induced pain in 12 subjects by using a filament to touch their upper lips, then detected the associated increases in brain activity with a magnetic resonance imaging device. As the subjects' pain was relieved with acupuncture needles placed between thumb and forefinger, images taken of their brains showed the activity diminishing. The pain-induced activity subsided in 60 percent to 70 percent of the entire brain during treatment with acupuncture needles, the researchers said. ``We're using a new technology to understand how this 2,500-year-old technique works,'' study co-author Huey-Jen Lee said. The rise in brain activity, which is based on an increase in blood flow, was seen in the parietal area, the sensory center of the brain, and the brain stem. But each subject exhibited differences in where brain activity increased. ``So many people with pain, whether from cancer, headache or a chronic, unexplained condition, rely on medications, such as morphine, which can become addicting,'' Huey-Jen Lee said. ''Acupuncture has no side effects, and other studies have shown the pain relief it provides can last for months.'' The researchers presented their findings to the Radiological Society of North America, meeting in Chicago. In 1950 Yoshio Nakatani demonstrated that in specific organ disease a number of acupuncture points along that organ's acupuncture meridian had a markedly decreased electrical resistance compared with the surrounding skin. (e.g. in Kidney disease several of the kidney points had a lowered skin resistance). He found the resistance values for these points varied with the time of the day, ambient temperature, activity and emotional state of the subject. In the late 1970's Dr. Robert Becker and associates similarly identified lowered resistance values for over 50% of acupoints along the Large Intestine meridian. Becker suggested that the acupoints acted as amplifiers of a semi conducting Direct Current travelling along the perineural cells which wrap around each and every nerve in the body. This D C system became more negative as it traveled to the ends of fingers and toes and more positive as it returned to the trunk and head (i.e. a Yin - Yang flow). It was known that the skin acted as a battery (outside of skin is negative and inside was positive) and Becker found the acupuncture point was more positive than the surrounding skin. The insertion of a needle would short circuit this battery and generate a current of injury lasting for several days. Further electrical activity occurred because of: (1) ionic reactivity between the metal needle and body fluids (2) low frequency pulses of electricity from twirling the needle. This generated electrical energy would flow along this DC system to the brain and would be analogous to the Qi described by classical acupuncture. In 1978 Luciani produced Kirlean photographs of the LED(light emission diode) effect of acupoints along the small intestine meridian and the large intestine meridian. The existence of the meridian system was further established by French researcher Pierre de Vernejoul, who injected radioactive isotopes into the acupoints of humans and tracked their movement with a special gamma imaging camera. The isotopes traveled thirty centimeters along acupuncture meridians within four to six minutes. Vernejoul then challenged his work by injecting isotopes into the blood vessels at random areas of the body rather than into acupoints. The isotopes did not travel in the same manner at all, further indicating that the meridians do indeed comprise a system of separate pathways within the body.