The ultimate goal of this proposed study is to understand the CNS mechanisms by which acupuncture treats disease. In order to accomplish this goal and to relieve suffering and illness, our long-term objectives are the following: 1) to utilize the newest technology in fMRI to demonstrate functional changes of the brain during stimulation of specific acupoints in the peripheral nervous system; 2) to study the data from real time fMRI to describe """"""""functional circuitry"""""""" of """"""""streaming"""""""" between areas of the CNS to gain insight into basic acupuncture mechanisms and to discover new functional relationships; 3) to develop new techniques for delineating anatomy of the peripheral nervous system in vivo to facilitate reproducibility of fMRI-acupuncture research and to improve the effectiveness of acupuncture therapy; and 4) to study patients with focal cerebrovascular accidents (CVA's or strokes) of the visual cortex when using acupuncture stimulation in order to understand the effects of acupuncture on disease states as well as on normal controls, possibly giving a rationale for the use of acupuncture in the treatment of strokes. A carefully-controlled double-blinded study of 25 normal controls will utilize real time fMRI to record neuronal activity change in the cerebral cortex during acupuncture stimulation of 12 major acupoints. The technique will include gradient echo EPI sequences and the sagittal view Z-Readout mode to avoid acoustic noise effects. The information of """"""""functional circuitry"""""""" and """"""""streaming"""""""" will be found in the post-processing of data using the obtained time-course data and our more recently developed Gabor-decomposition-analysis technique. New techniques to delineate the functional anatomy of the peripheral nerves will include Optical Coherence Tomography (OCT) and MRI neurography in the living subject. The study of cerebral blood flow in stroke patients with pathology in only a localized area of the brain, the occipital cortex, will be compared with our work on normal controls using gradient echo EPI sequences. The results of this research will give new insight and approaches to understanding the mechanisms of acupuncture, with a most important windfall of improving the efficacy and specificity of a 3,000 year-old Oriental medical therapy, acupuncture.
