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With the advance of deep learning networks, their applications in the assessment of pavement conditions are gaining more attention. A convolutional neural network (CNN) is the most commonly used network in image classification. In terms of pavement assessment, most existing CNNs are designed to only distinguish between cracks and non-cracks. Few networks classify cracks in different levels of severity. Information on the severity of pavement cracks is critical for pavement repair services. In this study, the state-of-the-art CNN used in the detection of pavement cracks was improved to localize the cracks and identify their distress levels based on three categories (low, medium, and high). In addition, a fully convolutional network (FCN) was, for the first time, utilized in the detection of pavement cracks. These designed architectures were validated using the data acquired on four highways in Ontario, Canada, and compared with the ground truth that was provided by the Ministry of Transportation of Ontario (MTO). The results showed that with the improved CNN, the prediction precision on a series of test image patches were 72.9%, 73.9%, and 73.1% for cracks with the severity levels of low, medium, and high, respectively. The precision for the FCN was tested on whole pavement images, resulting in 62.8%, 63.3%, and 66.4%, respectively, for cracks with the severity levels of low, medium, and high. It is worth mentioning that the ground truth contained some uncertainties, which partially contributed to the relatively low precision.

Objectives Traditional moxibustion might be not safe due to the excessive heat stimulation or toxic chemical components involved. Electric moxibustion (EM), which has been recently developed as an alternative, offers adjustable and constant heat stimulation. This study aimed to investigate the psychophysical and psychophysiological responses to EM heat stimulation. Methods Twenty-seven healthy volunteers received two different levels of heat stimulation using EM. High-temperature (HT) and medium-temperature (MT) heat stimulations were randomly delivered at the TE5 acupoint on the left or right arm. Participants rated the intensity and the spatial information of the heat sensations immediately after each EM stimulation. Local blood flow around the acupoint was measured with Laser Doppler perfusion imaging before and after heat stimulation. Results Both HT-EM and MT-EM induced considerable heat sensations and enhanced local blood flow around the acupoints. HT-EM resulted in greater heat sensation compared to MT-EM. HT-EM induced a higher increase in local blood flow around the stimulation site compared to MT-EM. No remarkable adverse effects were noted. Conclusion Two different levels of EM heat stimulation induced two different levels of heat sensations and enhanced local blood flow. This preliminary study suggests that the newly developed EM can be further applied to examine the effectiveness of moxibustion in clinical trials.

Objective: Itch is an unpleasant sensation associated with an urge to scratch and is a major health care issue associated with atopic dermatitis (AD). Contagious itch, i.e., subjective feelings of itchiness induced by watching others’ scratching behavior, is common in patients with AD. Using electroencephalography, we examined alpha (8–13 Hz) oscillations in sensorimotor areas associated with the desire to scratch in patients with AD. Methods: Thirty-six patients with AD and 34 healthy controls (HCs) participated in this study. They evaluated their itch levels after watching short videos of a model scratching or tapping parts of his body. Neural oscillations were recorded from nine electrodes, including those placed over sensorimotor areas. Time–frequency analysis was used to compare mu rhythm suppression over the sensorimotor areas in response to these videos between patients with AD and HCs. Results: The behavioral test showed that the visual stimuli induced increased feelings of itchiness in patients with AD relative to HCs under the tapping and scratching conditions. The time–frequency analysis revealed that mu rhythm suppression in response to scratching images was significantly prominent in patients with AD, but not in HCs. Conclusion: Patients with AD exhibited increased susceptibility to contagious itch. This phenomenon might be related to enhanced mu rhythm suppression in sensorimotor areas of the brain in these patients. Our findings provide new insight into the neurophysiological basis of itch sensations in patients with AD.

The operant conditioning has been less studied than the classical conditioning as a mechanism of placebo-like effect, and two distinct learning mechanisms have never been compared to each other in terms of their neural activities. Twenty-one participants completed cue-learning based pain rating tasks while their brain responses were measured using functional magnetic resonance imaging. After choosing (instrumental) or viewing (classical) one of three predictive cues (low- and high-pain cues with different level of certainty), they received painful stimuli according to the selected cues. Participants completed the same task during the test session, except that they received only a high pain stimulus regardless of the selected cues to identify the effects of two learning paradigms. While receiving a high pain stimulation, low-pain cue significantly reduced pain ratings compared to high-pain cue, and the overall ratings were significantly lower under operant than under classical conditioning. Operant behavior activated the temporoparietal junction significantly more than the passive behavior did, and neural activity in the primary somatosensory cortex was significantly reduced during pain in instrumental as compared with classical conditioning trials. The results suggest that pain modulation can be induced by classical and operant conditioning, and mechanisms of attention and context change are involved in instrumental learning.

Faces can be categorized in various ways, for example as male or female or as belonging to a specific biogeographic ancestry (race). Here we tested the importance of the main facial features for race perception. We exchanged inner facial features (eyes, mouth or nose), face contour (everything but those) or texture (surface information) between Asian and Caucasian faces. Features were exchanged one at a time, creating for each Asian/Caucasian face pair ten facial variations of the original face pair. German and Korean participants performed a race classification task on all faces presented in random order. The results show that eyes and texture are major determinants of perceived biogeographic ancestry for both groups of participants and for both face types. Inserting these features in a face of another race changed its perceived biogeographic ancestry. Contour, nose and mouth, in that order, had decreasing and much weaker influence on race perception for both participant groups. Exchanging those features did not induce a change of perceived biogeographic ancestry. In our study, all manipulated features were imbedded in natural looking faces, which were shown in an off-frontal view. Our findings confirm and extend previous studies investigating the importance of various facial features for race perception.

The classification of Alzheimer’s disease (AD) using deep learning methods has shown promising results, but successful application in clinical settings requires a combination of high accuracy, short processing time, and generalizability to various populations. In this study, we developed a convolutional neural network (CNN)-based AD classification algorithm using magnetic resonance imaging (MRI) scans from AD patients and age/gender-matched cognitively normal controls from two populations that differ in ethnicity and education level. These populations come from the Seoul National University Bundang Hospital (SNUBH) and Alzheimer’s Disease Neuroimaging Initiative (ADNI). For each population, we trained CNNs on five subsets using coronal slices of T1-weighted images that cover the medial temporal lobe. We evaluated the models on validation subsets from both the same population (within-dataset validation) and other population (between-dataset validation). Our models achieved average areas under the curves of 0.91–0.94 for within-dataset validation and 0.88–0.89 for between-dataset validation. The mean processing time per person was 23–24 s. The within-dataset and between-dataset performances were comparable between the ADNI-derived and SNUBH-derived models. These results demonstrate the generalizability of our models to different patients with different ethnicities and education levels, as well as their potential for deployment as fast and accurate diagnostic support tools for AD.

We investigated whether enhanced interoceptive bodily states of fear would facilitate recognition of the fearful faces. Participants performed an emotional judgment task after a bodily imagery task inside a functional magnetic resonance imaging scanner. In the bodily imagery task, participants were instructed to imagine feeling the bodily sensations of two specific somatotopic patterns: a fear-associated bodily sensation (FBS) or a disgust-associated bodily sensation (DBS). They were shown faces expressing various levels of fearfulness and disgust and instructed to classify the facial expression as fear or disgust. We found a stronger bias favoring the “fearful face” under the congruent FBS condition than under the incongruent DBS condition. The brain response to fearful versus intermediate faces increased in the fronto-insular-temporal network under the FBS condition, but not the DBS condition. The fearful face elicited activity in the anterior cingulate cortex and extrastriate body area under the FBS condition relative to the DBS condition. Furthermore, functional connectivity between the anterior cingulate cortex/extrastriate body area and the fronto-insular-temporal network was modulated according to the specific bodily sensation. Our findings suggest that somatotopic patterns of bodily sensation provide informative access to the collective visceral state in the fear processing via the fronto-insular-temporal network.

Background. Multivoxel pattern analysis has provided new evidence on somatotopic representation in the human brain. However, the effects of stimulus modality (e.g., penetrating needle versus non-penetrating touch) and level of classification (e.g., multiclass versus binary classification) on patterns of brain activity encoding spatial information of body parts have not yet been studied. We hypothesized that performance of brain-based prediction models may vary across the types of stimuli, and neural patterns of voxels in the SI and parietal cortex would significantly contribute to the prediction of stimulated locations. Objective. We aimed to (1) test whether brain responses to tactile stimuli could distinguish among stimulated locations on the body surface, (2) investigate whether the stimulus modality and number of classes affect classification performance, and (3) localize brain regions encoding the spatial information of somatosensory stimuli. Methods. Fifteen healthy participants completed two functional magnetic resonance imaging (MRI) scans and were stimulated via the insertion of acupuncture needles or by non-invasive touch stimuli (5.46-sized von Frey filament). Participants received the stimuli at four different locations on the upper and lower limbs (two sites each) for 5 min while blood-oxygen-level-dependent activity (BOLD) was measured using 3-Tesla MRI. We performed multivariate pattern analysis (MVPA) using parameter estimate images of each trial for each participant and the support vector classifier (SVC) function, and the prediction accuracy and other MVPA outcomes were evaluated using stratified five-fold cross validation. We estimated the significance of the classification accuracy using a permutation test with randomly labeled training data (n=10,000). Searchlight analysis was conducted to identify brain regions associated with significantly higher accuracy compared to predictions based on chance as obtained from a random classifier. Results. For the four-class classification (classifying four stimulated points on the body), SVC analysis of whole-brain beta values in response to acupuncture stimulation was able to discriminate among stimulated locations (mean accuracy, 0.31; q<0.01). The searchlight analysis found that values related to the right primary somatosensory cortex (SI) and intraparietal sulcus were significantly more accurate than those due to chance (p<0.01). On the other hand, the same classifier did not predict stimulated locations accurately for touch stimulation (mean accuracy, 0.25; q=0.66). For binary classification (discriminating between two stimulated body parts, i.e., the arm or leg), the SVC algorithm successfully predicted the stimulated body parts for both acupuncture (mean accuracy, 0.63; q<0.001) and touch stimulation (mean accuracy, 0.60; q<0.01). Searchlight analysis revealed that predictions based on the right SI, primary motor cortex (MI), paracentral gyrus, and superior frontal gyrus were significantly more accurate compared to predictions based on chance (p<0.05). Conclusion. Our findings suggest that the SI, as well as the MI, intraparietal sulcus, paracentral gyrus, and superior frontal gyrus, is responsible for the somatotopic representation of body parts stimulated by tactile stimuli. The MVPA approach for identifying neural patterns encoding spatial information of somatosensory stimuli may be affected by the stimulus type (penetrating needle versus non-invasive touch) and the number of classes (classification of four small points on the body versus two large body parts). Future studies with larger samples will identify stimulus-specific neural patterns representing stimulated locations, independent of subjective tactile perception and emotional responses. Identification of distinct neural patterns of body surfaces will help in improving neural biomarkers for pain and other sensory percepts in the future.

Background Although alopecia affects the quality of life, its pathogenesis is unknown, because cellular interactions in the hair follicle are complex. Several authors have suggested using herbal medicine to treat alopecia, and bioinformatics and network pharmacology may constitute a new research strategy in this regard because herbal medicines contain various chemical components. This study used association rule mining (ARM) and network analysis to analyze the combinations of medicinal herbs used to treat alopecia. Methods We searched Chinese, Korean, and English databases for literature about alopecia treatment, extracting the names of each herbal prescription and herb. The meridian tropism and classification category of each herb were also investigated. Using ARM, we identified frequently combined two-herb and three-herb sets. Using network analysis, we divided the herbs into several modules according to prescription pattern. Results Fifty-six articles and 489 herbal medicines were included—312 internal and 177 external medicines. Among the 312 medicinal herbs used in internal medicine group, the most frequently combined two-herb set was Polygonum multiflorum Thunb. (何首烏) and Angelica sinensis (Oliv.) Dlels (當歸). The most frequently used three-herb combination was Polygonum multiflorum Thunb., Angelica sinensis (Oliv.) Dlels, and Ligusticum chuanxiong Hort. (川芎). In network analysis, three modules were identified. The herbs of Module 1 were related to the liver and kidney meridians, and those of Module 3 were related to the Stomach meridian. Conclusions We identified the frequency, characteristics, and functional modules of herb combinations frequently used in alopecia treatment. We confirmed the value of classical medicinal herb theory. This finding will prompt further bioinformatics and network pharmacology research on alopecia. Electronic supplementary material The online version of this article (10.1186/s12906-018-2269-7) contains supplementary material, which is available to authorized users.

Additional file 1: Table S1. Additional tables.

Objective: The optimal acupoints for a particular disease can be determined by analysis of diagnosis patterns. The objective of this study was to reveal the association between such patterns and the acupoints prescribed in clinical practice using medical data extracted from case reports. Methods: This study evaluated online virtual diagnoses made by currently practicing Korean medical doctors (N = 80). The doctors were presented with 10 case reports published in Korean medical journals and were asked to diagnose the patients and prescribe acupoints accordingly. A network analysis and the term frequency-inverse document frequency (tf-idf) method were used to analyse and quantify the relationship between diagnosis patterns and prescribed acupoints. Results: The network analysis showed that ST36, LI4, LR3, and SP6 were the most frequently used acupoints across all diagnoses. The tf-idf values showed the acupoints used for specific diseases, such as BL40 for bladder disease and LU9 for lung disease. Conclusions: The associations between diagnosis patterns and prescribed acupoints were identified using an online virtual diagnosis modality. Network and text mining analyses revealed commonly applied and disease-specific acupoints in both qualitative and quantitative terms.

The present study applied multivoxel pattern analysis to decode spatial discrimination in pain perception to acupuncture needle from brain functional magnetic resonance image. Fourteen participants were stimulated by acupuncture needles at two adjacent body parts on their left forearm (PC6 vs. HT7). We trained support vector machines on the spatial information from the whole-brain functional magnetic resonance imaging data and projected the support vector machine weight to the brain image space to represent the effect of each voxel on the classifier output. Using region-of-interest masks in individual brains, we trained and tested a linear support vector machine classifier on the accuracy of spatial discrimination in trial-wise functional magnetic resonance imaging data. A classical univariate general linear model analysis testing for differences between the two different locations did not reveal any significant differences. Multivoxel pattern analysis revealed that the brain regions for the prediction of sensory discrimination in pain perceptions to two different points were in the primary somatosensory cortex, primary motor cortex, and supramarginal gyrus, anterior and posterior insula, anterior and posterior cingulate cortex, ventromedial prefrontal cortex, and inferior parietal lobule. Our findings suggest that spatial localizations of pain perceptions to acupuncture needle can be predicted by the neural response patterns in the somatosensory areas and the frontoparietal areas.

The experience of pain relief arises from physiological and psychological factors, and attributes such as the commercial features of analgesic treatments have been shown to influence placebo analgesia by affecting treatment expectations. Therefore, treatment valuation from price information should influence the placebo analgesic effect. This hypothesis was tested in a functional magnetic resonance imaging study in which healthy subjects were enrolled in a 2-day experiment. On day 1, the participants (n = 19) had treatment experiences with 2 different placebo creams during a conditioning session without receiving information on treatment price. On day 2, placebo analgesia was tested after providing price information (high vs low) while functional magnetic resonance imaging was performed. The results showed that the higher priced placebo treatment leads to enhanced pain relief. Placebo analgesia in response to the higher priced treatment was associated with activity in the ventral striatum, ventromedial prefrontal cortex, and ventral tegmental area. The behavioral results indicate that the experience of pain was influenced by treatment valuation from price. Our findings reveal that the context of values in pain control is associated with activity in expectation- and reward-related circuitry. Perspective Treatment with higher price was associated with enhanced placebo analgesia, and this effect was influenced by activities in expectation and reward processing brain areas. The context of value such as medical cost influences cognitive evaluation processes to modulate pain. Our study may help evaluate a patient's preference toward high-priced drugs.

Objective. Attempts to understand the emotion have evolved from the perspective of an independent cognitive system of the mind to that of an interactive response involving the body. This study aimed to quantify and visualize relationships between different emotions and bodily organ systems from the perspective of East Asian medicine. Methods. Term frequency-inverse document frequency (tf-idf) method was used to quantify the significance of Five Viscera and the gallbladder relative to seven different emotions through the classical medical text of DongUiBoGam. Bodily organs that corresponded to different emotions were visualized using a body template. Results. The emotions had superior tf-idf values with the following bodily organs: anger with the liver, happiness with the heart, thoughtfulness with the heart and spleen, sadness with the heart and lungs, fear with the kidneys and the heart, surprise with the heart and the gallbladder, and anxiety with the heart and the lungs. Specific patterns between the emotions and corresponding bodily organ systems were identified. Conclusion. The present findings will further the current understanding of the relationship between the mind and body from the perspective of East Asian medicine. Western medicine characterizes emotional disorders using “neural” language while East Asian medicine uses “somatic” language.

Objectives : Pulse diagnosis is considered particularly important among several methods of diagnosis in DongUiBoGam. In spite of its importance, numerous and various pulse descriptions made it difficult to learn and practice pulse diagnosis. In this article, we tried to analyze properties of the twenty-seven pulses from pulse diagnosis cases from DongUiBoGam to enable the practical understanding of pulse diagnosis. Methods : We constituted the four axis according to the eight important pulses. And we analyzed properties of the twenty-seven pulses through the relationship between the four pairs of important pulses and the twenty-seven pulses. To quantify the relevances of important pulses to the twenty-seven pulses, we used the term frequency-inverse document frequency(TF-IDF) method. Results : We could elicit properties of the twenty-seven pulses according to the four axis. Also, we reexamined the categorization of the seven exterior pulses / the eight interior pulses and the similar pulses from DongUiBoGam with the analysis results. Conclusions : We could understand properties of the twenty-seven pulses more specifically with the eight important pulses. And we also could see the relationship among the twenty-seven pulses on each axis. However, the limitation arising from insufficient number of pulse diagnosis cases in this research requires further research with more sources such as other traditional medical records or clinical records in the present time.

Background : Saam acupuncture were composed by applying the elemental concepts from the Five Phase theory - the relationships between the cycles such as Saeng(Sheng, ‘nourishing’ or ‘creating’) and Geuk(Ke, ‘suppressing’ or ‘controlling’) - onto the Five Phase points and 12 channels to compensate for the imbalance in each of the 12 main energy traits. Objective : The present study is aimed to find out the characteristics of Five Phase points pattern in Saam acupuncture. Methods : We analysed the characteristics of five elements of the Five Phase points in Korean medical texts such as Saamdoinchimguyogyeol, Dongeuibogam and Chimgugyeongheombang in mid Chosun Dynasty. Using non-negative factorization(NNMF) methods, we extracted the feature matrix of five elements of Five Phase points in each classic medical text. Results : In Saam acupuncture, two characteristics were most prominent: (1) "Self" component of Five elements, (2) "Mother" and "Grandmother" component of Five elements. Conclusions : Saam acupuncture used the combination of Five-Shu acupoint based on ZangFu pattern identification. Our findings suggest that grasping the characteristics of Five Phase points combinations can improve the understanding the selection of the relevant acupoints based on the ZangFu pattern identifications.

The brain actively interprets sensory inputs by integrating top-down and bottom-up information. Humans can make inferences on somatosensation based on prior experiences and expectations even without the actual stimulation. We used functional magnetic resonance imaging to investigate the neural substrates of the expectations of the sensory experience of cutaneous electrical stimulation on acupoint without actual stimuli. This study included 22 participants who wore sticker-type electrodes attached on three different acupoints on different body regions: CV17 (chest), CV23 (chin), and left PC6 (arm). Participants evaluated de qi sensations after they expected electrical stimulation on those points in random order without actual stimulation. All stimuli were presented with corresponding visual information of the stimulation sites. The control condition included the same visual information but outside the body. The expectations of cutaneous electrical stimuli without actual stimulation on three acupoints resulted in greater de qi sensation compared to the control condition. Cognitive components of cutaneous electrical stimulation exhibited greater brain activation in the anterior insula, pre-supplementary motor area, and secondary somatosensory area. The expectations of acupuncture stimulation exhibited a distinct experience of somatosensation as well as brain activations in insula and pre-supplementary motor area. Our findings suggest that the sensory experience of the pseudo-cutaneous stimulation may be derived from the predictive role of the salience network in monitoring internal and external body states., Highlights • The pseudo-cutaneous stimulation can elicit remarkable somatic sensations. • Insula and pre-SMA are involved in the expectations of sensory experience. • Somatic sensation from pseudo-stimulation is influenced by top-down information.

The brain can only attend to a fraction of all the information that is entering the visual system at any given moment. One way of overcoming the so-called bottleneck of selective attention (e.g., J. M. Wolfe, Vo, Evans, & Greene, 2011) is to make use of redundant visual information and extract summarized statistical information of the whole visual scene. Such ensemble representation occurs for low-level features of textures or simple objects, but it has also been reported for complex high-level properties. While the visual system has, for example, been shown to compute summary representations of facial expression, gender, or identity, it is less clear whether perceptual input from all parts of the visual field contributes equally to the ensemble percept. Here we extend the line of ensemble-representation research into the realm of race and look at the possibility that ensemble perception relies on weighting visual information differently depending on its origin from either the fovea or the visual periphery. We find that observers can judge the mean race of a set of faces, similar to judgments of mean emotion from faces and ensemble representations in low-level domains of visual processing. We also find that while peripheral faces seem to be taken into account for the ensemble percept, far more weight is given to stimuli presented foveally than peripherally. Whether this precision weighting of information stems from differences in the accuracy with which the visual system processes information across the visual field or from statistical inferences about the world needs to be determined by further research.

Ye-Seul Lee,1 Won-Mo Jung,1 Hyunchul Jang,2 Sanghyun Kim,2 Sun-Yong Chung,3 Younbyoung Chae1 1Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, 2Mibyeong Research Center, Korean Institute of Oriental Medicine, Daejeon, 3Department of Neuropsychiatry, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea Objectives: Recently, there has been increasing interest in preventing and managing diseases both inside and outside medical institutions, and these concerns have supported the development of the individual Personal Health Record (PHR). Thus, the current study created a mobile platform called “Mind Mirror” to evaluate psychological and physical conditions and investigated whether PHRs would be a useful tool for assessment of the dynamic relationship between the emotional and physical conditions of an individual.Methods: Mind Mirror was used to collect 30days of observational data about emotional valence and the physical states of pain and fatigue from 20 healthy participants, and these data were used to analyze the dynamic relationship between emotional and physical conditions. Additionally, based on the cross-correlations between these three parameters, a multilevel multivariate regression model (mixed linear model [MLM]) was implemented.Results: The strongest cross-correlation between emotional and physical conditions was at lag 0, which implies that emotion and body condition changed concurrently. In the MLM, emotional valence was negatively associated with fatigue (β =-0.233, P

Results : In our pilot experiment, half of the participants showed significantly improved manipulation skills in complex lifting/thrusting techniques after training with AMES which is developed in this study, while the other half of the participants did not show significant improvements. Conclusions : The AMES could be useful in acupuncture-manipulation training for students. Our findings suggest that novice can improve sophisticated hand movement for acupuncture manipulation with sensorimotor learning using visual feedback.

Magnetic resonance (MR) imaging plays a highly important role in radiotherapy treatment planning for the segmentation of tumor volumes and organs. However, the use of MR is limited, owing to its high cost and the increased use of metal implants for patients. This study is aimed towards patients who are contraindicated owing to claustrophobia and cardiac pacemakers, and many scenarios in which only computed tomography (CT) images are available, such as emergencies, situations lacking an MR scanner, and situations in which the cost of obtaining an MR scan is prohibitive. From medical practice, our approach can be adopted as a screening method by radiologists to observe abnormal anatomical lesions in certain diseases that are difficult to diagnose by CT. The proposed approach can estimate an MR image based on a CT image using paired and unpaired training data. In contrast to existing synthetic methods for medical imaging, which depend on sparse pairwise-aligned data or plentiful unpaired data, the proposed approach alleviates the rigid registration of paired training, and overcomes the context-misalignment problem of unpaired training. A generative adversarial network was trained to transform two-dimensional (2D) brain CT image slices into 2D brain MR image slices, combining the adversarial, dual cycle-consistent, and voxel-wise losses. Qualitative and quantitative comparisons against independent paired and unpaired training methods demonstrated the superiority of our approach.

We investigated commonalities and differences in brain responses to enhanced bodily attention around acupuncture points with and without stimulation. Fourteen participants received acupuncture needles at both PC6 and HT7 acupoints in the left hand. To enhance bodily attention to acupoints, participants responded to the locations of stimulations in a two-alternative forced choice task. Two fMRI scans were taken in a block design: session 1 labeled with manual stimulation (genuine stimulation) and session 2 labeled with electro-acupuncture (pseudo-stimulation). To compare cortical activation patterns, data were analyzed using the Freesurfer software package. Both genuine-and pseudo-stimulation resulted in brain activations in the insula, anterior cingulate cortex, secondary somatosensory cortex, superior parietal cortex and brain deactivation in the medial prefrontal cortex, posterior cingulate cortex, inferior parietal cortex and the parahippocampus. Genuine acupuncture stimulation exhibited greater brain activation in the posterior insula, posterior operculum and the caudal part of the anterior cingulate cortex, compared with pseudo-stimulation. We demonstrated that enhanced bodily attention triggered by genuine acupuncture stimulation can activate the salience network and deactivate the default mode network regardless of the type of stimulation. The component of enhanced attention to a certain part of the body is significant in the brain response to acupuncture stimulation.

The indications of acupoints are thought to be highly associated with the lines of the meridian systems. The present study used data mining methods to analyze the characteristics of the indications of each acupoint and to visualize the relationships between the acupoints and disease sites in the classic Korean medical textChimgoogyeongheombang. Using a term frequency-inverse document frequency (tf-idf) scheme, the present study extracted valuable data regarding the indications of each acupoint according to the frequency of the cooccurrences of eight Source points and eighteen disease sites. Furthermore, the spatial patterns of the indications of each acupoint on a body map were visualized according to the tf-idf values. Each acupoint along the different meridians exhibited different constellation patterns at various disease sites. Additionally, the spatial patterns of the indications of each acupoint were highly associated with the route of the corresponding meridian. The present findings demonstrate that the indications of each acupoint were primarily associated with the corresponding meridian system. Furthermore, these findings suggest that the routes of the meridians may have clinical implications in terms of identifying the constellations of the indications of acupoints.

Objective Humans can acquire a wide variety of motor skills using sensory feedback pertaining to discrepancies between intended and actual movements. Acupuncture needle manipulation involves sophisticated hand movements and represents a fundamental skill for acupuncturists. We investigated whether untrained students could improve their motor performance during acupuncture needle manipulation using visual feedback (VF). Methods Twenty-one untrained medical students were included, randomly divided into concurrent (n = 10) and post-trial (n = 11) VF groups. Both groups were trained in simple lift/thrusting techniques during session 1, and in complicated lift/thrusting techniques in session 2 (eight training trials per session). We compared the motion patterns and error magnitudes of pre- and post-training tests. Results During motion pattern analysis, both the concurrent and post-trial VF groups exhibited greater improvements in motion patterns during the complicated lifting/thrusting session. In the magnitude error analysis, both groups also exhibited reduced error magnitudes during the simple lifting/thrusting session. For the training period, the concurrent VF group exhibited reduced error magnitudes across all training trials, whereas the post-trial VF group was characterized by greater error magnitudes during initial trials, which gradually reduced during later trials. Conclusions Our findings suggest that novices can improve the sophisticated hand movements required for acupuncture needle manipulation using sensorimotor learning with VF. Use of two types of VF can be beneficial for untrained students in terms of learning how to manipulate acupuncture needles, using either automatic or cognitive processes.

Every acupoint has specific indications for acupuncture treatment. These indications, primarily established based on the meridian system, have spatial patterns of symptoms on the human body. We investigated the associations between acupoints and symptom locations in 75 patients with chronic pain who were asked to sketch the localization of their symptoms on body schemes using the bodily sensation map (BSM) system. Combining the BSM and clinical information, we estimated the statistical parameters of relationships between acupoints and spatial information on symptoms. We further visualized spatial patterns of indications of the representative acupoints on the human body template using a Z score. Using a statistical parametric map method, we observed significant activation patterns of 12 acupoint indications with spatial patterns. The 1st group of patterns was distant from the acupoint locus and was strongly associated with the route of the corresponding meridian. The 2nd group was found around the acupoint locus, the majority of which was located at the trunk or back areas. Intensive investigations of the spatial patterns of acupoint indications would be a novel paradigm to explain point specificity of acupuncture treatment based on the original concept of the meridian system. Future studies should include more meaningful clinical data with larger sample sizes.

Acupuncture stimulation increases local blood flow around the site of stimulation and induces signal changes in brain regions related to the body matrix. The rubber hand illusion (RHI) is an experimental paradigm that manipulates important aspects of bodily self-awareness. The present study aimed to investigate how modifications of body ownership using the RHI affect local blood flow and cerebral responses during acupuncture needle stimulation. During the RHI, acupuncture needle stimulation was applied to the real left hand while measuring blood microcirculation with a LASER Doppler imager (Experiment 1, N = 28) and concurrent brain signal changes using functional magnetic resonance imaging (fMRI; Experiment 2, N = 17). When the body ownership of participants was altered by the RHI, acupuncture stimulation resulted in a significantly lower increase in local blood flow (Experiment 1), and significantly less brain activation was detected in the right insula (Experiment 2). This study found changes in both local blood flow and brain responses during acupuncture needle stimulation following modification of body ownership. These findings suggest that physiological responses during acupuncture stimulation can be influenced by the modification of body ownership.

Throughout the history of East Asian medicine, different kinds of acupuncture treatment experiences have been accumulated in classical medical texts. Reexamining knowledge from classical medical texts is expected to provide meaningful information that could be utilized in current medical practices. In this study, we used data mining methods to analyze the association between acupoints and patterns of disorder with the classical medical bookDongUiBoGamof Korean medicine. Using the term frequency-inverse document frequency (tf-idf) method, we quantified the significance of acupoints to its targeting patterns and, conversely, the significance of patterns to acupoints. Through these processes, we extracted characteristics of each acupoint based on its treating patterns. We also drew practical information for selecting acupoints on certain patterns according to their association. Data analysis onDongUiBoGam’s acupuncture treatment gave us an insight into the main idea ofDongUiBoGam. We strongly believe that our approach can provide a novel understanding of unknown characteristics of acupoint and pattern identification from the classical medical text using data mining methods.

Background. The appropriate selection of acupoints is fundamental to obtain a therapeutic effect from clinical acupuncture.Objective. Using a network analysis method, we investigated the acupoints that are combined to treat low back pain (LBP).Methods. To analyze the patterns of the combinations of acupoints, we used acupoint information from clinical trials to calculate the modified mutual information (MI) value, integrated these data, and visualized the network.Results. Based on the highest MI values, we found two different types of acupoint pairs used in the treatment of LBP: pairs of distant acupoints and pairs of local acupoints. Using modular analysis, we found that three acupoint modules were applied in the treatment of LBP: local acupoints, distant acupoints along the meridian, and distant acupoints based on the symptom differentiations.Conclusion. Using the modified MI technique, we provide a systematic framework for the acupoint combination network, and reveal how the technique of acupoint combination is used in the treatment of LBP. Application of this knowledge in acupuncture research may help clarify the mechanisms underlying acupuncture treatment at the systems level, bridging the gap between traditional medicine and modern science.

Acupuncture is a therapeutic treatment that is defined as the insertion of needles into the body at specific points (ie, acupoints). Advances in functional neuroimaging have made it possible to study brain responses to acupuncture; however, previous studies have mainly concentrated on acupoint specificity. We wanted to focus on the functional brain responses that occur because of needle insertion into the body. An activation likelihood estimation meta-analysis was carried out to investigate common characteristics of brain responses to acupuncture needle stimulation compared to tactile stimulation. A total of 28 functional magnetic resonance imaging studies, which consisted of 51 acupuncture and 10 tactile stimulation experiments, were selected for the meta-analysis. Following acupuncture needle stimulation, activation in the sensorimotor cortical network, including the insula, thalamus, anterior cingulate cortex, and primary and secondary somatosensory cortices, and deactivation in the limbic-paralimbic neocortical network, including the medial prefrontal cortex, caudate, amygdala, posterior cingulate cortex, and parahippocampus, were detected and assessed. Following control tactile stimulation, weaker patterns of brain responses were detected in areas similar to those stated above. The activation and deactivation patterns following acupuncture stimulation suggest that the hemodynamic responses in the brain simultaneously reflect the sensory, cognitive, and affective dimensions of pain. Perspective This article facilitates a better understanding of acupuncture needle stimulation and its effects on specific activity changes in different brain regions as well as its relationship to the multiple dimensions of pain. Future studies can build on this meta-analysis and will help to elucidate the clinically relevant therapeutic effects of acupuncture.