Neuroanatomical characteristics of deep and superficial needling using LI11 as an example.

OBJECTIVES: To compare the neuroanatomical characteristics of the deep and superficial tissues at acupuncture point LI11 using a neural tracing technique, in order to examine the neural basis of potential differences between deep and superficial needling techniques. METHODS: In order to mimic the situations of the deep and superficial needling, the retrograde neural tracer Alexa Fluor 488 conjugate of cholera toxin subunit B (AF488-CTB) was injected into the muscle or subcutaneous tissue, respectively, at acupuncture point LI11 in eight rats (n=4 each). Three days following injection, the distribution of motor and sensory neurons labelled with AF488-CTB was examined in the spinal cord and dorsal root ganglia (DRG) under a fluorescent microscope. RESULTS: For both types of injection, labelled motor and sensory neurons were distributed on the side ipsilateral to the injection in the spinal cord and DRG between spinal levels C5 and T1. The number of labelled motor neurons following intramuscular injection was significantly higher than subcutaneous injection. By contrast, the number of labelled sensory neurons following subcutaneous injection was significantly higher in number and extended over a greater number of spinal segments compared to intramuscular injection. CONCLUSIONS: These data indicate that the motor and sensory innervation of muscle and subcutaneous tissue beneath LI11 differ, and suggest that acupuncture signals induced by deep and superficial needling stimulation may be transmitted through different neural pathways.

The spatial and segmental innervation of somatic acupoint - a study of canine Shen-Shu point (BL-23).

Although an acupuncture needle penetrates the skin, subcutaneous tissue, and underlying muscle, the most effective locus for the somatic acupoint on the needle path is not well established. We therefore investigated the sensory innervations of tissues in the needle path of the canine Shen-Shu point and evaluated their roles in initiating an acupunctural signal. Horseradish peroxidase solution was injected at all three levels within the acupoint. Only a few peroxidase-positive neurons were observed in the L1 dorsal root ganglion following intradermal injection. Following subcutaneous injection, peroxidase-labeled neurons were detected extending from spinal levels T10 to L2, with maximal labeling at T12 (46.3%). Approximately 95% of positive neurons were at spinal levels T11, T12, T13, and L1. As a result of an intramuscular injection, labeled neurons were observed at spinal levels T12 to L3, with most labeling occurring at L1 (39.9%). Approximately 95% of positive neurons were at spinal levels T13, L1, and L2. The results suggest that most afferent terminals are in the subcutaneous tissue rather than the muscular tissue, with an approximate ratio of 3.75:1. The data provide solid evidence that sensory innervation to a somatic acupoint is confined to a spinal segment and spatially organized, and we speculate that to cause a maximum effect, the centripetally transmitted signal from needling a somatic acupoint is spatio-segmental and divergently amplified.