Acupuncture tonifying-reducing manipulations (TRMs) are typically classified into tonifying manipulations (TMs) and reducing manipulations (RMs) according to their tonifying and reducing effects, and further subdivided into single and complex TRMs based on the different amount of stimulation applied. Different TRMs can produce different therapeutic effects, so distinguishing different TRMs is important for precise acupuncture treatment. This study investigated the specificity and commonality of brain responses induced by TRMs in terms of both the different effects of acupuncture and the different amount of acupuncture stimulation, deepening the understanding of TRMs and promoting their clinical applications. Design, setting, participants and interventions : A randomized crossover trial was conducted with 35 healthy participants, and each participant received four of the most commonly used TRMs at the left Quchi (LI11) in a randomized order, with an interval of at least one day between consecutive manipulations: single TM (STM), single RM (SRM), complex TM (CTM), and complex RM (CRM). Functional near-infrared spectroscopy was used to measure cerebral hemodynamic changes during the administration of TRMs. Main outcome measures : The cerebral hemodynamic changes, including cortical activation and functional connectivity, were used as the primary outcomes. Other indexes, such as cortical oxygenated hemoglobin concentration and acupuncture needle sensations, were evaluated as secondary outcomes. Due to dropouts and fNIRS data defects among the initial 35 participants, the final analysis included 33 participants who accepted acupuncture at the left LI11 with STM, 31 with SRM, 29 with CTM, and 33 with CRM. Results showed that (1) the prefrontal cortex (PFC) and primary somatosensory cortex (S1) were common sites of response for all TRMs, (2) a trend of stronger activation in the PFC and S1 was observed in TMs compared to RMs, and (3) a stronger response in the PFC and S1 was observed in complex TRMs compared to single TRMs. These findings indicated that acupuncture with these TRMs could elicit both shared and specific cerebral responses. The common characteristics revealed that extensive overlapping activation regions were observed in the PFC and S1, which were mediated by TRMs stimulation. Differences in the activation intensity of these brain regions indicated that TRMs also exhibited relative specificity. This may have significant implications for TRM application in clinical practice. Trial registration : Chinese Clinical Trial Registry (ChiCTR2100051886). Please cite this article as: Qu YZ, Cao JY, Chen L, Tian ZL, Guo J, Gong YL, Lin ZF, He BX, Yin T, Zeng F. Commonality and specificity of acupuncture tonifying-reducing manipulations based on functional near-infrared spectroscopy. J Integr Med . 2026; Epub ahead of print.
Qu et al. (Sun,) studied this question.