Acupuncture Produces Central Activations in Pain Regions

Biella, Gabriele; Sotgiu, Maria Luisa; Pellegata, Giulio; Paulesu, Eraldo; Castiglioni, Isabella; Fazio, Ferruccio

doi:10.1006/nimg.2001.0798

Cited by 162 publications

(97 citation statements)

References 40 publications

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“…Several acupuncture studies have already emphasized the importance brainstem in the endogenous monoaminergic and opioidergic systems (1,4). The activation of SII and the thalamus was expected under somatosensory stimulation at somatic points (37), and the thalamus is also part of the reported neuromatrix of pain (38,39). In conclusion, the group results became more sensitive when we removed the outlier and the results had their biological significance and relevance to acupuncture.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of group homogeneity during acupuncture stimulation in fMRI studies

Sun

Qin

Dong

et al. 2010

Magnetic Resonance Imaging

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Purpose: To evaluate the extent of individual differences of functional MRI (fMRI) signal changes induced by acupuncture stimulation. Materials and Methods:Acupuncture at ST36 and checkerboard stimulation was applied to 16 subjects. We calculated the mean distance using beta values in a generalized linear model (GLM) analysis and employed it to study the group homogeneity by detecting the outliers.Results: A more significant individual difference was presented in acupuncture stimulation compared with visual stimulation through evaluation of the mean distance. From the group results, we found that the activations were more significant in the homogeneous group results. Combining the behavior and fMRI results, there was no direct correlation between deqi index and mean distance in acupuncture stimulation. The deqi index of the outlier was in the normal range and did not differ significantly from others. Conclusion:Traditional group results without removing outliers were not sensitive enough to detect the real acupuncture effect. We suggest that individual difference should be taken into consideration for future acupuncture studies. Also, group analysis paralleled with individual analysis is critical for a full understanding of acupuncture effects.

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Section: Discussionmentioning

confidence: 99%

Evaluation of group homogeneity during acupuncture stimulation in fMRI studies

Sun

Qin

Dong

et al. 2010

Magnetic Resonance Imaging

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“…Several studies have found that acupuncture appears to have effects on numerous brain areas, [7][8][9] and these effects are often claimed to be specific, occurring only at 'real' and not 'control' acupuncture sites. For example, Hui et al report that needle stimulation at LI4 caused reduction of signal intensity in the nucleus accumbens, amygdala, hippocampus, parahippocampus, hypothalamus, ventral tegmental area, anterior cingulate gyrus, caudate, putamen, temporal lobe and insula in all of 11 subjects who experienced acupuncture sensation, together with increased signal intensity in the somatosensory cortex.…”

Section: Recent Brain Imaging Studiesmentioning

confidence: 99%

Point Specificity of Acupuncture in the Light of Recent Clinical and Imaging Studies

Campbell

2006

Acupunct Med

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One fundamental question that is still not resolved is whether acupuncture needles must be inserted in specific points to have their greatest effects. In the majority of large RCTs recently conducted in Germany, acupuncture was significantly more effective than doing nothing but not than sham acupuncture. Only for one study of chronic knee pain was acupuncture superior to sham. Brain imaging with functional magnetic resonance (fMRI) and positron emission tomography (PET) may be helpful but is still in its early stages. Several studies have shown differences between the way the deep central areas of the brain respond to genuine acupuncture compared with sham. Acupuncture can clearly produce complex changes that are relevant to pain transmission and perception, though it is still uncertain how specific these are. Similar changes have been seen after the application of placebo cream and after hypnosis. Aprevious paper discussed the likely central role of the limbic system in acupuncture, evidenced by euphoria and out of body experiences. There may be a good deal of common ground between acupuncture, placebo treatments, hypnosis, and even manipulative treatments. This understanding could offer a way out of the sterile debate about whether acupuncture is merely a placebo: acupuncture could be one effective way of stimulating responses within these deep areas of the brain, though not the only way.

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“…Functional magnetic resonance imaging (fMRI) and Positron Emission Tomography (PET) studies of acupuncture needle manipulation [3,11,[20][21][22]24,25,29,31,[42][43][44] and acupuncture analgesia [5,45,46] demonstrate involvement of these neuronal networks during acupuncture. Additionally, there is strong evidence that acupuncture analgesia is mediated at least in part by opioid systems [4,6,26,32].…”

Section: Introductionmentioning

confidence: 99%

A combined [11C]diprenorphine PET study and fMRI study of acupuncture analgesia

Dougherty

Kong

Webb

et al. 2008

Behavioural Brain Research

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Functional neuroimaging studies suggest that a lateral network in the brain is associated with the sensory aspects of pain perception while a medial network is associated with affective aspects. The highest concentration of opioid receptors is in the medial network. There is significant evidence that endogenous opioids are central to the experience of pain and analgesia. We applied an integrative multimodal imaging approach during acupuncture. We found functional magnetic resonance imaging signal changes in the orbitofrontal cortex, insula, and pons and [11C]diprenorphine positron emission tomography signal changes in the orbitofrontal cortex, medial prefrontal cortex, insula, thalamus, and anterior cingulate cortex. These findings include brain regions within both the lateral and medial pain networks.

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Acupuncture Produces Central Activations in Pain Regions

Cited by 162 publications

References 40 publications

Evaluation of group homogeneity during acupuncture stimulation in fMRI studies

Evaluation of group homogeneity during acupuncture stimulation in fMRI studies

Point Specificity of Acupuncture in the Light of Recent Clinical and Imaging Studies

A combined [11C]diprenorphine PET study and fMRI study of acupuncture analgesia

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