<p>The low-frequency BOLD signal oscillation response in the insular associated to immediate analgesia of ankle acupuncture in patients with chronic low back pain</p>

Abstract

Purpose The present study evaluated the modulation effect of a painless acupuncture technique, ankle acupuncture (AA), on resting-state functional change in patients with chronic low back pain (CLBP). Patients and methods Fourteen participants diagnosed with CLBP received AA and underwent one brain functional image scan after tactile stimulation and another one following the insertion of the needle. The needling sensations and clinical pain intensities were evaluated after the end of each functional image scan. The significance levels of Visual Analog Scales/Scores (VASs) before and after acupuncture were determined using paired t -test. The brain areas showing differences in the amplitude of low-frequency fluctuation (ALFF) and fractional ALFF (fALFF) between the two scans were identified. We also explored the relationship between mean ALFF values in brain areas identified and VAS scores based on Pearson correlation coefficient. Results A complete-case analysis was performed on 12 participants. Neither different needling sensations nor any local sensations during the two scans was found. The clinical findings indicated that the scores of VAS scores were significantly lower after AA intervention ( P <0.001). Compared with those after tactile stimulation, ALFF decreased in the left insular and increased in the left precuneus and right precentral gyrus, and fALFF decreased in the left insular, during retaining of AA (corrected). Moreover, there was a positive correlation found between mean ALFF change in the left insular and that of VAS values ( P <0.05). Conclusion The present study demonstrated the low-frequency BOLD signal oscillation response in the left insular in brain activity was associated with an immediate analgesia of AA in patients with CLBP, which provides new insights into intrinsic connections between low-frequency brain signals and analgesic effects of acupuncture.

Neuroimaging Studies of Acupuncture on Low Back Pain: A Systematic Review

“…A total of 310 results were yielded from the databases. After deduplication and screening phases, 19 studies (Ji et al, 2007 ; Junhai et al, 2008 ; Yongsong et al, 2011 ; Li et al, 2012 , 2014 ; Guoqiang et al, 2014 ; Jialiang et al, 2014 ; Tao et al, 2015 ; Lin and Xianmo, 2017 ; Yijun et al, 2017 ; Makary et al, 2018 ; Lee et al, 2019 ; Tu et al, 2019 ; Xiang et al, 2019 ; Yan et al, 2019 ; Kim et al, 2020 ; Lan et al, 2020 ; Liu et al, 2020 ; Yu et al, 2020 ) between 2007 and 2020 were incorporated in this review ( Table 1 ). Among the articles, 14 studies were performed in China (Ji et al, 2007 ; Junhai et al, 2008 ; Yongsong et al, 2011 ; Li et al, 2012 , 2014 ; Guoqiang et al, 2014 ; Jialiang et al, 2014 ; Tao et al, 2015 ; Lin and Xianmo, 2017 ; Yijun et al, 2017 ; Xiang et al, 2019 ; Yan et al, 2019 ; Lan et al, 2020 ; Liu et al, 2020 ), three were conducted in the USA (Tu et al, 2019 ; Kim et al, 2020 ; Yu et al, 2020 ), and two were conducted in South Korea (Makary et al, 2018 ; Lee et al, 2019 ).…”

“…After deduplication and screening phases, 19 studies (Ji et al, 2007 ; Junhai et al, 2008 ; Yongsong et al, 2011 ; Li et al, 2012 , 2014 ; Guoqiang et al, 2014 ; Jialiang et al, 2014 ; Tao et al, 2015 ; Lin and Xianmo, 2017 ; Yijun et al, 2017 ; Makary et al, 2018 ; Lee et al, 2019 ; Tu et al, 2019 ; Xiang et al, 2019 ; Yan et al, 2019 ; Kim et al, 2020 ; Lan et al, 2020 ; Liu et al, 2020 ; Yu et al, 2020 ) between 2007 and 2020 were incorporated in this review ( Table 1 ). Among the articles, 14 studies were performed in China (Ji et al, 2007 ; Junhai et al, 2008 ; Yongsong et al, 2011 ; Li et al, 2012 , 2014 ; Guoqiang et al, 2014 ; Jialiang et al, 2014 ; Tao et al, 2015 ; Lin and Xianmo, 2017 ; Yijun et al, 2017 ; Xiang et al, 2019 ; Yan et al, 2019 ; Lan et al, 2020 ; Liu et al, 2020 ), three were conducted in the USA (Tu et al, 2019 ; Kim et al, 2020 ; Yu et al, 2020 ), and two were conducted in South Korea (Makary et al, 2018 ; Lee et al, 2019 ). Five kinds of diseases were involved in these studies: chronic low back pain (Li et al, 2014 ; Tu et al, 2019 ; Xiang et al, 2019 ; Yan et al, 2019 ; Kim et al, 2020 ; Yu et al, 2020 ), non-specific low back pain (Makary et al, 2018 ; Lee et al, 2019 ), lumbar disc herniation (Yongsong et al, 2011 ; Guoqiang et al, 2014 ; Jialiang et al, 2014 ; Tao et al, 2015 ; Lin and Xianmo, 2017 ; Yijun et al, 2017 ; Lan et al, ...…”

“…Among the articles, 14 studies were performed in China (Ji et al, 2007 ; Junhai et al, 2008 ; Yongsong et al, 2011 ; Li et al, 2012 , 2014 ; Guoqiang et al, 2014 ; Jialiang et al, 2014 ; Tao et al, 2015 ; Lin and Xianmo, 2017 ; Yijun et al, 2017 ; Xiang et al, 2019 ; Yan et al, 2019 ; Lan et al, 2020 ; Liu et al, 2020 ), three were conducted in the USA (Tu et al, 2019 ; Kim et al, 2020 ; Yu et al, 2020 ), and two were conducted in South Korea (Makary et al, 2018 ; Lee et al, 2019 ). Five kinds of diseases were involved in these studies: chronic low back pain (Li et al, 2014 ; Tu et al, 2019 ; Xiang et al, 2019 ; Yan et al, 2019 ; Kim et al, 2020 ; Yu et al, 2020 ), non-specific low back pain (Makary et al, 2018 ; Lee et al, 2019 ), lumbar disc herniation (Yongsong et al, 2011 ; Guoqiang et al, 2014 ; Jialiang et al, 2014 ; Tao et al, 2015 ; Lin and Xianmo, 2017 ; Yijun et al, 2017 ; Lan et al, 2020 ), sciatica (Ji et al, 2007 ; Li et al, 2012 ; Liu et al, 2020 ), and low back and leg pain (Junhai et al, 2008 ).…”

The Instant Effects of Continuous Transcutaneous Auricular Vagus Nerve Stimulation at Acupoints on the Functional Connectivity of Amygdala in Migraine without Aura: A Preliminary Study

“…Therefore, limbic system dysfunction plays an important role in the occurrence, development, and regulation of migraines. Further study of acupuncture analgesia [ 49 ] found that the amplitude of low-frequency fluctuation (ALFF) in left insula decreased in patients with chronic low back pain after acupuncture, and the decrease of average ALFF was positively related to the decrease of VAS value, which confirms that regulating the function of limbic system may be one of the mechanisms for endogenous analgesia. The taVNS could regulate amygdala activity from a recent study [ 50 ] and caused extensive negative activation in the limbic system [ 30 ].…”

Influence of the Intensity, Components, and Spreading of the Deqi Sensation on the Analgesic Effect of SP6 Needling in Primary Dysmenorrhea Patients: A Secondary Analysis of a Randomised Controlled Trial

“…Interestingly, wrist-ankle acupuncture, a needling method via inserting the needle through the skin shallowly in the subcutaneous tissue level in the wrist or ankle without manipulation and needle sensation, exerts similar analgesic effect to traditional acupuncture [52]. Xiang et al found that this shallow and no sensory inputting needling method induced the low-frequency BOLD signal oscillation response in the left insular in patients with chronic low back pain [53]. Concerning the results of the current study, it seems that analgesic effects achieved by invasive needling at an acupoint without deqi may be correlated with some kinds of activities among some structures in the brain.…”