Objective To determine the current perception thresholds (CPTs) for arm and mental foramen areas to enable a quantitative evaluation of the effectiveness of acupuncture treatment. Methods Ninety-eight volunteers enrolled as participants and were randomly assigned to one of three groups: an acupuncture group (34 subjects); a sham acupuncture group (32 subjects) and a waiting group (32 subjects). CPTs for the arm and mental foramen areas were determined before and after acupuncture at LI4 Hegu of the left hand. A Neurometer CPT was used to evaluate the perception threshold at the homolateral mental foramen and arm. For further exploration, thresholds of homolateral and contralateral mental foramina were determined before and after acupuncture in a subgroup of 13 participants in the acupuncture group. Results Acupuncture at LI4 increased the perception thresholds of the left mental foramen in the acupuncture group signifi cantly (p<0.01). The increases were signifi cantly greater than in the control group for all frequencies, and signifi cantly greater than sham acupuncture for 250 Hz and 5 Hz. In the subgroup, only the CPTs at 5 Hz increased signifi cantly for the contralateral mental foramen. Conclusions Acupuncture at LI4 increases the perception threshold in the mandibular area, but not in the arm. This fi nding is probably related to the analgesic effect of acupuncture.
INTRODUCTIONPractised in China and other Asian countries for more than 4000 years, acupuncture has considerable potential for pain control. Of the acupuncture points used to induce analgesia, LI4 Hegu has been widely used to control dental pain 1 2 and masticatory muscle pain.
3Despite growing clinical acceptance of acupuncture as a method for alleviating pain of varying causes-notably, musculoskeletal and chronic pain, 4 debate continues about its effi cacy.5 6 The consensus appears to be that poor objective data and problems with quantitative methods and measures in many of the acupuncture studies to date preclude any defi nitive conclusions. For this trial, we used an objective assessment measurement in place Effect of acupuncture on perception threshold: a randomised controlled trial of the more commonly used symptom scales (eg, Visual Analogue Scale).The Neurometer current perception threshold (CPTs) was selected as the objective assessment method owing to its inter-rater reliability and capacity for non-traumatic examination. The three different frequencies targeted were Aβ, Aδ and C fi bres, respectively. Clearly, the use of electrical stimulus means that low frequencies will probably affect all fi bre classes. Based on the threshold current required to evoke a response, it has been shown that acupuncture of peripheral nerves selectively affects the response to stimulus at 5 Hz, 250 Hz and 2000 Hz. Electrodiagnostic tests performed with a Neurometer CPT device (Neurometer NS-3000, Neurotron Inc, Baltimore, Maryland, USA) allowed direct quantitative measurements of peripheral sensory nerve function. This automated electrodiagnosti...