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Expectancy and belief modulate the neuronal substrates of pain treated by acupuncture. Neuroimage, 25, 1161-1167

Wellcome Department of Imaging Neuroscience, 12 Queen Square, WC1N 3BG London, UK.
NeuroImage (Impact Factor: 6.36). 06/2005; 25(4):1161-7. DOI: 10.1016/j.neuroimage.2005.01.016
Source: PubMed

ABSTRACT Both specific and non-specific factors may play a role in acupuncture therapy for pain. We explored the cerebral consequences of needling and expectation with real acupuncture, placebo acupuncture and skin-prick, using a single-blind, randomized crossover design with 14 patients suffering from painful osteoarthritis, who were scanned with positron emission tomography (PET). The three interventions, all of which were sub-optimal acupuncture treatment, did not modify the patient's pain. The insula ipsilateral to the site of needling was activated to a greater extent during real acupuncture than during the placebo intervention. Real acupuncture and placebo (with the same expectation of effect as real acupuncture) caused greater activation than skin prick (no expectation of a therapeutic effect) in the right dorsolateral prefrontal cortex, anterior cingulate cortex, and midbrain. These results suggest that real acupuncture has a specific physiological effect and that patients' expectation and belief regarding a potentially beneficial treatment modulate activity in component areas of the reward system.

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    • "Furthermore, the reduced rsFC from both MHb and LHb to the aMCC and pACC may link chronic pain states to changes in negative affect, pain, and cognitive control (Vogt 2005; Geha et al. 2008; Shackman et al. 2011). Another interesting finding relates to the reduced rsFC to the pgACC previously implicated in pain inhibition systems (Petrovic et al. 2002; Wager et al. 2004; Bingel et al. 2006) and to the dlPFC repeatedly associated with pain modulation (Lorenz et al. 2003; Brighina et al. 2004; Fierro et al. 2010), perceived control over pain (Pariente et al. 2005; Wiech et al. 2006), and pain catastrophizing (Seminowicz and Davis 2006). "
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    Journal of Neurophysiology 10/2013; 111(2). DOI:10.1152/jn.00405.2013 · 3.04 Impact Factor
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    • "During the verum acupuncture, needles create the specific needle sensation called " deqi " ( " aching, " " dull, " " heavy, " " numb, " " radiating, " " spreading " and " tingling " ) at specific acupuncture points [19]. Deqi is suggested to be the main mechanisms producing effects from acupuncture [20], by generating a release of spinal and supraspinal beta-endorphins, proinflammatory neuropeptides and an increase in peripheral circulation [21]. However, there is lack of adequate experimental data to indicate the relationship between deqi sensation and modulation effect of acupuncture on ANS [22]. "
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    • "Converging evidence from fMRI studies on acupuncture at commonly used acupoints have revealed significant modulatory effects at widespread cerebrocerebellar brain regions. These regions process information in circuits that can broadly be assumed to engage endogenous antinociceptive limbic networks as well as higher-order cognitive and affective control centers within the prefrontal cortex and medial temporal lobe [13] [14] [15] [16] [17] [18] [19] [20]. Researches from Wu et al. indicated that stimulation at LI4 and ST36 resulted in increases in signal intensity of the hypothalamus and nucleus accumbens, as well as decreases in the rostral part of the anterior cingulated cortex, amygdala, and hippocampus [18]. "
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