The neural substrates of verum acupuncture compared to non-penetrating placebo needle: an fMRI study. Neurosci Lett 450:80-4
Acupuncture & Meridian Science Research Center, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul 130-701, Republic of Korea. Neuroscience Letters
(Impact Factor: 2.03).
12/2008; 450(2):80-4. DOI: 10.1016/j.neulet.2008.11.048
Acupuncture, an ancient East Asian therapeutic technique, is currently emerging as an important modality in complementary and alternative medicine around the world. Several studies have provided useful information regarding neurophysiological mechanisms of acupuncture in human brain activation. We explored brain activation using functional magnetic resonance imaging (fMRI) and compared verum acupuncture to placebo needles. Two fMRI scans were taken in random order in a block design, one for verum acupuncture and one for non-penetrating placebo needles at the motor function-implicated acupoint LR2, on the left foot, in 10 healthy volunteers. We calculated the contrast that subtracted the blood oxygen level-dependent (BOLD) responses between the verum and sham acupuncture. Verum acupuncture stimulation elicited significant activation in both motor function-related brain areas, including the caudate, claustrum, and cerebellum, and limbic-related structures, such as the medial frontal gyrus, the cingulate gyrus, and the fusiform gyrus. These findings suggest that acupuncture not only elicited acupoint-implicated brain activation, but also modulated the affective components of the pain matrix. The current investigation of the specific pattern of the brain activation related to genuine acupuncture provides new information regarding the neurobiological basis of acupuncture.
Available from: Peggy Margaretha, Petronella, Carolina Bosch
- "To measure the effects of acupuncture with fMRI, studies have been conducted on healthy participants [12–15], indicating that each acupoint has its own specific effect, and on patients with diseases, showing that acupuncture is able to improve the symptoms of patients [16–18]. However, to our knowledge, there has so far been no fMRI study that directly measures and compares brain activity in response to acupuncture stimulating manipulation in healthy participants to those of patients with Parkinson’s disease (PD). "
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ABSTRACT: Acupuncture is increasingly used as an additional treatment for patients with Parkinson’s disease (PD).
In this functional magnetic resonance imaging study, brain activation in response to acupuncture in a group of 12 patients with PD was compared with a group of 12 healthy participants. Acupuncture was conducted on a specific acupoint, the right GB 34 (Yanglingquan), which is a frequently used acupoint for motor function treatment in the oriental medical field.
Acupuncture stimulation on this acupoint activates the prefrontal cortex, precentral gyrus, and putamen in patients with PD; areas that are known to be impaired in patients with PD. Compared with healthy participants, patients with PD showed significantly higher brain activity in the prefrontal cortex and precentral gyrus, especially visible in the left hemisphere.
The neuroimaging results of our study suggest that in future acupuncture research; the prefrontal cortex as well as the precentral gyrus should be treated for symptoms of Parkinson’s disease and that GB 34 seems to be a suitable acupoint. Moreover, acupuncture evoked different brain activations in patients with Parkinson’s disease than in healthy participants in our study, stressing the importance of conducting acupuncture studies on both healthy participants as well as patients within the same study, in order to detect acupuncture efficacy.
KCT0001122 at cris.nih.go.kr (registration date: 20140530)
Available from: Carolyn Ee
- "The needle and base unit is collectively referred to as the Park Sham Device (see Figure 2). This sham needle has been validated in both acupuncture-naïve and acupuncture-experienced participants, and in healthy volunteers and patients [41,43,44,55,58]. It has been demonstrated to be less likely to induce de qi or the specific needling sensation than a true acupuncture needle . "
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Hot flushes and night sweats (vasomotor symptoms) are common menopausal symptoms, often causing distress, sleep deprivation and reduced quality of life. Although hormone replacement therapy is an effective treatment, there are concerns about serious adverse events. Non-hormonal pharmacological therapies are less effective and can also cause adverse effects. Complementary therapies, including acupuncture, are commonly used for menopausal vasomotor symptoms. While the evidence for the effectiveness of acupuncture in treating vasomotor symptoms is inconclusive, acupuncture has a low risk of adverse effects, and two small studies suggest it may be more effective than non-insertive sham acupuncture. Our objective is to assess the efficacy of needle acupuncture in improving hot flush severity and frequency in menopausal women. Our current study design is informed by methods tested in a pilot study.
This is a stratified, parallel, randomised sham-controlled trial with equal allocation of participants to two trial groups. We are recruiting 360 menopausal women experiencing a minimum average of seven moderate hot flushes a day over a seven-day period and who meet diagnostic criteria for the Traditional Chinese Medicine diagnosis of Kidney Yin deficiency. Exclusion criteria include breast cancer, surgical menopause, and current hormone replacement therapy use. Eligible women are randomised to receive either true needle acupuncture or sham acupuncture with non-insertive (blunt) needles for ten treatments over eight weeks. Participants are blinded to treatment allocation. Interventions are provided by Chinese medicine acupuncturists who have received specific training on trial procedures. The primary outcome measure is hot flush score, assessed using the validated Hot Flush Diary. Secondary outcome measures include health-related quality of life, anxiety and depression symptoms, credibility of the sham treatment, expectancy and beliefs about acupuncture, and adverse events. Participants will be analysed in the groups in which they were randomised using an intention-to-treat analysis strategy.
Results from this trial will significantly add to the current body of evidence on the role of acupuncture for vasomotor symptoms. If found to be effective and safe, acupuncture will be a valuable additional treatment option for women who experience menopausal vasomotor symptoms.
Australian New Zealand Clinical Trials Registry ACTRN12611000393954 11/02/2009.
Available from: PubMed Central
- "Since the original validation studies, the Park device has been used in several acupuncture RCTs as a placebo acupuncture control [31–34]. For instance, in one RCT , the authors compared the efficacy of verum acupuncture (56 stroke patients) and the Park device (60 stroke patients) and they found that verum acupuncture was not superior to placebo treatment in terms of improvements in health-related quality of life after suffering a stroke. "
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ABSTRACT: Determining an appropriate control for use in acupuncture research remains one of the largest methodological challenges acupuncture researchers face. In general, acupuncture controls fall under one of two categories: (1) sham acupuncture, in which the skin is punctured with real acupuncture needles either fully at nonacupoint locations or shallowly at acupoint locations or both and (2) placebo acupuncture, which utilizes nonpenetrating acupuncture devices. In this study, we will focus on non-penetrating placebo acupuncture devices (blunted-needle and nonneedle devices) that are currently available in acupuncture research. We will describe each device and discuss each device's validation and application in previous studies. In addition, we will outline the advantages and disadvantages of these devices and highlight how the differences among placebo devices can be used to isolate distinct components of acupuncture treatment and investigate their effects. We would like to emphasize that there is no single placebo device that can serve as the best control for all acupuncture studies; the choice of an acupuncture control should be determined by the specific aim of the study.
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