Abstract
BackgroundAcupuncture has analgesic effect to most pain conditions. Many neuroimaging studies were conducted to explore acupoint specificity in pain and other condition, but till now there is still discrepancy. Based on our previous finding, this study investigated the brain metabolism changes of acupuncture analgesia induced by sub-specific acupoint and non-acupoint stimulation.Methods30 migraineurs were included and randomly assigned to 3 groups: Acupuncture Group (AG), Sham Acupuncture Group (SAG) and Migraine Group (MG). In AG, a combination sub-specific points of Shaoyang meridians, Luxi (TE19), San Yangluo (TE8), and Xi Yangguan(GB33) has been stimulated with electroacupuncture, while non-acupoints for SAG were used and MG received no treatment. Positron emission tomography with computed tomography (PET-CT) was used to identify differences in brain glucose metabolism between groups.ResultsIn the AG, brain glucose metabolism increase compared with the MG was observed in the middle frontal gyrus, postcentral gyrus, the precuneus, parahippocampus, cerebellum and middle cingulate cortex (MCC), and decrease were observed in the left hemisphere of Middle Temporal Cortex (MTC).In the SAG, compared with MG, glucose metabolism increased in the poster cingulate cortex (PCC), insula, inferior temporal gyrus, MTC, superior temporal gyrus, postcentral gyrus, fusiform, inferior parietal lobe, superior parietal lobe, supramarginal gyrus, middle occipital lobe, angular and precuneus; while, decreased in cerebellum, parahippocampus.ConclusionsAcupuncture stimulation at both sub-specific acupoint and non-acupoint yields ameliorating effect to migraine pain, but with evidently differed central mechanism as measured by PET-CT. The pattern of brain glucose metabolism change in acupoint is pertinent and targeted, while in non-acupoint that was disordered and randomized. These finding may provide new perspectives into the validation of acupoint specificity, optimizing acupuncture analgesia and revealing central mechanism of acupuncture analgesia by neuroimaging measurement.Trial registrationThis trial was registered in the Chinese Clinical Trial Registry, with registration no. ChiCTR-TRC-11001813.
Highlights
Acupuncture has analgesic effect to most pain conditions
Exclusion criteria Patients were excluded if any one of the following exclusion criterion was matched: (1) headaches that were secondary to organic disorders other than migraine, such as cerebropathy, vascular malformation, hypertension, or arteriosclerosis; (2) other conditions like psychosis, bleeding disorders, or allergies; (3) other pain conditions that may contaminate the nociceptive sensation of migraine; (4) included in other study; (5) pregnancy or lactating, or participants considering to conceive in the following 6 months; (6) medication with vasoactive agent in the last two weeks; (7) with emotional disorders such as major anxiety disorder and/or depression; and (8) presence of any contraindications to Positron emission tomography with computed tomography (PET-CT) or electroacupuncture
Effect of acupuncture on pain The pain intensity measured by Visual Analogue Scale (VAS) was significantly reduced in the Acupuncture Group (AG) (P < 0.05) and Sham Acupuncture Group (SAG) (P < 0.05) after acupuncture treatment compared with baseline
Summary
Acupuncture has analgesic effect to most pain conditions. Many neuroimaging studies were conducted to explore acupoint specificity in pain and other condition, but till there is still discrepancy. Based on our previous finding, this study investigated the brain metabolism changes of acupuncture analgesia induced by sub-specific acupoint and non-acupoint stimulation. Doctors and patients in West countries usually employ acupuncture as adjunct to conventional drugs for a wide spectrum of pain conditions. Though it was dominantly mediated by 5-HT and endogenous opioid system, the mechanism of acupuncture analgesia remains to be elucidated. In the long history of clinical practice, traditional acupuncture formed its therapeutic principles, and the experience of acupuncturists successively enriched the fruitfulness of acupuncture theories. Well-defined acupoints selection principles for practitioners to consider in clinical situation were developed and utilized under the umbrella of the existence of acupoint specificity. That it raised questions and doubts to the existence of acupoint specificity [6]
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