Acupuncture-evoked
response in somatosensory and prefrontal cortices predicts immediate pain
reduction in carpal tunnel syndrome
The
linkage between brain response to acupuncture and subsequent analgesia remains
poorly understood. Our aim was to evaluate this linkage in chronic pain
patients with carpal tunnel syndrome (CTS). Brain response to
electroacupuncture (EA) was evaluated with functional MRI. Subjects were
randomized to 3 groups: (1) EA applied at local acupoints on the affected wrist
(PC-7 to TW-5), (2) EA at distal acupoints (contralateral ankle, SP-6 to LV-4),
and (3) sham EA at nonacupoint locations on the affected wrist. Symptom ratings
were evaluated prior to and following the scan. Subjects in the local and
distal groups reported reduced pain. Verum EA produced greater reduction of
paresthesia compared to sham. Compared to sham EA, local EA produced greater
activation in insula and S2 and greater deactivation in ipsilateral S1, while
distal EA produced greater activation in S2 and deactivation in posterior
cingulate cortex. Brain response to distal EA in prefrontal cortex (PFC) and
brain response to verum EA in S1, SMA, and PFC were correlated with pain
reduction following stimulation. Thus, while greater activation to verum
acupuncture in these regions may predict subsequent analgesia, PFC activation
may specifically mediate reduced pain when stimulating distal acupoints.
Source:
http://www.ncbi.nlm.nih.gov/pubmed/23843881
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