Acupuncture Mechanism for Knee Asteoarthritis
In this study, we investigated cortical thickness and
functional connectivity across longitudinal acupuncture treatments in patients
with knee osteoarthritis (OA). Over a period of four weeks (six treatments), we
collected resting state functional magnetic resonance imaging (fMRI) scans from
30 patients before their first, third and sixth treatments. Clinical outcome
showed a significantly greater Knee Injury and Osteoarthritis Outcome Score
(KOOS) pain score (improvement) with verum acupuncture compared to the sham acupuncture.
Longitudinal cortical thickness analysis showed that the cortical thickness at
left posterior medial prefrontal cortex (pMPFC) decreased significantly in the
sham group across treatment sessions as compared with verum group. Resting
state functional connectivity (rsFC) analysis using the left pMPFC as a seed
showed that after longitudinal treatments, the rsFC between the left pMPFC and
the rostral anterior cingulate cortex (rACC), medial frontal pole (mFP) and
periaquiduct grey (PAG) are significantly greater in the verum acupuncture
group as compared with the sham group. Our results suggest that acupuncture may
achieve its therapeutic effect on knee OA pain by preventing cortical thinning
and decreases in functional connectivity in major pain related areas, therefore
modulating pain in the descending pain modulatory pathway.
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