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Verum and sham acupuncture exert distinct cerebral activation in pain processing areas: a crossover fMRI investigation in healthy volunteers

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Abstract

Although acupuncture is effective for treating pain, its site-specificity is questioned. The aim was to compare the cerebral responses of needling applied to an acupuncture point to the needling of a sham point, using functional magnetic resonance imaging (fMRI). Twenty-one healthy male volunteers were enrolled. Manual stimulation of the acupuncture (ST44) and sham points on the dorsum of the left foot was applied during fMRI in a crossover manner. fMRI data analysis was performed contrasting the ST44 and the sham conditions. Stimulation intensity, subjective discrimination of the needling site and the incidence of “Qi” sensation were additionally recorded. Stimulation of ST44 acupoint, in comparison to the sham procedure, was associated with an increased fMRI-activation in the primary somatosensory, the inferior parietal and the prefrontal cortex and the posterior insula. Sham needling was associated with increased activation in the anterior cingulate cortex and the anterior insula. Verum acupuncture increased the activity of discriminative somatosensory and cognitive pain processing areas of the brain, whereas sham needling activated the areas responsible for affective processing of pain. This may explain favorable effects of verum acupuncture in clinical studies about treatment of chronic pain patients.

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Acknowledgments

The authors thank the volunteers, who took part in this investigation.

Disclosures

This study was funded from the institutional sources. Taras I. Usichenko, Toni Wesolowski & Martin Lotze declare no conflicts of interest.

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Department of Anesthesiology and Intensive Care Medicine, University Medicine of Greifswald, Fleischmannstr. 42-44, 17475, Greifswald, Germany

    Taras I. Usichenko

  2. Department of Surgery, Hospital of Luneburg, Luneburg, Germany

    Toni Wesolowski

  3. Functional Imaging Unit, Center for Diagnostic Radiology and Neuroradiology, University Medicine of Greifswald, Greifswald, Germany

    Martin Lotze

Authors
  1. Taras I. Usichenko
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  2. Toni Wesolowski
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  3. Martin Lotze
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Correspondence to Taras I. Usichenko.

Additional information

Dr. Usichenko and Mr. Wesolowski made equal contributions in conducting the investigation and writing the manuscript.

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Usichenko, T.I., Wesolowski, T. & Lotze, M. Verum and sham acupuncture exert distinct cerebral activation in pain processing areas: a crossover fMRI investigation in healthy volunteers. Brain Imaging and Behavior 9, 236–244 (2015). https://doi.org/10.1007/s11682-014-9301-4

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  • DOI: https://doi.org/10.1007/s11682-014-9301-4

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