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Mechanistic and thermal characterization of acupuncture for chemotherapy-induced peripheral neuropathy as measured by quantitative sensory testing

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Abstract

Purpose

Chemotherapy-induced peripheral neuropathy (CIPN) is a common and debilitating side effect of chemotherapy. Acupuncture is a promising non-pharmacological intervention for CIPN. However, the physiological effects of acupuncture treatment remain poorly understood. We examined the effects of acupuncture on CIPN using semi-objective quantitative sensory testing (QST).

Methods

We conducted a randomized controlled trial of real acupuncture (RA) and sham acupuncture (SA) compared to usual care (UC) in cancer survivors with moderate-to-severe CIPN. Treatment response was assessed with QST measures of tactile and vibration detection thresholds in hands and feet, thermal detection, and pain thresholds at weeks 0, 8, and 12. Constrained linear mixed model (cLMM) regression was used for statistical analysis.

Results

63 patients completed QST testing. At week 8, vibrational detection thresholds in feet were significantly lower in RA and SA (p = 0.019 and p = 0.046) than in UC, with no difference between RA and SA (p = 0.637). Both RA and SA also showed significantly higher cool thermal detection than UC (p = 0.008 and p = 0.013, respectively), with no difference between RA and SA (p = 0.790). No differences in tactile detection, vibrational detection in hands, warm thermal detection, and thermal pain thresholds were detected among the three arms at weeks 8 and 12.

Conclusion

QST demonstrated different patterns in RA, SA, and UC. After eight weeks of RA, we observed significant improvements in the vibrational detection threshold in feet and cool thermal detection threshold in hands compared to UC. No significant differences were seen when compared to SA.

Trial Registration: ClinicalTrials.gov (NCT03183037); June 9, 2017.

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Data availability

The data underlying this article will be shared on reasonable request to the corresponding author.

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Acknowledgements

The authors would like to extend their gratitude to Patricia Chen for her assistance in conducting this study. The authors would also like to thank all the cancer survivors in the study for their participation.

Funding

This work was supported in part by the National Institutes of Health/National Cancer Institute Cancer Center Support Grant (grant number P30 CA008748), the Translational and Integrative Medicine Research Fund at Memorial Sloan Kettering Cancer Center, and the Frueauff Foundation. The funding sources were not involved in the study design; collection, analysis, and interpretation of the data; writing of the report; or decision to submit the article for publication. Ting Bao is supported by the National Cancer Institute (grant numbers R37CA248563, R01CA240417, R01CA251470). W. Iris Zhi is supported by the Gateway for Cancer Research (grant number G-22-1200).

Author information

Authors and Affiliations

  1. Breast Medicine Service, Department of Medicine, Solid Tumor Division, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    W. Iris Zhi

  2. Department of Epidemiology and Biostatistics, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Raymond E. Baser

  3. Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Dristi Talukder & Ting Bao

  4. Barnard College, Columbia University, New York, NY, USA

    Ying Zi Mei

  5. Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA

    Steven E. Harte

  6. Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 321 East 61st Street, Room 458, New York, NY, 10065, USA

    Ting Bao

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  1. W. Iris Zhi
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Contributions

WIZ and TB contributed to conceptualization/design. TB contributed to provision of study material or patients. DT and YZM contributed to collection and/or assembly of data. WIZ, REB, and TB contributed to data analysis and interpretation. WIZ, REB, DT, YZM, AK, SEH, and TB contributed to manuscript writing. WIZ, REB, DT, YZM, SEH, and TB contributed to final approval of manuscript.

Corresponding author

Correspondence to Ting Bao.

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Conflict of interest

We certify that there are no affiliations with or involvement in any organization or entity with any financial interest or other equity interests or non-financial interests that influenced the design, outcome, and submission of this study.

Ethical approval

This study was approved by Memorial Sloan Kettering’s Institutional Review Board and the clinical trial was registered at ClinicalTrials.gov (NCT03183037). All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Zhi, W.I., Baser, R.E., Talukder, D. et al. Mechanistic and thermal characterization of acupuncture for chemotherapy-induced peripheral neuropathy as measured by quantitative sensory testing. Breast Cancer Res Treat 197, 535–545 (2023). https://doi.org/10.1007/s10549-022-06846-3

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  • DOI: https://doi.org/10.1007/s10549-022-06846-3

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