Abstract

Although acupuncture is an effective therapeutic intervention for pain reduction, the exact difference between real and sham acupuncture has not been clearly understood because a somatosensory tactile component is commonly included in the existing sham acupuncture protocols. In an event-related fMRI experiment, we implemented a novel form of sham acupuncture, phantom acupuncture, that reproduces the acupuncture needling procedure without somatosensory tactile stimulation while maintaining the credibility of the acupuncture treatment context. Fifty-six non-specific low back pain patients received either real (REAL) or phantom (PHNT) acupuncture stimulation in a parallel group study. The REAL group exhibited greater activation in the posterior insula and anterior cingulate cortex, reflecting the needling-specific components of acupuncture. We demonstrated that PHNT could be delivered credibly. Interestingly, the PHNT-credible group exhibited bilateral activation in SI/SII and also reported vicarious acupuncture sensations without needling stimulation. The PHNT group showed greater activation in the bilateral dorsolateral/ventrolateral prefrontal cortex (dlPFC/vlPFC). Moreover, the PHNT group exhibited significant pain reduction, with a significant correlation between the subjective fMRI signal in the right dlPFC/vlPFC and a score assessing belief in acupuncture effectiveness. These results support an expectation-related placebo analgesic effect on subjective pain intensity ratings, possibly mediated by right prefrontal cortex activity.

Details

Title
Phantom Acupuncture Induces Placebo Credibility and Vicarious Sensations: A Parallel fMRI Study of Low Back Pain Patients
Author
Makary, Meena M 1 ; Lee, Jeungchan 2 ; Lee, Eunyoung 3 ; Seulgi Eun 4 ; Kim, Jieun 3 ; Geon-Ho Jahng 5 ; Kim, Kiok 6 ; You-Suk Youn 6 ; Jun-Hwan, Lee 7 ; Park, Kyungmo 4 

 Systems and Biomedical Engineering Department, Faculty of Engineering, Cairo University, Giza, Egypt; Department of Biomedical Engineering, Kyung Hee University, Yongin, Republic of Korea; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; The John B. Pierce Laboratory, New Haven, CT, USA 
 Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA 
 Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea 
 Department of Biomedical Engineering, Kyung Hee University, Yongin, Republic of Korea 
 Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea 
 Department of Spine Center, Mokhuri Neck & Back Hospital, Seoul, Republic of Korea 
 Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea; Korean Medicine Life Science, University of Science & Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon, Republic of Korea 
Pages
1-22
Publication year
2018
Publication date
Jan 2018
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
1988511993
Copyright
© 2018. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.