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Mol Pain. 2015 Oct 29;11:67. doi: 10.1186/s12990-015-0071-9.

The modulation effect of longitudinal acupuncture on resting state functional connectivity in knee osteoarthritis patients.

Author information

1
Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA. peaceinheavenhelen@gmail.com.
2
Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA. rosa.babbitt.spaeth@gmail.com.
3
Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA. sgfreeman@gmail.com.
4
Mass General Orthopaedics Sports Performance Center, Massachusetts General Hospital, Foxborough, MA, USA. DSCARBOROUGH@mgh.harvard.edu.
5
Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA. Javeria.Hashmi@dal.ca.
6
Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA. wey@nmr.mgh.harvard.edu.
7
Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA. NEGOROVA2@mgh.harvard.edu.
8
MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, 120, 2nd Ave. Suite 101, Charlestown, MA, 02129, USA. vangel@nmr.mgh.harvard.edu.
9
Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA. vangel@nmr.mgh.harvard.edu.
10
Departments of Anesthesiology, Massachusetts General Hospital, Charlestown, MA, USA. JMAO@mgh.harvard.edu.
11
Departments of Anesthesiology and Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. AWASAN@partners.org.
12
Departments of Anesthesiology, Perioperative, and Pain Medicine, and Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. RREDWARDS@partners.org.
13
Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA. RGOLLUB@partners.org.
14
MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, 120, 2nd Ave. Suite 101, Charlestown, MA, 02129, USA. RGOLLUB@partners.org.
15
Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA. kongj@nmr.mgh.harvard.edu.
16
MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, 120, 2nd Ave. Suite 101, Charlestown, MA, 02129, USA. kongj@nmr.mgh.harvard.edu.

Abstract

Recent advances in brain imaging have contributed to our understanding of the neural activity associated with acupuncture treatment. In this study, we investigated functional connectivity across longitudinal acupuncture treatments in older patients with knee osteoarthritis (OA). Over a period of 4 weeks (six treatments), we collected resting state functional magnetic resonance imaging (fMRI) scans from 30 patients before and after their first, third and sixth treatments. Clinical outcome showed a significantly greater pain subscore on the Knee Injury and Osteoarthritis Outcome Score (KOOS) (indicative of improvement) with verum acupuncture than with sham acupuncture. Independent component analysis (ICA) of the resting state fMRI data showed that the right frontoparietal network (rFPN) and the executive control network (ECN) showed enhanced functional connectivity (FC) with the rostral anterior cingulate cortex/medial prefrontal cortex, a key region in the descending pain modulatory system, in the verum groups as compared to the sham group after treatments. We also found that the rFPN connectivity with the left insula is (1) significantly associated with changes in KOOS pain score after treatments, and (2) significantly enhanced after verum acupuncture treatments as compared to sham treatment. Analysis of the acupuncture needle stimulation scan showed that compared with sham treatment, verum acupuncture activated the left operculum/insula, which also overlaps with findings observed in resting state analysis. Our results suggest that acupuncture may achieve its therapeutic effect on knee OA pain by modulating functional connectivity between the rFPN, ECN and the descending pain modulatory pathway.

CLINICAL TRIAL NUMBER:

NCT01079390.

PMID:
26511911
PMCID:
PMC4625557
DOI:
10.1186/s12990-015-0071-9
[Indexed for MEDLINE]
Free PMC Article

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