Acupuncture Works by ‘Re-Wiring’ the Brain, Evidence Suggests

By Vitaly Napadow | October 6, 2017 11:13 am
shutterstock_512664499

(Credit: Shutterstock)

Acupuncture is a form of traditional medical therapy that originated in China several thousand years ago. It was developed at a time bereft of tools such as genetic testing or even a modern understanding of anatomy, so medical philosophers did the best they could with what was available – herbs, animal products and rudimentary needles. In the process, perhaps, they stumbled on an effective medical approach.

In the past century, some modernization has taken place. For instance, acupuncture has been paired with electrical currents, allowing for stimulation to be more continuous and to penetrate deeper into the body. This approach was termed electro-acupuncture and represents a convergence between the ancient practice of acupuncture therapy and modern forays into targeted electrostimulation delivered to the skin or nerves. Such approaches have attracted the attention of the pharmaceutical industry and are part of a growing class of neuromodulatory therapies.

So why all the rancour against acupuncture from some corners of the internet (and academia)? Shouldn’t we apply our modern research methods to see which classical acupuncture techniques have solid physiological backing?

It’s not as easy as it seems. Let’s look at the clinical research. A recent landmark meta-analysis threw together data from thousands of chronic-pain patients enrolled in prior clinical trials, finding that acupuncture might be just marginally better than sham acupuncture (in which non-inserted needles are used as a placebo control). The differences were statistically significant, but lack of a larger difference could be due to the clinical outcome measure that the researchers studied. Symptoms such as pain (along with fatigue, nausea and itch) are notoriously difficult for different people to rate in a consistent manner. Conventional wisdom says that these kinds of symptoms are improved by placebo, but what about improvements in the body’s physiology? For instance, in a recent study that assigned an albuterol inhaler for asthma to some patients and sham acupuncture to others, patients reported both as effective. But objective physiological measures demonstrated significant improvement only for albuterol. It’s clear that in evaluations of acupuncture, research should explicitly hunt for potential physiological improvements, in addition to patient reports.

While most chronic-pain disorders lack such established, objective outcomes of disease, this is not true for carpal tunnel syndrome (CTS), a neuropathic pain disorder that can be validated by measuring electrical conduction across the median nerve, which passes through the wrist. Interestingly, the slowing of nerve conduction at the wrist does not occur in isolation – it’s not just the nerve in the wrist that’s affected in CTS. My own department’s research and others’ has clearly demonstrated that the brain, and particularly a part of the brain called the primary somatosensory cortex (S1), is re-mapped by CTS. Specifically, in functional magnetic resonance imaging (fMRI) brain scans, the representation of fingers innervated by the median nerve are blurred in S1. We then showed that both real and placebo acupuncture improved CTS symptoms. Does this mean that acupuncture is a placebo? Maybe not. While symptom relief was the same immediately following therapy, real acupuncture was linked to long-term improvement while sham acupuncture was not. And better S1 re-mapping immediately following therapy was linked with better long-term symptom reduction. Thus, sham acupuncture might work through an alternative route, by modulating known placebo circuitry in the brain, while real acupuncture rewires brain regions such as S1, along with modulating local blood flow to the median nerve in the wrist.

Where you stick the needle might matter as well. While site-specificity is one of the key features of acupuncture therapy, it has been controversial. Interestingly, in the S1 region of the brain, different body areas are represented in different spatial areas – this is how we localize the mosquito that’s biting us, and swat it. Different S1 areas might also pass along information to a diverse set of other areas that affect different bodily systems such as the immune, autonomic and other internal motor systems. As far as acupuncture is concerned, the body-specific map in S1 could serve as the basis for a crude form of point specificity. In our study, we compared patients receiving real acupuncture locally to the wrist with patients receiving real acupuncture far from the wrist, in the opposite ankle. Our results suggested that both local and distal acupuncture improved median nerve function at the wrist. This suggests that the brain changes resulting from acupuncture might not just be a reflection of changes at the wrist, but could also drive the improved median nerve function directly by linking to autonomic brain regions that control blood vessel diameter and blood flow to the median nerve.

This new research clearly demonstrates that bodily response is not the only means by which acupuncture works; response within the brain might be the most critical part. Once we better understand how acupuncture works to relieve pain, we can optimize this therapy to provide effective, non-pharmacological care for many more chronic-pain patients.Aeon counter – do not remove

 

This article was originally published at Aeon and has been republished under Creative Commons.

CATEGORIZED UNDER: Health & Medicine, Top Posts
ADVERTISEMENT
  • OWilson

    The Placebo Effect is the most influential factor in whether some borderline remedies are effective.

    I book written years ago, Dr. Hamilton’s Back Book, had a huge influence on me.

    In it, the good doctor, explained that the human body itself goes to work to heal most non life threatening maladies in about 6 weeks, if no complications.

    He says whatever you are being prescribed at the moment that you feel relief, will be forever ingrained in you, as “The Solution”,

    A pleasant doctor, certain pills, chiropractic, acupuncture, massage, hot compresses or cold compresses, bed rest, or physical activity all have their devoted followers if you ask folks how they get relief from common ailments.

    My own placebo effect is knowing that staying away from doctors, pills, hospitals and “annual check ups” as much as possible, has provided me with a long, healthy and happy life!

    • Adam Lowe

      However, the week after, OWilson was struck down by undiagnosed testicular cancer…

      • OWilson

        Too late!

        I already had a long happy and healthy life, full of good friends, family and co-workers.

        Your “week after”, I will be playing golf with the young ones, vying for our Golf Trophy.

        When it’s time, I’ll be ready, with no complaints.

        But thanks for your good wishes anyway!

        • Tammy A. Brown

          Do you find yourself fed up from nine to 5 responsibility? Trying to find an opportunity to work from home by doing very simple work by using your personal computer and also internet and actually want to get paid full-time revenue of $500 to $1000 every week? I have been focusing on this awesome opporutinity since four years and working merely four-five hours each day and five days in a single week and earning potential here is quite high and also you get the results of your tasks you are doing right now in coming days also. So in general it really is a tremendous project to work on and even that’s too from convenience of your home. What you need is personal pc and a fast internet access and you are ready to proceed. I suggest you to not to waste your time and check out all the details immediately… BINB.OOO/XUBAD

        • Humberto Da Silva Lourenço

          I think the same about health. And I’ve loved your answer! Best wishes, friend!

          • OWilson

            Thanks!

            I actually saw this drug ad a half hour ago.

            “You take something for your …….., you take something for your ……., why not take something for your brain?” – Prevegen.

          • Maia

            Still shocking to me that it’s even legal to advertise Rx drugs!!

          • OWilson

            Folks have only one life, one body, and they want to optimize and maximize it.

            The drug, supplement. and cosmetic industry supplies the need, (and often creates it!)

    • Barliman

      So I daresay that Dr Hamilton of “the Back Book” has an awesome placebo effect- because he empowered to embrace the healing potential of your body.

      I dont think that most people are simple enough to believe that their last treatment was “the solution” though.

      Acupuncture is far from a marginal therapy though, and the infrastructure of TCM in China is amazing.

      • OWilson

        Folks are indeed simple. They demand their drugs for every occasion, and doctors are happy to send them home happy. Then perhaps another drug to mitigate side effects.

        Prescription drugs are advertised on TV more than breakfast cereals. Drug dependency is rife in today’s society.

        The last time I was in a doctor’s office, I had broken an arm. They wrapped it to keep it from moving, but 6 weeks later my body alone had healed it. As good as new!

        That was mechanics, not medicine!

    • stluyjuy

      I have had acupuncture treatment, by a ‘real acupuncture doctor, not some 6 week wonder chiropractor, and it works unbelievably well. It does more than any PT or Osteopath that I have ever gone to.

  • Debbie Cottrell

    Electro acupuncture is not acupuncture at all. The term has been hijacked by TCM practitioners to lend credibility to a pseudoscience that requires belief in meridians and qi. As a veterinarian, I see this all the time in the horse world. Electroacupuncture is electrical stimulation of known nerves in known areas associated by known stimuli. TCM acupuncture claims to cure colic by sticking needles into a horse’s front leg. There is no similarity.

    • mimi

      Actual acupuncture points are never on nerves (or on vessels), they are in connective tissue, or fascia. You’re not wrong that the electricity has something to do with the effect – you can “find” most traditional acupuncture point locations with machines that measure resistance over the skin (high conductivity) – rf. the book ‘The Body Electric’ by Becker, orthopedic surgeon. But overall it’s not simple nerve stimulation.

      • Barliman

        It seems that most of the points are perforations in myofascial planes that allow the passage of an arteriole, a venule, and a sympathetic nerve ending. The myofascial planes are anatomically very close to the acupuncture meridians.
        The other point is that an active point is usually tender- and that probably represents traction on that myofascial plane, traction that may be affected by pain elsewhere.

NEW ON DISCOVER
OPEN
CITIZEN SCIENCE
ADVERTISEMENT

The Crux

A collection of bright and big ideas about timely and important science from a community of experts.
ADVERTISEMENT

See More

ADVERTISEMENT

Discover's Newsletter

Sign up to get the latest science news delivered weekly right to your inbox!

Collapse bottom bar
+