{"id":221572,"date":"2017-03-02T07:46:51","date_gmt":"2017-03-02T12:46:51","guid":{"rendered":"https:\/\/news.harvard.edu\/gazette\/?p=221572"},"modified":"2017-03-05T14:16:09","modified_gmt":"2017-03-05T19:16:09","slug":"study-reveals-differences-in-the-effects-of-real-and-sham-acupuncture","status":"publish","type":"post","link":"https:\/\/news.harvard.edu\/gazette\/story\/2017\/03\/study-reveals-differences-in-the-effects-of-real-and-sham-acupuncture\/","title":{"rendered":"Study shows differences in effects of \u2018real\u2019 and \u2018sham\u2019 acupuncture\u00a0"},"content":{"rendered":"<header\n\tclass=\"wp-block-harvard-gazette-article-header alignfull article-header is-style-square has-light-background has-colored-heading\"\n\tstyle=\" \"\n>\n\t\n\t<div class=\"article-header__content\">\n\t\t\t<a\n\t\t\tclass=\"article-header__category\"\n\t\t\thref=\"https:\/\/news.harvard.edu\/gazette\/section\/health\/\"\n\t\t>\n\t\t\tHealth\t\t<\/a>\n\t\t\n\t\t<h1 class=\"article-header__title wp-block-heading \">\n\t\tStudy shows differences in effects of \u2018real\u2019 and \u2018sham\u2019 acupuncture\u00a0\t<\/h1>\n\n\t\n\t\n\t<div class=\"article-header__meta\">\n\t\t<div class=\"wp-block-post-author\">\n\t\t\t<address class=\"wp-block-post-author__content\">\n\t\t\t\t\t<p class=\"author wp-block-post-author__name\">\n\t\tGary Boas\t<\/p>\n\t\t\t<p class=\"wp-block-post-author__byline\">\n\t\t\tMartinos Center Communications\t\t<\/p>\n\t\t\t\t\t<\/address>\n\t\t<\/div>\n\n\t\t<time class=\"article-header__date\" datetime=\"2017-03-02\">\n\t\t\tMarch 2, 2017\t\t<\/time>\n\n\t\t<span class=\"article-header__reading-time\">\n\t\t\t4 min read\t\t<\/span>\n\t<\/div>\n\n\t\t\t<\/div>\n\t\t\n\t\t\t<h2 class=\"article-header__subheading wp-block-heading\">\n\t\t\tAcupuncture improves outcomes in carpal tunnel syndrome in part by remapping the brain\t\t<\/h2>\n\t\t\n<\/header>\n\n\n\n<div class=\"wp-block-group alignwide has-global-padding is-content-justification-center is-layout-constrained wp-block-group-is-layout-constrained\">\n\n\n\t\t<p>The practice of acupuncture predates current understanding of physiology by several millennia, and modern studies have found it often provides measureable improvements in health outcomes, particularly in the area of chronic pain. Now, in a <a href=\"https:\/\/academic.oup.com\/brain\/article-abstract\/doi\/10.1093\/brain\/awx015\/3058778\/Rewiring-the-primary-somatosensory-cortex-in\">study reported in the journal Brain<\/a>, a team of investigators based at the Athinoula A. Martinos Center for Biomedical Imaging at Massachusetts General Hospital (MGH) sheds new light on the question of how.<\/p>\n<p>\u201cAcupuncture is a medical therapy that originated in China several thousand years ago,\u201d said Vitaly Napadow, director of the Center for Integrative Pain Neuroimaging at the Martinos Center and senior author of the Brain paper. \u201cBut despite its long history, the intervention itself \u2014 particularly when coupled with electrical stimulation \u2014 has significant similarities to many conventional therapies, such as transcutaneous electrical nerve stimulation (TENS). A large body of clinical research exploring acupuncture for chronic pain disorders has demonstrated that it may be marginally better than a placebo procedure in reducing pain ratings. But questions still remain: How exactly does acupuncture work? Is it any better at improving objective outcomes for chronic pain?\u201d<\/p>\n<p>To get to the root of these questions, Napadow and colleagues performed a sham controlled acupuncture neuroimaging study of carpal tunnel syndrome (CTS), a neuropathic pain disorder. Few chronic pain disorders have established biomarkers or measureable treatment outcomes. However, in CTS, measurements taken at the wrist of the speed at which signals are transmitted along the median nerve are a well-known and accepted biomarker. In addition, studies by Napadow and others have shown that the brain \u2014 particularly the primary somatosensory cortex, which receives signals related to the sense of touch \u2014 is remapped in CTS. Specifically, brain cells that usually respond to touch signals from specific fingers start to respond to signals from multiple fingers, which\u00a0provides another measureable outcome.<\/p>\n<p>Using functional magnetic resonance imaging (fMRI) taken before and after several months of therapy in three different groups of CTS patients \u2014 one receiving electro-acupuncture at the affected hand, one receiving electro-acupuncture at the ankle opposite the affected hand, and the other receiving sham electro-acupuncture with placebo needles near the affected hand \u2014 the researchers found that both real and sham acupuncture improved patient-reported CTS symptoms. However, there were notable differences in physiologic measures. Real acupuncture at the affected hand led to measurable improvements in outcomes both at the affected wrist and in the brain, while acupuncture at the opposite ankle produced improvement at the wrist only. Brain remapping immediately after real acupuncture was linked to long-term improvement in CTS symptoms. No physiologic improvements resulted from sham acupuncture.<\/p>\n<p>Even after years of clinical research, controversy continues as to whether acupuncture works primarily by the placebo effect, especially given the slight differences between the efficacy of real and sham acupuncture. The findings of the Brain study help address this question. Sham acupuncture may produce a stronger placebo effect than a pill because it sends inputs to the brain via skin receptors and is coupled with a specific ritual. But the symptom improvement produced by sham treatment for conditions like CTS also might derive from entirely different mechanisms than those elicited by real acupuncture, the mechanisms of which may more specifically target CTS pathophysiology.<\/p>\n<p>\u201cSham acupuncture may \u2018work\u2019 by modulating known placebo circuitry in the brain,\u201d said Napadow, who is an associate professor in radiology at Harvard Medical School. \u201cIn contrast, real acupuncture may improve CTS symptoms by rewiring the primary somatosensory cortex, in addition to modulating local blood flow to the peripheral nerve in the wrist. In other words, both peripheral and central neurophysiological changes in CTS may be halted or even reversed by electro-acupuncture interventions that provide more prolonged and regulated input to the brain \u2014 something that future, longer-term neuroimaging studies should explore.\u201d<\/p>\n<p>Napadow and colleagues plan to follow up the Brain study with further research linking objective\/physiological and subjective\/psychological outcomes for acupuncture-produced pain relief. Better understanding of how acupuncture works to relieve pain ultimately will enable them and others to optimize the therapy to provide effective, non-pharmacological care for chronic pain patients.<\/p>\n<p>Yumi Maeda and Hyungjun Kim of the Martinos Center are co-lead authors of the Brain paper. The study was supported by grants from the National Center for Complementary and Integrative Health, the Korea Institute of Oriental Medicine, and the National Center for Research Resources.<\/p>\n\n\n<\/div>\n\n\t\t","protected":false},"excerpt":{"rendered":"<p>Researchers saw improvement in carpal tunnel syndrome symptoms after \u201creal\u201d acupuncture and brain remapping. The study also found no physiologic improvements from \u201csham\u201d acupuncture.<\/p>\n","protected":false},"author":105622744,"featured_media":221588,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"gz_ga_pageviews":110,"gz_ga_lastupdated":"2022-05-16 11:39","document_color_palette":null,"author":"Gary Boas","affiliation":"Martinos Center Communications","_category_override":"","_yoast_wpseo_primary_category":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[39644],"tags":[2946,37914,37913,7274,37915,37916],"gazette-formats":[],"series":[],"class_list":["post-221572","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health","tag-acupuncture","tag-athinoula-a-martinos-center-for-biomedical-imaging-at-massachusetts-general-hospital","tag-brain-remapping","tag-carpal-tunnel-syndrome","tag-center-for-integrative-pain-neuroimaging-at-the-martinos-center","tag-vitaly-napadow"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v23.0 (Yoast SEO v27.1.1) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Study shows differences in effects of \u2018real\u2019 and \u2018sham\u2019 acupuncture\u00a0 &#8212; Harvard Gazette<\/title>\n<meta name=\"description\" content=\"Researchers saw improvement in carpal tunnel syndrome symptoms after \u201creal\u201d acupuncture and brain remapping. The study also found no physiologic improvements from \u201csham\u201d acupuncture.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/news.harvard.edu\/gazette\/story\/2017\/03\/study-reveals-differences-in-the-effects-of-real-and-sham-acupuncture\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Study shows differences in effects of \u2018real\u2019 and \u2018sham\u2019 acupuncture\u00a0 &#8212; Harvard Gazette\" \/>\n<meta property=\"og:description\" content=\"Researchers saw improvement in carpal tunnel syndrome symptoms after \u201creal\u201d acupuncture and brain remapping. The study also found no physiologic improvements from \u201csham\u201d acupuncture.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/news.harvard.edu\/gazette\/story\/2017\/03\/study-reveals-differences-in-the-effects-of-real-and-sham-acupuncture\/\" \/>\n<meta property=\"og:site_name\" content=\"Harvard Gazette\" \/>\n<meta property=\"article:published_time\" content=\"2017-03-02T12:46:51+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2017-03-05T19:16:09+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/news.harvard.edu\/gazette\/wp-content\/uploads\/2017\/03\/acupuncture_twitter.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"605\" \/>\n\t<meta property=\"og:image:height\" content=\"403\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"harvardgazette\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/news.harvard.edu\/gazette\/story\/2017\/03\/study-reveals-differences-in-the-effects-of-real-and-sham-acupuncture\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/news.harvard.edu\/gazette\/story\/2017\/03\/study-reveals-differences-in-the-effects-of-real-and-sham-acupuncture\/\"},\"author\":{\"name\":\"harvardgazette\",\"@id\":\"https:\/\/news.harvard.edu\/gazette\/#\/schema\/person\/78d028cf624923e92682268709ffbc4b\"},\"headline\":\"Study shows differences in effects of \u2018real\u2019 and \u2018sham\u2019 acupuncture\u00a0\",\"datePublished\":\"2017-03-02T12:46:51+00:00\",\"dateModified\":\"2017-03-05T19:16:09+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/news.harvard.edu\/gazette\/story\/2017\/03\/study-reveals-differences-in-the-effects-of-real-and-sham-acupuncture\/\"},\"wordCount\":725,\"publisher\":{\"@id\":\"https:\/\/news.harvard.edu\/gazette\/#organization\"},\"image\":{\"@id\":\"https:\/\/news.harvard.edu\/gazette\/story\/2017\/03\/study-reveals-differences-in-the-effects-of-real-and-sham-acupuncture\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/news.harvard.edu\/wp-content\/uploads\/2017\/03\/acupuncture_twitter.jpg\",\"keywords\":[\"Acupuncture\",\"Athinoula A. 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napadow\"],\"dateCreated\":\"2017-03-02T12:46:51Z\",\"datePublished\":\"2017-03-02T12:46:51Z\",\"dateModified\":\"2017-03-05T19:16:09Z\"}<\/script>","tracker_url":"https:\/\/cdn.parsely.com\/keys\/news.harvard.edu\/p.js"},"jetpack_featured_media_url":"https:\/\/news.harvard.edu\/wp-content\/uploads\/2017\/03\/acupuncture_twitter.jpg","has_blocks":true,"block_data":{"0":{"blockName":"harvard-gazette\/article-header","attrs":{"blockColorPalette":"","coloredHeading":"","creditText":"","displayDetails":"","displayTitle":"","categoryId":39644,"mediaAlt":"","mediaCaption":"","mediaId":"","mediaSize":"","mediaType":"","mediaUrl":"","poster":"","title":"Study shows differences in effects of \u2018real\u2019 and \u2018sham\u2019 acupuncture\u00a0","subheading":"Acupuncture improves outcomes in carpal tunnel syndrome in part by remapping the brain","className":"is-style-square","backgroundFixed":false,"backgroundTone":"light","centeredImage":false,"coloredBackground":false,"displayOverlay":true,"fadeInText":false,"isAmbient":false,"mediaHeight":0,"mediaLength":"","mediaPosition":"","mediaWidth":0,"posterText":"","titleAbove":false,"useUncroppedImage":false,"lock":[],"metadata":[]},"innerBlocks":[],"innerHTML":"","innerContent":[],"rendered":"<header\n\tclass=\"wp-block-harvard-gazette-article-header alignfull article-header is-style-square has-light-background has-colored-heading\"\n\tstyle=\" \"\n>\n\t\n\t<div class=\"article-header__content\">\n\t\t\t<a\n\t\t\tclass=\"article-header__category\"\n\t\t\thref=\"https:\/\/news.harvard.edu\/gazette\/section\/health\/\"\n\t\t>\n\t\t\tHealth\t\t<\/a>\n\t\t\n\t\t<h1 class=\"article-header__title wp-block-heading \">\n\t\tStudy shows differences in effects of \u2018real\u2019 and \u2018sham\u2019 acupuncture\u00a0\t<\/h1>\n\n\t\n\t\n\t<div class=\"article-header__meta\">\n\t\t<div class=\"wp-block-post-author\">\n\t\t\t<address class=\"wp-block-post-author__content\">\n\t\t\t\t\t<p class=\"author wp-block-post-author__name\">\n\t\tGary Boas\t<\/p>\n\t\t\t<p class=\"wp-block-post-author__byline\">\n\t\t\tMartinos Center Communications\t\t<\/p>\n\t\t\t\t\t<\/address>\n\t\t<\/div>\n\n\t\t<time class=\"article-header__date\" datetime=\"2017-03-02\">\n\t\t\tMarch 2, 2017\t\t<\/time>\n\n\t\t<span class=\"article-header__reading-time\">\n\t\t\t4 min read\t\t<\/span>\n\t<\/div>\n\n\t\t\t<\/div>\n\t\t\n\t\t\t<h2 class=\"article-header__subheading wp-block-heading\">\n\t\t\tAcupuncture improves outcomes in carpal tunnel syndrome in part by remapping the brain\t\t<\/h2>\n\t\t\n<\/header>\n"},"2":{"blockName":"core\/group","attrs":{"templateLock":false,"metadata":{"name":"Article content"},"align":"wide","layout":{"type":"constrained","justifyContent":"center"},"tagName":"div","lock":[],"className":"","style":[],"backgroundColor":"","textColor":"","gradient":"","fontSize":"","fontFamily":"","borderColor":"","ariaLabel":"","anchor":""},"innerBlocks":[{"blockName":"core\/freeform","attrs":{"content":"","lock":[],"metadata":[]},"innerBlocks":[],"innerHTML":"\n\t\t<p>The practice of acupuncture predates current understanding of physiology by several millennia, and modern studies have found it often provides measureable improvements in health outcomes, particularly in the area of chronic pain. Now, in a <a href=\"https:\/\/academic.oup.com\/brain\/article-abstract\/doi\/10.1093\/brain\/awx015\/3058778\/Rewiring-the-primary-somatosensory-cortex-in\">study reported in the journal Brain<\/a>, a team of investigators based at the Athinoula A. Martinos Center for Biomedical Imaging at Massachusetts General Hospital (MGH) sheds new light on the question of how.<\/p>\n<p>\u201cAcupuncture is a medical therapy that originated in China several thousand years ago,\u201d said Vitaly Napadow, director of the Center for Integrative Pain Neuroimaging at the Martinos Center and senior author of the Brain paper. \u201cBut despite its long history, the intervention itself \u2014 particularly when coupled with electrical stimulation \u2014 has significant similarities to many conventional therapies, such as transcutaneous electrical nerve stimulation (TENS). A large body of clinical research exploring acupuncture for chronic pain disorders has demonstrated that it may be marginally better than a placebo procedure in reducing pain ratings. But questions still remain: How exactly does acupuncture work? Is it any better at improving objective outcomes for chronic pain?\u201d<\/p>\n<p>To get to the root of these questions, Napadow and colleagues performed a sham controlled acupuncture neuroimaging study of carpal tunnel syndrome (CTS), a neuropathic pain disorder. Few chronic pain disorders have established biomarkers or measureable treatment outcomes. However, in CTS, measurements taken at the wrist of the speed at which signals are transmitted along the median nerve are a well-known and accepted biomarker. In addition, studies by Napadow and others have shown that the brain \u2014 particularly the primary somatosensory cortex, which receives signals related to the sense of touch \u2014 is remapped in CTS. Specifically, brain cells that usually respond to touch signals from specific fingers start to respond to signals from multiple fingers, which\u00a0provides another measureable outcome.<\/p>\n<p>Using functional magnetic resonance imaging (fMRI) taken before and after several months of therapy in three different groups of CTS patients \u2014 one receiving electro-acupuncture at the affected hand, one receiving electro-acupuncture at the ankle opposite the affected hand, and the other receiving sham electro-acupuncture with placebo needles near the affected hand \u2014 the researchers found that both real and sham acupuncture improved patient-reported CTS symptoms. However, there were notable differences in physiologic measures. Real acupuncture at the affected hand led to measurable improvements in outcomes both at the affected wrist and in the brain, while acupuncture at the opposite ankle produced improvement at the wrist only. Brain remapping immediately after real acupuncture was linked to long-term improvement in CTS symptoms. No physiologic improvements resulted from sham acupuncture.<\/p>\n<p>Even after years of clinical research, controversy continues as to whether acupuncture works primarily by the placebo effect, especially given the slight differences between the efficacy of real and sham acupuncture. The findings of the Brain study help address this question. Sham acupuncture may produce a stronger placebo effect than a pill because it sends inputs to the brain via skin receptors and is coupled with a specific ritual. But the symptom improvement produced by sham treatment for conditions like CTS also might derive from entirely different mechanisms than those elicited by real acupuncture, the mechanisms of which may more specifically target CTS pathophysiology.<\/p>\n<p>\u201cSham acupuncture may \u2018work\u2019 by modulating known placebo circuitry in the brain,\u201d said Napadow, who is an associate professor in radiology at Harvard Medical School. \u201cIn contrast, real acupuncture may improve CTS symptoms by rewiring the primary somatosensory cortex, in addition to modulating local blood flow to the peripheral nerve in the wrist. In other words, both peripheral and central neurophysiological changes in CTS may be halted or even reversed by electro-acupuncture interventions that provide more prolonged and regulated input to the brain \u2014 something that future, longer-term neuroimaging studies should explore.\u201d<\/p>\n<p>Napadow and colleagues plan to follow up the Brain study with further research linking objective\/physiological and subjective\/psychological outcomes for acupuncture-produced pain relief. Better understanding of how acupuncture works to relieve pain ultimately will enable them and others to optimize the therapy to provide effective, non-pharmacological care for chronic pain patients.<\/p>\n<p>Yumi Maeda and Hyungjun Kim of the Martinos Center are co-lead authors of the Brain paper. The study was supported by grants from the National Center for Complementary and Integrative Health, the Korea Institute of Oriental Medicine, and the National Center for Research Resources.<\/p>\n","innerContent":["\n\t\t<p>The practice of acupuncture predates current understanding of physiology by several millennia, and modern studies have found it often provides measureable improvements in health outcomes, particularly in the area of chronic pain. Now, in a <a href=\"https:\/\/academic.oup.com\/brain\/article-abstract\/doi\/10.1093\/brain\/awx015\/3058778\/Rewiring-the-primary-somatosensory-cortex-in\">study reported in the journal Brain<\/a>, a team of investigators based at the Athinoula A. Martinos Center for Biomedical Imaging at Massachusetts General Hospital (MGH) sheds new light on the question of how.<\/p>\n<p>\u201cAcupuncture is a medical therapy that originated in China several thousand years ago,\u201d said Vitaly Napadow, director of the Center for Integrative Pain Neuroimaging at the Martinos Center and senior author of the Brain paper. \u201cBut despite its long history, the intervention itself \u2014 particularly when coupled with electrical stimulation \u2014 has significant similarities to many conventional therapies, such as transcutaneous electrical nerve stimulation (TENS). A large body of clinical research exploring acupuncture for chronic pain disorders has demonstrated that it may be marginally better than a placebo procedure in reducing pain ratings. But questions still remain: How exactly does acupuncture work? Is it any better at improving objective outcomes for chronic pain?\u201d<\/p>\n<p>To get to the root of these questions, Napadow and colleagues performed a sham controlled acupuncture neuroimaging study of carpal tunnel syndrome (CTS), a neuropathic pain disorder. Few chronic pain disorders have established biomarkers or measureable treatment outcomes. However, in CTS, measurements taken at the wrist of the speed at which signals are transmitted along the median nerve are a well-known and accepted biomarker. In addition, studies by Napadow and others have shown that the brain \u2014 particularly the primary somatosensory cortex, which receives signals related to the sense of touch \u2014 is remapped in CTS. Specifically, brain cells that usually respond to touch signals from specific fingers start to respond to signals from multiple fingers, which\u00a0provides another measureable outcome.<\/p>\n<p>Using functional magnetic resonance imaging (fMRI) taken before and after several months of therapy in three different groups of CTS patients \u2014 one receiving electro-acupuncture at the affected hand, one receiving electro-acupuncture at the ankle opposite the affected hand, and the other receiving sham electro-acupuncture with placebo needles near the affected hand \u2014 the researchers found that both real and sham acupuncture improved patient-reported CTS symptoms. However, there were notable differences in physiologic measures. Real acupuncture at the affected hand led to measurable improvements in outcomes both at the affected wrist and in the brain, while acupuncture at the opposite ankle produced improvement at the wrist only. Brain remapping immediately after real acupuncture was linked to long-term improvement in CTS symptoms. No physiologic improvements resulted from sham acupuncture.<\/p>\n<p>Even after years of clinical research, controversy continues as to whether acupuncture works primarily by the placebo effect, especially given the slight differences between the efficacy of real and sham acupuncture. The findings of the Brain study help address this question. Sham acupuncture may produce a stronger placebo effect than a pill because it sends inputs to the brain via skin receptors and is coupled with a specific ritual. But the symptom improvement produced by sham treatment for conditions like CTS also might derive from entirely different mechanisms than those elicited by real acupuncture, the mechanisms of which may more specifically target CTS pathophysiology.<\/p>\n<p>\u201cSham acupuncture may \u2018work\u2019 by modulating known placebo circuitry in the brain,\u201d said Napadow, who is an associate professor in radiology at Harvard Medical School. \u201cIn contrast, real acupuncture may improve CTS symptoms by rewiring the primary somatosensory cortex, in addition to modulating local blood flow to the peripheral nerve in the wrist. In other words, both peripheral and central neurophysiological changes in CTS may be halted or even reversed by electro-acupuncture interventions that provide more prolonged and regulated input to the brain \u2014 something that future, longer-term neuroimaging studies should explore.\u201d<\/p>\n<p>Napadow and colleagues plan to follow up the Brain study with further research linking objective\/physiological and subjective\/psychological outcomes for acupuncture-produced pain relief. Better understanding of how acupuncture works to relieve pain ultimately will enable them and others to optimize the therapy to provide effective, non-pharmacological care for chronic pain patients.<\/p>\n<p>Yumi Maeda and Hyungjun Kim of the Martinos Center are co-lead authors of the Brain paper. The study was supported by grants from the National Center for Complementary and Integrative Health, the Korea Institute of Oriental Medicine, and the National Center for Research Resources.<\/p>\n"],"rendered":"\n\t\t<p>The practice of acupuncture predates current understanding of physiology by several millennia, and modern studies have found it often provides measureable improvements in health outcomes, particularly in the area of chronic pain. Now, in a <a href=\"https:\/\/academic.oup.com\/brain\/article-abstract\/doi\/10.1093\/brain\/awx015\/3058778\/Rewiring-the-primary-somatosensory-cortex-in\">study reported in the journal Brain<\/a>, a team of investigators based at the Athinoula A. Martinos Center for Biomedical Imaging at Massachusetts General Hospital (MGH) sheds new light on the question of how.<\/p>\n<p>\u201cAcupuncture is a medical therapy that originated in China several thousand years ago,\u201d said Vitaly Napadow, director of the Center for Integrative Pain Neuroimaging at the Martinos Center and senior author of the Brain paper. \u201cBut despite its long history, the intervention itself \u2014 particularly when coupled with electrical stimulation \u2014 has significant similarities to many conventional therapies, such as transcutaneous electrical nerve stimulation (TENS). A large body of clinical research exploring acupuncture for chronic pain disorders has demonstrated that it may be marginally better than a placebo procedure in reducing pain ratings. But questions still remain: How exactly does acupuncture work? Is it any better at improving objective outcomes for chronic pain?\u201d<\/p>\n<p>To get to the root of these questions, Napadow and colleagues performed a sham controlled acupuncture neuroimaging study of carpal tunnel syndrome (CTS), a neuropathic pain disorder. Few chronic pain disorders have established biomarkers or measureable treatment outcomes. However, in CTS, measurements taken at the wrist of the speed at which signals are transmitted along the median nerve are a well-known and accepted biomarker. In addition, studies by Napadow and others have shown that the brain \u2014 particularly the primary somatosensory cortex, which receives signals related to the sense of touch \u2014 is remapped in CTS. Specifically, brain cells that usually respond to touch signals from specific fingers start to respond to signals from multiple fingers, which\u00a0provides another measureable outcome.<\/p>\n<p>Using functional magnetic resonance imaging (fMRI) taken before and after several months of therapy in three different groups of CTS patients \u2014 one receiving electro-acupuncture at the affected hand, one receiving electro-acupuncture at the ankle opposite the affected hand, and the other receiving sham electro-acupuncture with placebo needles near the affected hand \u2014 the researchers found that both real and sham acupuncture improved patient-reported CTS symptoms. However, there were notable differences in physiologic measures. Real acupuncture at the affected hand led to measurable improvements in outcomes both at the affected wrist and in the brain, while acupuncture at the opposite ankle produced improvement at the wrist only. Brain remapping immediately after real acupuncture was linked to long-term improvement in CTS symptoms. No physiologic improvements resulted from sham acupuncture.<\/p>\n<p>Even after years of clinical research, controversy continues as to whether acupuncture works primarily by the placebo effect, especially given the slight differences between the efficacy of real and sham acupuncture. The findings of the Brain study help address this question. Sham acupuncture may produce a stronger placebo effect than a pill because it sends inputs to the brain via skin receptors and is coupled with a specific ritual. But the symptom improvement produced by sham treatment for conditions like CTS also might derive from entirely different mechanisms than those elicited by real acupuncture, the mechanisms of which may more specifically target CTS pathophysiology.<\/p>\n<p>\u201cSham acupuncture may \u2018work\u2019 by modulating known placebo circuitry in the brain,\u201d said Napadow, who is an associate professor in radiology at Harvard Medical School. \u201cIn contrast, real acupuncture may improve CTS symptoms by rewiring the primary somatosensory cortex, in addition to modulating local blood flow to the peripheral nerve in the wrist. In other words, both peripheral and central neurophysiological changes in CTS may be halted or even reversed by electro-acupuncture interventions that provide more prolonged and regulated input to the brain \u2014 something that future, longer-term neuroimaging studies should explore.\u201d<\/p>\n<p>Napadow and colleagues plan to follow up the Brain study with further research linking objective\/physiological and subjective\/psychological outcomes for acupuncture-produced pain relief. Better understanding of how acupuncture works to relieve pain ultimately will enable them and others to optimize the therapy to provide effective, non-pharmacological care for chronic pain patients.<\/p>\n<p>Yumi Maeda and Hyungjun Kim of the Martinos Center are co-lead authors of the Brain paper. The study was supported by grants from the National Center for Complementary and Integrative Health, the Korea Institute of Oriental Medicine, and the National Center for Research Resources.<\/p>\n"}],"innerHTML":"\n<div class=\"wp-block-group alignwide\">\n\n\n\n<\/div>\n","innerContent":["\n<div class=\"wp-block-group alignwide\">\n\n","\n\n<\/div>\n"],"rendered":"\n<div class=\"wp-block-group alignwide has-global-padding is-content-justification-center is-layout-constrained wp-block-group-is-layout-constrained\">\n\n\n\t\t<p>The practice of acupuncture predates current understanding of physiology by several millennia, and modern studies have found it often provides measureable improvements in health outcomes, particularly in the area of chronic pain. Now, in a <a href=\"https:\/\/academic.oup.com\/brain\/article-abstract\/doi\/10.1093\/brain\/awx015\/3058778\/Rewiring-the-primary-somatosensory-cortex-in\">study reported in the journal Brain<\/a>, a team of investigators based at the Athinoula A. Martinos Center for Biomedical Imaging at Massachusetts General Hospital (MGH) sheds new light on the question of how.<\/p>\n<p>\u201cAcupuncture is a medical therapy that originated in China several thousand years ago,\u201d said Vitaly Napadow, director of the Center for Integrative Pain Neuroimaging at the Martinos Center and senior author of the Brain paper. \u201cBut despite its long history, the intervention itself \u2014 particularly when coupled with electrical stimulation \u2014 has significant similarities to many conventional therapies, such as transcutaneous electrical nerve stimulation (TENS). A large body of clinical research exploring acupuncture for chronic pain disorders has demonstrated that it may be marginally better than a placebo procedure in reducing pain ratings. But questions still remain: How exactly does acupuncture work? Is it any better at improving objective outcomes for chronic pain?\u201d<\/p>\n<p>To get to the root of these questions, Napadow and colleagues performed a sham controlled acupuncture neuroimaging study of carpal tunnel syndrome (CTS), a neuropathic pain disorder. Few chronic pain disorders have established biomarkers or measureable treatment outcomes. However, in CTS, measurements taken at the wrist of the speed at which signals are transmitted along the median nerve are a well-known and accepted biomarker. In addition, studies by Napadow and others have shown that the brain \u2014 particularly the primary somatosensory cortex, which receives signals related to the sense of touch \u2014 is remapped in CTS. Specifically, brain cells that usually respond to touch signals from specific fingers start to respond to signals from multiple fingers, which\u00a0provides another measureable outcome.<\/p>\n<p>Using functional magnetic resonance imaging (fMRI) taken before and after several months of therapy in three different groups of CTS patients \u2014 one receiving electro-acupuncture at the affected hand, one receiving electro-acupuncture at the ankle opposite the affected hand, and the other receiving sham electro-acupuncture with placebo needles near the affected hand \u2014 the researchers found that both real and sham acupuncture improved patient-reported CTS symptoms. However, there were notable differences in physiologic measures. Real acupuncture at the affected hand led to measurable improvements in outcomes both at the affected wrist and in the brain, while acupuncture at the opposite ankle produced improvement at the wrist only. Brain remapping immediately after real acupuncture was linked to long-term improvement in CTS symptoms. No physiologic improvements resulted from sham acupuncture.<\/p>\n<p>Even after years of clinical research, controversy continues as to whether acupuncture works primarily by the placebo effect, especially given the slight differences between the efficacy of real and sham acupuncture. The findings of the Brain study help address this question. Sham acupuncture may produce a stronger placebo effect than a pill because it sends inputs to the brain via skin receptors and is coupled with a specific ritual. But the symptom improvement produced by sham treatment for conditions like CTS also might derive from entirely different mechanisms than those elicited by real acupuncture, the mechanisms of which may more specifically target CTS pathophysiology.<\/p>\n<p>\u201cSham acupuncture may \u2018work\u2019 by modulating known placebo circuitry in the brain,\u201d said Napadow, who is an associate professor in radiology at Harvard Medical School. \u201cIn contrast, real acupuncture may improve CTS symptoms by rewiring the primary somatosensory cortex, in addition to modulating local blood flow to the peripheral nerve in the wrist. In other words, both peripheral and central neurophysiological changes in CTS may be halted or even reversed by electro-acupuncture interventions that provide more prolonged and regulated input to the brain \u2014 something that future, longer-term neuroimaging studies should explore.\u201d<\/p>\n<p>Napadow and colleagues plan to follow up the Brain study with further research linking objective\/physiological and subjective\/psychological outcomes for acupuncture-produced pain relief. Better understanding of how acupuncture works to relieve pain ultimately will enable them and others to optimize the therapy to provide effective, non-pharmacological care for chronic pain patients.<\/p>\n<p>Yumi Maeda and Hyungjun Kim of the Martinos Center are co-lead authors of the Brain paper. The study was supported by grants from the National Center for Complementary and Integrative Health, the Korea Institute of Oriental Medicine, and the National Center for Research Resources.<\/p>\n\n\n<\/div>\n"}},"jetpack-related-posts":[{"id":7236,"url":"https:\/\/news.harvard.edu\/gazette\/story\/2006\/02\/computer-use-deleted-as-carpal-tunnel-syndrome-cause\/","url_meta":{"origin":221572,"position":0},"title":"Computer use deleted as carpal tunnel syndrome cause","author":"harvardgazette","date":"February 2, 2006","format":false,"excerpt":"The popular belief that excessive computer use causes painful carpal tunnel syndrome has been contradicted by experts at Harvard Medical School. According to them, even as much as seven hours a day of tapping on a computer keyboard won't increase your risk of this disabling disorder.","rel":"","context":"In &quot;Health&quot;","block_context":{"text":"Health","link":"https:\/\/news.harvard.edu\/gazette\/section\/health\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":59508,"url":"https:\/\/news.harvard.edu\/gazette\/story\/2006\/02\/all-placebos-not-created-equal\/","url_meta":{"origin":221572,"position":1},"title":"All placebos not created equal","author":"harvardgazette","date":"February 1, 2006","format":false,"excerpt":"While researchers usually use placebos in clinical trials to test the effectiveness of a new treatment, a trial reported in the Feb. 1, 2006 British Medical Journal pitted one placebo against another.","rel":"","context":"In &quot;Health&quot;","block_context":{"text":"Health","link":"https:\/\/news.harvard.edu\/gazette\/section\/health\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":334495,"url":"https:\/\/news.harvard.edu\/gazette\/story\/2021\/11\/researchers-pinpoint-how-acupuncture-targets-inflammation\/","url_meta":{"origin":221572,"position":2},"title":"How acupuncture fights inflammation","author":"harvardgazette","date":"November 3, 2021","format":false,"excerpt":"Researchers have identified a subset of neurons that must be present for acupuncture to trigger an anti-inflammatory response.","rel":"","context":"In &quot;Health&quot;","block_context":{"text":"Health","link":"https:\/\/news.harvard.edu\/gazette\/section\/health\/"},"img":{"alt_text":"Acupuncture needles.","src":"https:\/\/news.harvard.edu\/wp-content\/uploads\/2021\/11\/iStock-Acupuncture.jpg?resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/news.harvard.edu\/wp-content\/uploads\/2021\/11\/iStock-Acupuncture.jpg?resize=350%2C200 1x, https:\/\/news.harvard.edu\/wp-content\/uploads\/2021\/11\/iStock-Acupuncture.jpg?resize=525%2C300 1.5x, https:\/\/news.harvard.edu\/wp-content\/uploads\/2021\/11\/iStock-Acupuncture.jpg?resize=700%2C400 2x"},"classes":[]},{"id":310246,"url":"https:\/\/news.harvard.edu\/gazette\/story\/2020\/08\/study-reveals-acupuncture-affects-disease-course\/","url_meta":{"origin":221572,"position":3},"title":"Quieting the storm","author":"Lian Parsons","date":"August 12, 2020","format":false,"excerpt":"Acupuncture activates inflammation-regulating pathways, tames cytokine storm in mice.","rel":"","context":"In &quot;Science &amp; Tech&quot;","block_context":{"text":"Science &amp; Tech","link":"https:\/\/news.harvard.edu\/gazette\/section\/science-technology\/"},"img":{"alt_text":"Person receiving acupuncture.","src":"https:\/\/news.harvard.edu\/wp-content\/uploads\/2020\/08\/acupuncture-850_2500.jpg?resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/news.harvard.edu\/wp-content\/uploads\/2020\/08\/acupuncture-850_2500.jpg?resize=350%2C200 1x, https:\/\/news.harvard.edu\/wp-content\/uploads\/2020\/08\/acupuncture-850_2500.jpg?resize=525%2C300 1.5x, https:\/\/news.harvard.edu\/wp-content\/uploads\/2020\/08\/acupuncture-850_2500.jpg?resize=700%2C400 2x"},"classes":[]},{"id":155921,"url":"https:\/\/news.harvard.edu\/gazette\/story\/2014\/05\/calming-the-working-mind\/","url_meta":{"origin":221572,"position":4},"title":"Calming the working mind","author":"harvardgazette","date":"May 13, 2014","format":false,"excerpt":"Marianne Bergonzi first tried yoga when she was 50 years old. Describing the experience as life-changing, Bergonzi soon began teaching classes. \u201cI knew I had to pass the yogic philosophy on to people who [may] never get a chance to learn the body, mind, and breath connection.\u201d","rel":"","context":"In &quot;Campus &amp; Community&quot;","block_context":{"text":"Campus &amp; Community","link":"https:\/\/news.harvard.edu\/gazette\/section\/campus-community\/"},"img":{"alt_text":"","src":"https:\/\/news.harvard.edu\/wp-content\/uploads\/2014\/05\/040214_yoga_068-cr2_-1_605.jpg?resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/news.harvard.edu\/wp-content\/uploads\/2014\/05\/040214_yoga_068-cr2_-1_605.jpg?resize=350%2C200 1x, https:\/\/news.harvard.edu\/wp-content\/uploads\/2014\/05\/040214_yoga_068-cr2_-1_605.jpg?resize=525%2C300 1.5x"},"classes":[]},{"id":164895,"url":"https:\/\/news.harvard.edu\/gazette\/story\/2015\/01\/breakthrough-on-chronic-pain\/","url_meta":{"origin":221572,"position":5},"title":"Breakthrough on chronic pain","author":"harvardgazette","date":"January 12, 2015","format":false,"excerpt":"Imaging study finds the first evidence of neuroinflammation in brains of chronic pain patients, which could lead to new, targeted treatments.","rel":"","context":"In &quot;Health&quot;","block_context":{"text":"Health","link":"https:\/\/news.harvard.edu\/gazette\/section\/health\/"},"img":{"alt_text":"","src":"https:\/\/news.harvard.edu\/wp-content\/uploads\/2015\/01\/scans.jpg?resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/news.harvard.edu\/wp-content\/uploads\/2015\/01\/scans.jpg?resize=350%2C200 1x, https:\/\/news.harvard.edu\/wp-content\/uploads\/2015\/01\/scans.jpg?resize=525%2C300 1.5x"},"classes":[]}],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/news.harvard.edu\/gazette\/wp-json\/wp\/v2\/posts\/221572","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/news.harvard.edu\/gazette\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/news.harvard.edu\/gazette\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/news.harvard.edu\/gazette\/wp-json\/wp\/v2\/users\/105622744"}],"replies":[{"embeddable":true,"href":"https:\/\/news.harvard.edu\/gazette\/wp-json\/wp\/v2\/comments?post=221572"}],"version-history":[{"count":5,"href":"https:\/\/news.harvard.edu\/gazette\/wp-json\/wp\/v2\/posts\/221572\/revisions"}],"predecessor-version":[{"id":221742,"href":"https:\/\/news.harvard.edu\/gazette\/wp-json\/wp\/v2\/posts\/221572\/revisions\/221742"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/news.harvard.edu\/gazette\/wp-json\/wp\/v2\/media\/221588"}],"wp:attachment":[{"href":"https:\/\/news.harvard.edu\/gazette\/wp-json\/wp\/v2\/media?parent=221572"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/news.harvard.edu\/gazette\/wp-json\/wp\/v2\/categories?post=221572"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/news.harvard.edu\/gazette\/wp-json\/wp\/v2\/tags?post=221572"},{"taxonomy":"format","embeddable":true,"href":"https:\/\/news.harvard.edu\/gazette\/wp-json\/wp\/v2\/gazette-formats?post=221572"},{"taxonomy":"series","embeddable":true,"href":"https:\/\/news.harvard.edu\/gazette\/wp-json\/wp\/v2\/series?post=221572"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}