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Author ACUPUNCTURE ACTIVATES THE BRAIN
Dr. Jai Maharaj

2005-05-06, 5:58 pm

Acupuncture activates the brain

By Andreas von Bubnoff
nature.com
Sunday, May 1, 2005

Medicinal use of needles does more than placebos.

[Caption] Needles are used in alternative therapy to
treat illness, pain and even addiction.
- Punchstock

Acupuncture has a measurable, if mysterious, effect on
the brain, UK scientists have found. The study adds to
evidence that patients benefit from acupuncture not
simply because of their expectations.

The research team used brain imaging to show that
treatment with genuine needles activates brain areas
beyond the ones that light up when trick needles are
used. "This is the first brain-imaging study that has
shown an effect beyond placebo," says George Lewith, an
expert in complementary medicine at the university of
Southampton who led the study.

Acupuncture is an ancient Chinese treatment for illness,
pain or even addiction, which uses fine needles in
defined points of the body. The mechanism behind this is
far from understood, and clinical trials into acupuncture
have had mixed results. "It has worked in some trials, it
hasn't worked in others, it's very complicated," says Ted
Kaptchuk, an acupuncture researcher at Harvard University
in Boston, Massachusetts. Many studies have suggested
that the placebo effect accounts for most of the benefits
seen.

"This is the first brain imaging study that has shown
an effect beyond placebo."
- George Lewith
University of Southampton

Part of this confusion may be thanks to the use of badly
defined controls in acupuncture tests, experts say. Some
studies use needles in non-acupuncture points, for
example. But this may simply prove that needling is an
effective treatment.

Stage dagger

For a better placebo, Lewith's team used a retractable
needle that doesn't really penetrate the skin, but tricks
the patients into thinking that it does. "It disappears
into its handle like a stage dagger," Lewith says. This
tricked the patients into believing they were being
treated when they weren't.

The study group, which consisted of 14 patients with
arthritic pain in their thumbs, was also treated with
both real acupuncture, and with blunt needles that didn't
penetrate the skin. In the last case the patients were
told that the procedure should not have any effect.

The researchers then used positron emission tomography to
measure brain activity. Both placebo treatment and real
treatment activated the brain in areas known to respond
to opiates: painkillers released by the brain.

Insula effect

True acupuncture also increased activity in a different
brain area called the insula, which is part of the
cerebral cortex. It's not clear what this activity means,
says Lewith, but it indicates some sort of real effect.
"What we have demonstrated is that acupuncture is
partially modulated by expectation, but is probably also
modulated by a real treatment effect," he says. They
report their findings in the journal NeuroImage1.

Lewith adds that his own previous work has indicated that
expectation accounts for some of acupuncture's benefits.
In a study of people with chronic neck pain, they found
the placebo effect accounted for about 80% of pain
relief2.

Kaptchuk says that the study should help researchers to
design better clinical trials of acupuncture in the
future. "This study gives a clarification of the possible
mechanisms by which acupuncture works, and by
understanding the mechanisms we can design better
placebos," he says.

References

Pariente J., White P., Frackowiak , Richard S. J. &
Lewith G. Neuroimage, 25. 1161 - 1167 (2005).

Article
http://dx.doi.org/10.1016%2Fj.neuroimage.2005.01.016

PubMed

http://www.ncbi.nlm.nih.gov/entrez/...3&dopt=Abstract

White P., Lewith G., Prescott P. & Conway J. Ann. Intern.
Med., 141. 911 - 919 (2004). PubMed

http://www.ncbi.nlm.nih.gov/entrez/...8&dopt=Abstract

More at:
http://www.nature.com/news/2005/050.../050425-12.html

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