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Acupuncture for chronic sciatica: Neural basis and predictors of efficacy

Chronic neuropathic pain Chronic neuropathic pain
Chronic neuropathic pain Chronic neuropathic pain

Chronic neuropathic pain, such as sciatica, is a major cause of disability. Acupuncture has shown the potential to ease this pain, but how it works on the brain is not well understood. A neuroimaging study aimed to explore the effects of acupuncture on pain and associated brain changes.

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Key take away

Acupuncture alleviates leg pain in chronic sciatica, with its neural effects centered in the somatosensory cortex. Neural and clinical markers may predict treatment efficacy.

Background

Chronic neuropathic pain, such as sciatica, is a major cause of disability. Acupuncture has shown the potential to ease this pain, but how it works on the brain is not well understood. A neuroimaging study aimed to explore the effects of acupuncture on pain and associated brain changes.

Method

Sixty sciatica patients were split into acupuncture and sham acupuncture groups, receiving 10 treatments over 4 weeks. Pain levels were estimated via the visual analog scale (VAS) while disability was examined via the Oswestry Disability Index (ODI). Brain activity before and after the intervention was gauged via resting-state functional magnetic resonance imaging scans. Fractional amplitudes of low-frequency fluctuations  (fALFF) and support vector regression evaluations were carried out.

Result

Acupuncture led to significant improvements in pain and disability scores compared to sham treatment. The intrinsic brain activity in the right superior parietal lobule and right postcentral gyrus appeared to modulate acupuncture in prolonged neuropathic discomfort, with right superior parietal lobule activity potentially serving as an indicator of acupuncture response.

With acupuncture, brain imaging exhibited increased fALFF in the right superior parietal lobule and right postcentral gyrus. The 4-week ODI values correlated positively with the support vector regression-anticipated values from right superior parietal lobule fALFF and baseline evaluations.

Conclusion

Acupuncture effectively reduced chronic sciatica pain, with enhanced neural activity in specific brain regions linked to its therapeutic effects. This study highlighted how brain imaging and artificial intelligence can reveal the mechanisms behind acupuncture’s benefits, offering new insights into managing chronic pain.

Source:

The Journal of Pain

Article:

Acupuncture Modulation of Chronic Neuropathic Pain and Its Association With Brain Functional Properties

Authors:

Xiao-Ya Wei et al.

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