title: Commonalities in the central nervous system's involvement with complementary medical therapies: limbic morphinergic processes.
abstract: BACKGROUND
  Currently, complementary and alternative medicine (CAM) are experiencing growing popularity, especially in former industrialized countries. However, most of the underlying physiological and molecular mechanisms as well as participating biological structures are still speculative. Specific and non-specific effects may play a role in CAM. Moreover, trust, belief, and expectation may be of importance, pointing towards common central nervous system (CNS) pathways involved in CAM.
  
  
  METHODS
  Four CAM approaches (acupuncture, meditation, music therapy, and massage therapy) were examined with regard to the CNS activity pattern involved. CNS commonalities between different approaches were investigated.
  
  
  RESULTS
  Frontal/prefrontal and limbic brain structures play a role in CAM. Particularly, left-anterior regions of the brain and reward or motivation circuitry constituents are involved, indicating positive affect and emotion-related memory processing--accompanied by endocrinologic and autonomic functions--as crucial components of CAM effects. Thus, trust and belief in a therapist or positive therapy expectations seem to be important. However, besides common non-specific or subjective effects, specific (objective) physiological components also exist.
  
  
  CONCLUSIONS
  Non-specific CNS commonalities are involved in various CAM therapies. Different therapeutic approaches physiologically overlap in the brain. However, molecular correspondents of the detected CNS analogies still have to be specified. In particular, fast acting autoregulatory signaling molecules presumably play a role. These may also be involved in the placebo response.
authors.affiliation: Charité-University Medicine Berlin, Institute for General and Family Medicine, Berlin, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Esch
authors.forename: Massimo
authors.initials: M
authors.lastname: Guarna
authors.forename: Enrica
authors.initials: E
authors.lastname: Bianchi
authors.forename: Wei
authors.initials: W
authors.lastname: Zhu
authors.forename: George B
authors.initials: GB
authors.lastname: Stefano
mesh_terms: D026881:Acupuncture; D000818:Animals; D000529:Complementary Therapies; D006801:Humans; D008032:Limbic System / Q000187:drug effects*; D019122:Meditation; D009020:Morphine / Q000378:metabolism / Q000494:pharmacology*; D009147:Music Therapy
chemical_list: D009020:Morphine