Commonalities in the central nervous system's involvement with complementary medical therapies: limbic morphinergic processes.
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.
Esch
Tobias
T
Charité-University Medicine Berlin, Institute for General and Family Medicine, Berlin, Germany.
Guarna
Massimo
M
Bianchi
Enrica
E
Zhu
Wei
W
Stefano
George B
GB
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
D009020:Morphine