title: Hypothalamus and amygdala response to acupuncture stimuli in Carpal Tunnel Syndrome.
abstract: Brain processing of acupuncture stimuli in chronic neuropathic pain patients may underlie its beneficial effects. We used fMRI to evaluate verum and sham acupuncture stimulation at acupoint LI-4 in Carpal Tunnel Syndrome (CTS) patients and healthy controls (HC). CTS patients were retested after 5 weeks of acupuncture therapy. Thus, we investigated both the short-term brain response to acupuncture stimulation, as well as the influence of longer-term acupuncture therapy effects on this short-term response. CTS patients responded to verum acupuncture with greater activation in the hypothalamus and deactivation in the amygdala as compared to HC, controlling for the non-specific effects of sham acupuncture. A similar difference was found between CTS patients at baseline and after acupuncture therapy. For baseline CTS patients responding to verum acupuncture, functional connectivity was found between the hypothalamus and amygdala--the less deactivation in the amygdala, the greater the activation in the hypothalamus, and vice versa. Furthermore, hypothalamic response correlated positively with the degree of maladaptive cortical plasticity in CTS patients (inter-digit separation distance). This is the first evidence suggesting that chronic pain patients respond to acupuncture differently than HC, through a coordinated limbic network including the hypothalamus and amygdala.
authors.affiliation: Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United States Department of Radiology, Logan College of Chiropractic, Chesterfield, MO, United States Martinos Center for Biomedical Imaging, Department of Neurology, Massachusetts General Hospital, Charlestown, MA, United States Spaulding Rehabilitation Hospital, Boston, MA, United States.
authors.forename: V
authors.initials: V
authors.lastname: Napadow
authors.forename: N
authors.initials: N
authors.lastname: Kettner
authors.forename: J
authors.initials: J
authors.lastname: Liu
authors.forename: M
authors.initials: M
authors.lastname: Li
authors.forename: K K
authors.initials: KK
authors.lastname: Kwong
authors.forename: M
authors.initials: M
authors.lastname: Vangel
authors.forename: N
authors.initials: N
authors.lastname: Makris
authors.forename: J
authors.initials: J
authors.lastname: Audette
authors.forename: K K S
authors.initials: KKS
authors.lastname: Hui
mesh_terms: D026881:Acupuncture; D000328:Adult; D000679:Amygdala / Q000502:physiology*; D002349:Carpal Tunnel Syndrome / Q000503:physiopathology* / Q000628:therapy*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007031:Hypothalamus / Q000502:physiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D010146:Pain / Q000503:physiopathology; D059408:Pain Management; D011601:Psychophysics