title: Therapeutic effects of acupuncture in patients with rheumatoid arthritis: a prospective study using (18)F-FDG-PET.
abstract: OBJECTIVE
  The purpose of this study was to investigate whether improvement of regional inflammatory findings in knee joints of rheumatoid arthritis (RA) could be detected by positron-emission tomography (PET) using (18)F-Fluorodeoxyglucose (FDG) after acupuncture treatments, as well as improvement of systemic inflammatory markers.
  
  
  METHODS
  Six RA patients (all female, 61 +/- 12 years old) received 10 acupuncture treatments in 2 months, to 11 traditional acupuncture points around a knee joint considered effective on RA. A visual analogue scale (VAS) for intensity of pain, knee joint range of motion (ROM), face scale for patient mood, and modified health assessment questionnaire (MHAQ) for disability of daily activities were assessed just before and after acupuncture. Maximum standardized uptake value (SUV(max)) and the volume with SUV more than 1.0 [Volume(SUV > 1)] on FDG-PET images as well as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were also measured before and after the treatments.
  
  
  RESULTS
  VAS, ROM, face scale and MHAQ improved in all patients and significantly after acupuncture, but no significant change was detected in ESR, CRP, SUV(max), or Volume(SUV > 1).
  
  
  CONCLUSIONS
  Acupuncture relieves symptom, remedies physical function, and improves quality of life in RA patients, but may have no or very limited anti-inflammatory effect systemically. The regional effects of acupuncture are unlikely to be induced through reduction of regional inflammation. We believe this clinical study is the first step for elucidating therapeutic mechanisms of acupuncture, which must be important for the rational use and further development of acupuncture.
authors.affiliation: Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Sato
authors.forename: Masayuki
authors.initials: M
authors.lastname: Inubushi
authors.forename: Tohru
authors.initials: T
authors.lastname: Shiga
authors.forename: Kenji
authors.initials: K
authors.lastname: Hirata
authors.forename: Shozo
authors.initials: S
authors.lastname: Okamoto
authors.forename: Tomohito
authors.initials: T
authors.lastname: Kamibayashi
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Tanimura
authors.forename: Nagara
authors.initials: N
authors.lastname: Tamaki