title: Does Acupuncture Alter Pain-related Functional Connectivity of the Central Nervous System? A Systematic Review.
abstract: Acupuncture has been studied for several decades to establish evidence-based clinical practice. This systematic review aims to evaluate evidence for the effectiveness of acupuncture in influencing the functional connectivity of the central nervous system in patients with musculoskeletal pain. A systematic search of the literature was conducted to identify studies in which the central response of acupuncture in patients with musculoskeletal pain was evaluated by neuroimaging techniques. Databases searched were AMED, CINAHL, Cochrane Library, EMBASE, MEDLINE, PEDro, Pubmed, SCOPUS, SPORTDiscuss, and Web of Science. Included studies were assessed by two independent reviewers for their methodological quality by using the Downs and Black questionnaire and for their levels of completeness and transparency in reporting acupuncture interventions by using Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) criteria. Seven studies met the inclusion criteria. Three studies were randomized controlled trials (RCTs) and four studies were nonrandomized controlled trials (NRCTs). The neuroimaging techniques used were functional magnetic resonance imaging (fMRI) and positron emission tomography (PET). Positive effects on the functional connectivity of the central nervous system more consistently occurred during long-term acupuncture treatment. The results were heterogeneous from a descriptive perspective; however, the key findings support acupuncture's ability to alter pain-related functional connectivity in the central nervous system in patients with musculoskeletal pain.
authors.affiliation: Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand. Electronic address: physio.villarreal@gmail.com.
authors.forename: María
authors.initials: M
authors.lastname: Villarreal Santiago
authors.affiliation: Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
authors.forename: Steve
authors.initials: S
authors.lastname: Tumilty
authors.affiliation: Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Mącznik
authors.affiliation: Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
authors.forename: Ramakrishnan
authors.initials: R
authors.lastname: Mani
mesh_terms: D015670:Acupuncture Therapy; D000818:Animals; D002490:Central Nervous System / Q000503:physiopathology*; D002986:Clinical Trials as Topic; D006801:Humans; D010146:Pain / Q000503:physiopathology*; D059408:Pain Management
keywords: acupuncture therapy; brain; functional neuroimaging; musculoskeletal pain