Assessing the Modulatory Effects of tDCS and Acupuncture on Cerebral Blood Flow in Chronic Low Back Pain Using Arterial Spin Labeling Perfusion Imaging
Background: Both transcranial direct current stimulation (tDCS) and acupuncture are promising methods for managing chronic low back pain (cLBP), however, their underlying mechanisms remain unclear. Methods: To explore the neural mechanisms of tDCS and acupuncture on cLBP, we examined how real and sh...
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MDPI AG
2025-02-01
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| author | Valeria Sacca Nasim Maleki Sveta Reddy Sierra Hodges Jian Kong |
| author_facet | Valeria Sacca Nasim Maleki Sveta Reddy Sierra Hodges Jian Kong |
| author_sort | Valeria Sacca |
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| description | Background: Both transcranial direct current stimulation (tDCS) and acupuncture are promising methods for managing chronic low back pain (cLBP), however, their underlying mechanisms remain unclear. Methods: To explore the neural mechanisms of tDCS and acupuncture on cLBP, we examined how real and sham tDCS applied to the bilateral motor cortex (M1), combined with real or sham acupuncture, influenced cerebral blood flow (CBF) using pulsed continuous arterial spin labeling (pCASL) imaging. tDCS was administered over six sessions, combined with real or sham acupuncture, over one month. Results: Following real tDCS, we observed increased CBF in the bilateral occipital cortex, precuneus, left hippocampus, and parahippocampal gyrus/posterior cingulate cortex. After sham tDCS, CBF decreased in regions including the bilateral superior parietal lobule, precuneus, bilateral precentral and postcentral gyri, and left angular gyrus. Real acupuncture led to reduced CBF in the bilateral occipital cortex and hippocampus, and left posterior cingulate gyrus, and increased CBF in the right postcentral gyrus, superior parietal lobule, and frontal areas. Sham acupuncture was associated with decreased CBF in the bilateral hippocampus and anterior cingulate gyrus. Conclusions: These results suggest both shared and distinct patterns of CBF changes between real and sham tDCS, as well as between real and sham acupuncture, reflecting mode-dependent effects on brain networks involved in pain processing and modulation. Our findings highlight the different neural circuits implicated in the therapeutic mechanisms of tDCS and acupuncture in the management of cLBP. |
| format | Article |
| id | doaj-art-39c6c9ca8e0d40d5b338cc6ffb3e47c3 |
| institution | DOAJ |
| issn | 2076-3425 |
| language | English |
| publishDate | 2025-02-01 |
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| spelling | doaj-art-39c6c9ca8e0d40d5b338cc6ffb3e47c32025-08-20T02:42:42ZengMDPI AGBrain Sciences2076-34252025-02-0115326110.3390/brainsci15030261Assessing the Modulatory Effects of tDCS and Acupuncture on Cerebral Blood Flow in Chronic Low Back Pain Using Arterial Spin Labeling Perfusion ImagingValeria Sacca0Nasim Maleki1Sveta Reddy2Sierra Hodges3Jian Kong4Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USADepartment of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USADepartment of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USADepartment of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USADepartment of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USABackground: Both transcranial direct current stimulation (tDCS) and acupuncture are promising methods for managing chronic low back pain (cLBP), however, their underlying mechanisms remain unclear. Methods: To explore the neural mechanisms of tDCS and acupuncture on cLBP, we examined how real and sham tDCS applied to the bilateral motor cortex (M1), combined with real or sham acupuncture, influenced cerebral blood flow (CBF) using pulsed continuous arterial spin labeling (pCASL) imaging. tDCS was administered over six sessions, combined with real or sham acupuncture, over one month. Results: Following real tDCS, we observed increased CBF in the bilateral occipital cortex, precuneus, left hippocampus, and parahippocampal gyrus/posterior cingulate cortex. After sham tDCS, CBF decreased in regions including the bilateral superior parietal lobule, precuneus, bilateral precentral and postcentral gyri, and left angular gyrus. Real acupuncture led to reduced CBF in the bilateral occipital cortex and hippocampus, and left posterior cingulate gyrus, and increased CBF in the right postcentral gyrus, superior parietal lobule, and frontal areas. Sham acupuncture was associated with decreased CBF in the bilateral hippocampus and anterior cingulate gyrus. Conclusions: These results suggest both shared and distinct patterns of CBF changes between real and sham tDCS, as well as between real and sham acupuncture, reflecting mode-dependent effects on brain networks involved in pain processing and modulation. Our findings highlight the different neural circuits implicated in the therapeutic mechanisms of tDCS and acupuncture in the management of cLBP.https://www.mdpi.com/2076-3425/15/3/261cerebral blood flow (CBF)chronic low back pain (cLBP)motor cortex (M1)pulsed continuous arterial spin labeling (pCASL)transcranial direct current stimulation (tDCS)acupuncture |
| spellingShingle | Valeria Sacca Nasim Maleki Sveta Reddy Sierra Hodges Jian Kong Assessing the Modulatory Effects of tDCS and Acupuncture on Cerebral Blood Flow in Chronic Low Back Pain Using Arterial Spin Labeling Perfusion Imaging Brain Sciences cerebral blood flow (CBF) chronic low back pain (cLBP) motor cortex (M1) pulsed continuous arterial spin labeling (pCASL) transcranial direct current stimulation (tDCS) acupuncture |
| title | Assessing the Modulatory Effects of tDCS and Acupuncture on Cerebral Blood Flow in Chronic Low Back Pain Using Arterial Spin Labeling Perfusion Imaging |
| title_full | Assessing the Modulatory Effects of tDCS and Acupuncture on Cerebral Blood Flow in Chronic Low Back Pain Using Arterial Spin Labeling Perfusion Imaging |
| title_fullStr | Assessing the Modulatory Effects of tDCS and Acupuncture on Cerebral Blood Flow in Chronic Low Back Pain Using Arterial Spin Labeling Perfusion Imaging |
| title_full_unstemmed | Assessing the Modulatory Effects of tDCS and Acupuncture on Cerebral Blood Flow in Chronic Low Back Pain Using Arterial Spin Labeling Perfusion Imaging |
| title_short | Assessing the Modulatory Effects of tDCS and Acupuncture on Cerebral Blood Flow in Chronic Low Back Pain Using Arterial Spin Labeling Perfusion Imaging |
| title_sort | assessing the modulatory effects of tdcs and acupuncture on cerebral blood flow in chronic low back pain using arterial spin labeling perfusion imaging |
| topic | cerebral blood flow (CBF) chronic low back pain (cLBP) motor cortex (M1) pulsed continuous arterial spin labeling (pCASL) transcranial direct current stimulation (tDCS) acupuncture |
| url | https://www.mdpi.com/2076-3425/15/3/261 |
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