Effect of acupuncture treatment for patients with knee osteoarthritis on brain fluctuation amplitude and functional connectivity: a randomized three-armed fMRI study
Abstract Background In clinical practice, the overall effect of a treatment includes specific and nonspecific components. Although the analgesic mechanism of specific acupuncture effect has been studied extensively, the understanding of neural basis about nonspecific placebo effect is insufficient....
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BMC
2025-07-01
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| Series: | BMC Complementary Medicine and Therapies |
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| Online Access: | https://doi.org/10.1186/s12906-025-04985-w |
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| author | Xiao-Ya Wei Ze-Yi Wang Guang-Xia Shi Na Zhang Jin-Ling Li Meng-Meng Ren Jun-Lian Liu Hang Zhou Chih-Kai Lee Jian-Feng Tu Xu Wang Cun-Zhi Liu |
| author_facet | Xiao-Ya Wei Ze-Yi Wang Guang-Xia Shi Na Zhang Jin-Ling Li Meng-Meng Ren Jun-Lian Liu Hang Zhou Chih-Kai Lee Jian-Feng Tu Xu Wang Cun-Zhi Liu |
| author_sort | Xiao-Ya Wei |
| collection | DOAJ |
| description | Abstract Background In clinical practice, the overall effect of a treatment includes specific and nonspecific components. Although the analgesic mechanism of specific acupuncture effect has been studied extensively, the understanding of neural basis about nonspecific placebo effect is insufficient. We aimed to reveal the neurological signatures associated with both specific effect and nonspecific effect of acupuncture in chronic pain using the functional magnetic resonance imaging (fMRI). Methods In this three-armed, randomized controlled trial, 90 patients with knee osteoarthritis (KOA) were divided into acupuncture group (AG), sham acupuncture group (SG), or waiting list group (WG), receiving 12 times of treatments during 4 weeks. NRS, WOMAC score, and fMRI data were collected before and after treatment. We assessed the amplitude of low frequency fluctuation (ALFF) and seed-based functional connectivity (FC) to investigate the brain functional bases of the nonspecific (SG vs. WG) and specific (AG vs. SG) effects of acupuncture. Results Acupuncture could significantly reduce NRS score in KOA patients (overall P < 0.001). Neurally, significant ALFF changes in left dorsolateral prefrontal cortex (DLPFC) were observed in the AG (vs. SG) and SG (vs. WG; Voxel P < 0.001, Cluster P < 0.001), respectively. And the decreased ALFF values of DLPFC had a positive correlation with the NRS score changes in the SG (spearman rho = 0.592, P = 0.002). Moreover, FC between DLPFC and thalamus was increased in the AG compared to SG. And compared to WG, there was a decreased FC between DLPFC and cerebellum in the SG. Conclusion The spontaneous activity of the DLPFC was involved in both the specific and nonspecific acupuncture effects, whereas different DLPFC FCs related to the specific or nonspecific effects of acupuncture. Our findings contribute to the understanding about the neuroimaging evidence of the acupuncture effects. Trial registration numbers Chinese Clinical Trial Registry ( www.chictr.org.cn ) ChiCTR1900025799. This study was registered on 9th September 2019. |
| format | Article |
| id | doaj-art-4d7e50895ace4763af5188f03e5fbf72 |
| institution | Kabale University |
| issn | 2662-7671 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Complementary Medicine and Therapies |
| spelling | doaj-art-4d7e50895ace4763af5188f03e5fbf722025-08-20T04:01:46ZengBMCBMC Complementary Medicine and Therapies2662-76712025-07-0125111110.1186/s12906-025-04985-wEffect of acupuncture treatment for patients with knee osteoarthritis on brain fluctuation amplitude and functional connectivity: a randomized three-armed fMRI studyXiao-Ya Wei0Ze-Yi Wang1Guang-Xia Shi2Na Zhang3Jin-Ling Li4Meng-Meng Ren5Jun-Lian Liu6Hang Zhou7Chih-Kai Lee8Jian-Feng Tu9Xu Wang10Cun-Zhi Liu11School of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese MedicineSchool of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese MedicineSchool of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese MedicineSchool of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese MedicineSchool of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese MedicineDepartment of Radiology, Beijing Hospital of Traditional Chinese Medicine affiliated with Capital Medical UniversityDepartment of Radiology, Beijing Hospital of Traditional Chinese Medicine affiliated with Capital Medical UniversitySchool of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese MedicineSchool of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese MedicineSchool of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese MedicineSchool of Life Sciences, Beijing University of Chinese MedicineSchool of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese MedicineAbstract Background In clinical practice, the overall effect of a treatment includes specific and nonspecific components. Although the analgesic mechanism of specific acupuncture effect has been studied extensively, the understanding of neural basis about nonspecific placebo effect is insufficient. We aimed to reveal the neurological signatures associated with both specific effect and nonspecific effect of acupuncture in chronic pain using the functional magnetic resonance imaging (fMRI). Methods In this three-armed, randomized controlled trial, 90 patients with knee osteoarthritis (KOA) were divided into acupuncture group (AG), sham acupuncture group (SG), or waiting list group (WG), receiving 12 times of treatments during 4 weeks. NRS, WOMAC score, and fMRI data were collected before and after treatment. We assessed the amplitude of low frequency fluctuation (ALFF) and seed-based functional connectivity (FC) to investigate the brain functional bases of the nonspecific (SG vs. WG) and specific (AG vs. SG) effects of acupuncture. Results Acupuncture could significantly reduce NRS score in KOA patients (overall P < 0.001). Neurally, significant ALFF changes in left dorsolateral prefrontal cortex (DLPFC) were observed in the AG (vs. SG) and SG (vs. WG; Voxel P < 0.001, Cluster P < 0.001), respectively. And the decreased ALFF values of DLPFC had a positive correlation with the NRS score changes in the SG (spearman rho = 0.592, P = 0.002). Moreover, FC between DLPFC and thalamus was increased in the AG compared to SG. And compared to WG, there was a decreased FC between DLPFC and cerebellum in the SG. Conclusion The spontaneous activity of the DLPFC was involved in both the specific and nonspecific acupuncture effects, whereas different DLPFC FCs related to the specific or nonspecific effects of acupuncture. Our findings contribute to the understanding about the neuroimaging evidence of the acupuncture effects. Trial registration numbers Chinese Clinical Trial Registry ( www.chictr.org.cn ) ChiCTR1900025799. This study was registered on 9th September 2019.https://doi.org/10.1186/s12906-025-04985-wAcupunctureALFFFunctional connectivityKnee osteoarthritisfMRI |
| spellingShingle | Xiao-Ya Wei Ze-Yi Wang Guang-Xia Shi Na Zhang Jin-Ling Li Meng-Meng Ren Jun-Lian Liu Hang Zhou Chih-Kai Lee Jian-Feng Tu Xu Wang Cun-Zhi Liu Effect of acupuncture treatment for patients with knee osteoarthritis on brain fluctuation amplitude and functional connectivity: a randomized three-armed fMRI study BMC Complementary Medicine and Therapies Acupuncture ALFF Functional connectivity Knee osteoarthritis fMRI |
| title | Effect of acupuncture treatment for patients with knee osteoarthritis on brain fluctuation amplitude and functional connectivity: a randomized three-armed fMRI study |
| title_full | Effect of acupuncture treatment for patients with knee osteoarthritis on brain fluctuation amplitude and functional connectivity: a randomized three-armed fMRI study |
| title_fullStr | Effect of acupuncture treatment for patients with knee osteoarthritis on brain fluctuation amplitude and functional connectivity: a randomized three-armed fMRI study |
| title_full_unstemmed | Effect of acupuncture treatment for patients with knee osteoarthritis on brain fluctuation amplitude and functional connectivity: a randomized three-armed fMRI study |
| title_short | Effect of acupuncture treatment for patients with knee osteoarthritis on brain fluctuation amplitude and functional connectivity: a randomized three-armed fMRI study |
| title_sort | effect of acupuncture treatment for patients with knee osteoarthritis on brain fluctuation amplitude and functional connectivity a randomized three armed fmri study |
| topic | Acupuncture ALFF Functional connectivity Knee osteoarthritis fMRI |
| url | https://doi.org/10.1186/s12906-025-04985-w |
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