Changes in resting‐state functional connectivity in nonacute sciatica with acupuncture modulation: A preliminary study

Abstract

Aims:To investigate the functional connectivity (FC) in nonacute sciatica and the neuronal correlation of acupuncture analgesia. Methods:A prospective study employing resting-state functional magnetic resonance imaging was conducted. Twelve sciatica patients were enrolled to receive six or 18 acupoints of acupuncture treatment twice a week for 4 weeks. Regional homogeneity (ReHo) and seed-based FC were performed. Results: Regional homogeneity analysis demonstrated a greater alteration in the right posterior cingulate cortex (PCC) during the pre-acupuncture phase than during the postacupuncture phase. Compared to that of healthy controls, the PCC-seeded FC (default mode network, DMN) of sciatica patients exhibited hyperconnectivity of PCC-FC with the PCC-bilateral insula, cerebellum, inferior parietal lobule, right medial prefrontal cortex, and dorsal anterior cingulate cortex during the pre-acupuncture phase as well as hypoconnectivity of PCC-FC with the right cerebellum, left precuneus, and left dorsal medial prefrontal cortex during the postacupuncture phase. Correlation analysis between PCC-seeded FC and behavior measurements revealed a positive association with the duration of sciatica in the right inferior parietal lobule prior to acupuncture treatment.Conclusions: Acupuncture in chronic sciatica patients is associated with normalized DMN activity and modulation of descending pain processing. The changes in the subclinical endophenotype of brain FC after acupuncture treatment may provide clues for understanding the mechanism of acupuncture-mediated analgesia in chronic pain. K E Y W O R D Sacupuncture, default mode network, functional connectivity, magnetic resonance imaging, sciatica

Neuroimaging Studies of Acupuncture on Low Back Pain: A Systematic Review

“…A total of 310 results were yielded from the databases. After deduplication and screening phases, 19 studies (Ji et al, 2007 ; Junhai et al, 2008 ; Yongsong et al, 2011 ; Li et al, 2012 , 2014 ; Guoqiang et al, 2014 ; Jialiang et al, 2014 ; Tao et al, 2015 ; Lin and Xianmo, 2017 ; Yijun et al, 2017 ; Makary et al, 2018 ; Lee et al, 2019 ; Tu et al, 2019 ; Xiang et al, 2019 ; Yan et al, 2019 ; Kim et al, 2020 ; Lan et al, 2020 ; Liu et al, 2020 ; Yu et al, 2020 ) between 2007 and 2020 were incorporated in this review ( Table 1 ). Among the articles, 14 studies were performed in China (Ji et al, 2007 ; Junhai et al, 2008 ; Yongsong et al, 2011 ; Li et al, 2012 , 2014 ; Guoqiang et al, 2014 ; Jialiang et al, 2014 ; Tao et al, 2015 ; Lin and Xianmo, 2017 ; Yijun et al, 2017 ; Xiang et al, 2019 ; Yan et al, 2019 ; Lan et al, 2020 ; Liu et al, 2020 ), three were conducted in the USA (Tu et al, 2019 ; Kim et al, 2020 ; Yu et al, 2020 ), and two were conducted in South Korea (Makary et al, 2018 ; Lee et al, 2019 ).…”

“…After deduplication and screening phases, 19 studies (Ji et al, 2007 ; Junhai et al, 2008 ; Yongsong et al, 2011 ; Li et al, 2012 , 2014 ; Guoqiang et al, 2014 ; Jialiang et al, 2014 ; Tao et al, 2015 ; Lin and Xianmo, 2017 ; Yijun et al, 2017 ; Makary et al, 2018 ; Lee et al, 2019 ; Tu et al, 2019 ; Xiang et al, 2019 ; Yan et al, 2019 ; Kim et al, 2020 ; Lan et al, 2020 ; Liu et al, 2020 ; Yu et al, 2020 ) between 2007 and 2020 were incorporated in this review ( Table 1 ). Among the articles, 14 studies were performed in China (Ji et al, 2007 ; Junhai et al, 2008 ; Yongsong et al, 2011 ; Li et al, 2012 , 2014 ; Guoqiang et al, 2014 ; Jialiang et al, 2014 ; Tao et al, 2015 ; Lin and Xianmo, 2017 ; Yijun et al, 2017 ; Xiang et al, 2019 ; Yan et al, 2019 ; Lan et al, 2020 ; Liu et al, 2020 ), three were conducted in the USA (Tu et al, 2019 ; Kim et al, 2020 ; Yu et al, 2020 ), and two were conducted in South Korea (Makary et al, 2018 ; Lee et al, 2019 ). Five kinds of diseases were involved in these studies: chronic low back pain (Li et al, 2014 ; Tu et al, 2019 ; Xiang et al, 2019 ; Yan et al, 2019 ; Kim et al, 2020 ; Yu et al, 2020 ), non-specific low back pain (Makary et al, 2018 ; Lee et al, 2019 ), lumbar disc herniation (Yongsong et al, 2011 ; Guoqiang et al, 2014 ; Jialiang et al, 2014 ; Tao et al, 2015 ; Lin and Xianmo, 2017 ; Yijun et al, 2017 ; Lan et al, ...…”

Efficacy of acupuncture for sciatica: study protocol for a randomized controlled pilot trial

“…Acupuncture is known to exert an analgesic effect through inhibiting cytokine production and activate sympathetic nerve fibers to increase endogenous opioids [31,32]. It may normalize default mode network activity and modulation of descending pain processing that help treat sciatica [33].…”

Efficacy of acupuncture for sciatica: study protocol for a randomized controlled pilot trial.

“…Acupuncture is known to exert an analgesic effect through inhibiting cytokine production and activate sympathetic nerve bers to increase endogenous opioids [31,32]. It may normalize default mode network activity and modulation of descending pain processing that help treat sciatica [33].…”