Deqi sensations without cutaneous sensory input: results of an RCT

Abstract

Background: Deqi is defined in relation to acupuncture needling as a sensory perception of varying character. In a recently published sham laser validation study, we found that subjects in the verum and the sham laser group experienced deqi sensations. Therefore, we aim to further analyze whether the perceptions reported in the two study arms were distinguishable and whether expectancy effects exhibited considerable impact on our results. Methods: A detailed re-analysis focusing on deqi sensations was performed from data collected in a previously published placebo-controlled, double-blind, clinical cross-over trial for a sham laser evaluation. Thirty-four healthy volunteers (28 ± 10.7 years; 16 women, 18 men) received two laser acupuncture treatments at three acupuncture points LI4 (hégu), LU7 (liéque), and LR3 (táichong); once by verum laser and once using a sham device containing an inactive laser in randomized order. Outcome measures were frequency, intensity (evaluated by visual analogue scale; VAS), and quality of the subjects' sensations perceived during treatments (assessed with the "acupuncture sensation scale"). Results: Both, verum and the sham laser acupuncture result in similar deqi sensations with regard to frequency (p-value = 0.67), intensity (p-value = 0.71) and quality (p-values between 0.15 -0.98). In both groups the most frequently used adjectives to describe these perceptions were "spreading", "radiating", "tingling", "tugging", "pulsing", "warm", "dull", and "electric". Sensations reported were consistent with the perception of deqi as previously defined in literature. Subjects' conviction regarding the effectiveness of laser acupuncture or the history of having received acupuncture treatments before did not correlate with the frequency or intensity of sensations reported. Conclusions: Since deqi sensations, described as sensory perceptions, were elicited without any cutaneous sensory input, we assume that they are a product of non-specific effects from the overall treatment procedure. Expectancyeffects due to previous acupuncture experience and belief in laser acupuncture do not seem to play a major role in elicitation of deqi sensations. Our results give hints that deqi might be a central phenomenon of awareness and consciousness, and that its relevance should be taken into account, even in clinical trials. However, further research is required to understand mechanisms underlying deqi.

Brain Areas Involved in Acupuncture Needling Sensation of de qi: A single-photon emission computed tomography (SPECT) study

“…Subjects with de qi sensation demonstrated that significant activated points are mainly located in Brodmann areas 6,8,19,21,28,33,35,37,47, parahippocampal gyrus, lentiform nucleus, claustrum and red nucleus, and deactivated points were shown in Brodmann areas 9 and 25. into de qi group, or use of different acupuncture points, or they may have arisen from differences in the statistical methodology and level of thresholding used.…”

“…Results All six subjects in the verum acupuncture at true acupuncture point group experienced de qi sensation; in contrast, all six subjects in the sham acupuncture at the sham point group responded with nothing other than non-sensation. Compared to the scan results from subjects who experienced non-sensation, SPECT scans from subjects with de qi sensation demonstrated significant activated points mainly located in brodmann areas 6,8,19,21,28, 33, 35, 37, 47, the parahippocampal gyrus, lentiform nucleus, claustrum and red nucleus; deactivated points were seen in brodmann areas 9 and 25. Conclusions Verum acupuncture at true acupuncture points is more likely to elicit de qi sensation.…”

Physiological Changes Associated with de qi during electroacupuncture to LI4 and LI11: A randomised, placebo-controlled trial

“…All these could reinforce subjects' expectation that they would feel something during the interventions. 41 The slight increase in LF/HF in the placebo group could be the result of the subject's anxiety, expectation or focused attention to the points, as an increase in awareness of spontaneous activity of motoneurons could lead to an increase in the muscle and skin sympathetic nerve activity. 42 …”

Seeing the Body: A New Mechanism for Acupuncture Analgesia?

“…31 As they remark, '[these] results give hints that de qi might be a central phenomenon of awareness and consciousness and that its relevance should be taken into account, even in clinical trials'. Bulley's report provides further evidence for this hypothesis.…”