Immediate Analgesic Effect of Acupuncture in Patients With Primary Dysmenorrhea: A fMRI Study

Abstract

Primary dysmenorrhea (PDM) is a common gynecological disease characterized by lower abdominal pain. Acupuncture is considered a good alternative therapy for PDM. However, the central mechanism of the analgesic effect of acupuncture is largely unknown. In this study, eligible patients were randomized into the real and sham acupuncture groups using a computer-generated, permuted block randomization method. The study cohort comprised 34 patients: 19 in the real acupuncture group and 15 in the sham acupuncture group. The clinical characteristics of the patients during their menstrual period were collected, and imaging scans were performed during the first 3 days of the patients’ menstrual period. We analyzed task and resting functional magnetic resonance imaging (fMRI) data to investigate the potential central mechanism of the immediate effect of acupuncture intervention on the intensity of PDM pain. The task fMRI study found that the rostral anterior cingulate cortex (rACC) and right supplemental motor area were activated during real acupuncture. Using the resting-state functional connectivity (FC) method, we found a post- versus pre-treatment change in the FC of the rACC and left precentral gyrus in the comparison of real acupuncture versus sham acupuncture. In addition, the FC of the rACC–left precentral gyrus at baseline was negatively correlated with short-term analgesia, while the change in the FC of the rACC–left precentral gyrus was positively correlated with short-term analgesia after acupuncture treatment. These findings support the importance of rACC–left precentral gyrus resting-state FC in the modulation of the intensity of PDM pain through acupuncture, which may shed light on the central mechanism of acupuncture in the treatment of PDM.

Revealing the Central Mechanism of Acupuncture for Primary Dysmenorrhea Based on Neuroimaging: A Narrative Review

“…The top one was Chengdu University of Traditional Chinese Medicine (8 studies) [ 17 , 22 – 28 ] ( Figure 1(c) ).…”

“…11 RCT studies were included in the study, 4 were considered “low risk” [ 24 , 28 – 30 ], and the remaining 7 were considered “some concerns” due to “deviations from the intended intervention” and “missing outcomes” [ 17 , 22 , 25 , 26 , 31 – 33 ]. Of the 14 non-RCT studies included, 3 were considered “low risk” [ 23 , 27 , 34 ], and the remaining 11 were considered “some concerns” due to “selection bias in participant studies,” “deviations from intended interventions,” and “missing outcomes” [ 35 – 42 ].…”

Acupuncture modulates the frequency-specific functional connectivity density in primary dysmenorrhea

“…Acupuncture treatments were performed by qualified practitioners who had undergone extensive clinical and operational training. The selection of the VA and SA was identical to the previous study ( Wang et al, 2021 ). The VA acupoints were bilateral SP6, which were known to alleviate PDM well ( Abaraogu et al, 2016 ; Yu et al, 2017 ).…”

Comparison of the effects of transcranial direct current stimulation and mindfulness-based stress reduction on mental fatigue, quality of life and aggression in mild traumatic brain injury patients: a randomized clinical trial

“…According to the existing studies and the opinions of some experts, after considering the two main points of the protocol, the amount of electric current from 1 to 2 mA during ten sessions (three sessions of 20 min per week) were considered. During the sessions, the amount of current was determined and electricity was increased [ 19 , 20 ].…”