Amazing acupuncture study
A few of comments about the acupuncture study below:
First, Cochran reviews published no less than 5 acupuncture or acupuncture related reviews two weeks ago. Since none of these have hit lay press we can suspect what the conclusions were. (Boringly inconclusive.) This study used PET "brain scans" to measure outcomes. Not much is known about imaging pain on PET scans. Newer imaging agents and ways to use PET (and MRI) are revolutionizing imaging in healthcare. That older first-generation MRI and PET machines are now working their way into tertiary clinics and practices helps to revolutionize imaging use as well - but that's another HF topic. Despite new cool ways to image brain physiology (maybe a primary point for doing the study), not enough has been observed to make the article's inferred associations about acupuncture's impact on the perception of pain in the brain. A PET scan can probably demonstrate that the "area of the brain associated with the production of natural opiates" were activated with trick, as well as real needle placement. And this is the most practical conclusion of the study in terms of better understanding of conjectured efficacy of acupuncture. That "another region of the brain, the insular, was excited" only by real treatment could really mean anything. But because this was observed during an acupuncture study, it's easy to speculate an affirmative association.
I have an idea, let's see if Tylenol stimulates the insular region. How about a loud noise, a nagging anxiety, or the violation of personal space by a stranger? What happens to this area on imaging when different kinds of pain are present, or administered? If we can determine this area can be associated with pain relief, how can we affect it consciously or therapeutically? How about after these questions are answered, we go back and review it in the context of acupuncture?
dras
Story from BBC NEWS:>http://news.bbc.co.uk/go/pr/fr/-/1/hi/health/4493011.stm>
Acupuncture 'more than a placebo'> Scientists say they have proof that acupuncture> works in its own right.> > Sceptics have said that any benefits gained from> acupuncture are merely> down to a person's expectation that the treatment> will work.> > But researchers at University College London and> Southampton University> say they have separated out this placebo effect.> > Their findings, based on a series of experiments and> brain scan results,> are published in the journal NeuroImage.> > Dummy treatment> > The researchers used positron emission tomography> (PET) scans to see> what was happening in the brains of people having> acupuncture treatment> for arthritis pain.> > The great bulk of trials to date do not provide> convincing evidence of> pain relief over placebo [dummy pill]> Professor Henry McQuay, University of Oxford> > Each of the 14 volunteers underwent each of three> interventions in a> random order.> > In one intervention, patients were touched with> blunt needles but were> aware that the needle would not pierce the skin and> that it did not have> any therapeutic value.> > Another intervention involved treatment with> specially developed "trick"> needles that give the impression that the skin was> being penetrated even> though the needles never actually pierced the skin.> > The needles worked like stage daggers, with the tip> disappearing into> the body of the needle when pressure is applied.> This was designed to> make the patients believed that the treatment was> real.> > The third intervention was real acupuncture.> > Brain activity> > When the researchers analysed the patients' PET scan> results they found> marked differences between the three interventions.> > Only the brain areas associated with the sensation> of touch were> activated when the volunteers were touched with the> blunt needles.> > During the trick needle treatment, an area of the> brain associated with> the production of natural opiates - substances that> act in a> non-specific way to relieve pain - were activated.> > This same area was activated with the real> acupuncture but, in addition,> another region of the brain, the insular, was> excited by the treatment.> > This was a pathway known to be associated with> acupuncture treatment and> thought to be involved in pain modulation.> > Sarah Williams of the British Acupuncture Council> said: "This is very> positive news for acupuncture and this latest> research is an exciting> illustration of what acupuncturists have known for a> long time - that> acupuncture works and its effectiveness goes beyond> the placebo effect."> > Professor Henry McQuay, professor of pain relief at> the University of> Oxford and member of the Bandolier group that looks> at the evidence> behind different medical treatments, said: "The> great bulk of the> randomised controlled trials to date do not provide> convincing evidence> of pain relief over placebo.> > "Some people do report that acupuncture makes them> feel better.> > "But it is extremely difficult, technically, to> study acupuncture and> tease out the placebo effect.">
First, Cochran reviews published no less than 5 acupuncture or acupuncture related reviews two weeks ago. Since none of these have hit lay press we can suspect what the conclusions were. (Boringly inconclusive.) This study used PET "brain scans" to measure outcomes. Not much is known about imaging pain on PET scans. Newer imaging agents and ways to use PET (and MRI) are revolutionizing imaging in healthcare. That older first-generation MRI and PET machines are now working their way into tertiary clinics and practices helps to revolutionize imaging use as well - but that's another HF topic. Despite new cool ways to image brain physiology (maybe a primary point for doing the study), not enough has been observed to make the article's inferred associations about acupuncture's impact on the perception of pain in the brain. A PET scan can probably demonstrate that the "area of the brain associated with the production of natural opiates" were activated with trick, as well as real needle placement. And this is the most practical conclusion of the study in terms of better understanding of conjectured efficacy of acupuncture. That "another region of the brain, the insular, was excited" only by real treatment could really mean anything. But because this was observed during an acupuncture study, it's easy to speculate an affirmative association.
I have an idea, let's see if Tylenol stimulates the insular region. How about a loud noise, a nagging anxiety, or the violation of personal space by a stranger? What happens to this area on imaging when different kinds of pain are present, or administered? If we can determine this area can be associated with pain relief, how can we affect it consciously or therapeutically? How about after these questions are answered, we go back and review it in the context of acupuncture?
dras
Story from BBC NEWS:>http://news.bbc.co.uk/go/pr/fr/-/1/hi/health/4493011.stm>
Acupuncture 'more than a placebo'> Scientists say they have proof that acupuncture> works in its own right.> > Sceptics have said that any benefits gained from> acupuncture are merely> down to a person's expectation that the treatment> will work.> > But researchers at University College London and> Southampton University> say they have separated out this placebo effect.> > Their findings, based on a series of experiments and> brain scan results,> are published in the journal NeuroImage.> > Dummy treatment> > The researchers used positron emission tomography> (PET) scans to see> what was happening in the brains of people having> acupuncture treatment> for arthritis pain.> > The great bulk of trials to date do not provide> convincing evidence of> pain relief over placebo [dummy pill]> Professor Henry McQuay, University of Oxford> > Each of the 14 volunteers underwent each of three> interventions in a> random order.> > In one intervention, patients were touched with> blunt needles but were> aware that the needle would not pierce the skin and> that it did not have> any therapeutic value.> > Another intervention involved treatment with> specially developed "trick"> needles that give the impression that the skin was> being penetrated even> though the needles never actually pierced the skin.> > The needles worked like stage daggers, with the tip> disappearing into> the body of the needle when pressure is applied.> This was designed to> make the patients believed that the treatment was> real.> > The third intervention was real acupuncture.> > Brain activity> > When the researchers analysed the patients' PET scan> results they found> marked differences between the three interventions.> > Only the brain areas associated with the sensation> of touch were> activated when the volunteers were touched with the> blunt needles.> > During the trick needle treatment, an area of the> brain associated with> the production of natural opiates - substances that> act in a> non-specific way to relieve pain - were activated.> > This same area was activated with the real> acupuncture but, in addition,> another region of the brain, the insular, was> excited by the treatment.> > This was a pathway known to be associated with> acupuncture treatment and> thought to be involved in pain modulation.> > Sarah Williams of the British Acupuncture Council> said: "This is very> positive news for acupuncture and this latest> research is an exciting> illustration of what acupuncturists have known for a> long time - that> acupuncture works and its effectiveness goes beyond> the placebo effect."> > Professor Henry McQuay, professor of pain relief at> the University of> Oxford and member of the Bandolier group that looks> at the evidence> behind different medical treatments, said: "The> great bulk of the> randomised controlled trials to date do not provide> convincing evidence> of pain relief over placebo.> > "Some people do report that acupuncture makes them> feel better.> > "But it is extremely difficult, technically, to> study acupuncture and> tease out the placebo effect.">
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10:36 PM
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