Abstract
The
The following awards, supported in part by the Journal of Alternative and Complementary Medicine (JACM), were given out for outstanding oral presentations in basic science and clinical research categories:
Category: Junior Researcher in Basic Science
Kylie Isenburg, Massachusetts General Hospital; Ishtiaq Mawla, Massachusetts General Hospital; Jeungchan Lee, Massachusetts General Hospital; Jessica Gerber, Massachusetts General Hospital; Jieun Kim, Korea Institute of Oriental Medicine; Hyungjun Kim, Korea Institute of Oriental Medicine; Suk‐Tak (Phoebe) Chan, Massachusetts General Hospital; Ana Ortiz, Massachusetts General Hospital; Ajay Wasan, University of Pittsburgh; Robert Edwards, Brigham and Women's Hospital; Randy Gollub, Massachusetts General Hospital; Jian Kong, Massachusetts General Hospital; Bruce Rosen, Massachusetts General Hospital; Vitaly Napadow, Massachusetts General Hospital
Purpose Chronic low back pain (cLBP) has been associated with aberrant brain processing and hyperalgesia, assessed by evoked, experimental pain testing. Due to a lack of effective pharmacological treatment, alternative therapies (e.g., acupuncture) have shown promise for cLBP. However, the central mechanisms supporting reduced hyperalgesia and clinical outcomes are unclear. We conducted a longitudinal neuroimaging study with brain response to painful mechanical pressure before and after 4 weeks (6 treatments) of real or sham acupuncture. Methods We enrolled 63 cLBP patients (33 male, 40.3 ± 11.7 years old) and 33 matched healthy controls, with patients randomized to verum (manual acupuncture) or sham acupuncture with variable somatosensory afference (Streitberger sham, mock‐laser acupuncture), or a no‐treatment/usual care control. LBP bothersomeness over the prior week (0‐100, VAS) and LBP intensity ratings (0‐100, NRS) prior to and after each treatment were collected. Changes in brain response to evoked leg cuff pain (calibrated to 40/100) was assessed with BOLD fMRI at baseline and post‐intervention sessions, and correlated with clinical outcomes. Results We found that within‐session reduction in LBP intensity was significant (p < 0.005) only for verum acupuncture. Moreover, only for verum acupuncture was within‐session change in LBP intensity correlated with change in cuff pain ratings (r = 0.55, p = 0.02), and with increased cuff pain‐evoked activation in right dorsolateral Prefrontal Cortex (dlPFC, p < 0.05) following 4 weeks of therapy. Conclusions Thus, cLBP patients treated by verum acupuncture showed greater within‐session LBP improvement, which was linked with 1) reduced hyperalgesia and 2) increased pain‐evoked activation in the dlPFC, a brain region previously implicated in inhibitory control of nociceptive information. Individuals with chronic pain have shown compromised dlPFC structure and/or function, and acupuncture (particularly manual acupuncture with somatosensory afference targeting deeper subcutaneous receptors) may facilitate cortical anti‐nociceptive modulation, leading to reduced hyperalgesia and clinical pain.
Category: Senior Researcher in Basic Science
Nuno M.P. de Matos, Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Switzerland; Daniel Pach, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics; Jing Jing Xing, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China; Jürgen Barth, Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Switzerland; Lara Elena Beyer, Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Switzerland; Xuemin Shi, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China; Alexandra Kern, Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich; Nenad Lukic, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Dominik A. Ettlin, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Mike Brügger, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Claudia M. Witt, 1Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Switzerland
Various animal models for neuropathic pain, inflammatory pain, cancer‐related pain, and visceral pain already exist in acupuncture research. We used a newly validated human pain model and examined whether acupuncture can influence experimentally induced dental pain. For this study, we compared the impact of real acupuncture, sham acupuncture and no acupuncture on experimentally induced dental pain in thirty‐five healthy men who were randomized to different sequences of all three interventions in a within‐subject design. BORG CR10 pain ratings and autonomous responses (electrodermal activity and heart rate variability) were investigated. An initial mixed model with repeated measures included preintervention pain ratings and the trial sequence as covariates. The results showed that acupuncture was effective in reducing pain intensity when compared to no acupuncture, showing a medium Cohen's d effect size of 0.56. The comparison to the sham acupuncture intervention revealed a small Cohen's d effect size of 0.25. No differences in autonomous responses between real and sham acupuncture were found during the intervention procedures. Conclusion: This study established a dental pain model for acupuncture research and provided evidence that, compared to a no treatment condition, experimentally induced dental pain in humans can be influenced by real acupuncture. Trial registration: The study was registered at clinicaltrials.gov (registration ID: NCT02589418)
Category: Senior Researcher in Clinical Research
Lisa Taylor‐Swanson, College of nursing, University of Utah; Jennifer Stone, Indiana University School of Medicine, Department of Anesthesia; Megan Gale, Washington East Asian Medicine Association; Catherine Dayhoff, Washington East Asian Medicine Association
Category: Junior Researcher in Clinical Research
Simone Ormsby, NICM, Western Sydney University; Caroline Smith, NICM, Western Sydney University; Hannah Dahlen, School of Midwifery, Western Sydney University; Phillipa Hay, Chair of Mental Health, Western Sydney University
Abstract Background Preliminary clinical trial evidence is suggestive that acupuncture may provide a promising adjunct treatment for the management of depression. Findings in antenatal populations are similar, however study numbers are small, hence further investigation is required. This study therefore aimed to additionally explore the feasibility of utilising acupuncture for the management of antenatal depressive symptomologies. Methods Fifty‐seven women meeting Edinburgh Postnatal Depression Scale (EPDS) scores of ≥13 were randomised to individually tailored depressed specific acupuncture, progressive muscle relaxation attention comparator, or treatment as usual. Women in either treatment arm received weekly one‐hour sessions in the antenatal clinics of two Sydney hospitals, from gestation weeks 24 to 31. Evaluations included: EPDS; Depression, Stress and Anxiety Scale; and World Health Organisation Quality of Life Scale at baseline, weeks four and eight, and six‐weeks postnatal; weekly and six‐weeks postnatal monitoring of distress via the Kessler 6; six‐weeks postnatal assessment of adjustment to mothering using the Being a Mother scale; and numerous birthing and postnatal outcomes. Results Forty‐six women completed all data sets. Findings demonstrated significantly reduced end of the intervention EPDS (p < 0.001), stress component of the DASS‐21 (p = 0.002), and K6 (p < 0.001) scores for acupuncture compared to progressive muscle relaxation and treatment as usual. No between group differences were observed for other pregnancy, birthing (n = 57) or postnatal outcomes (n = 45). The individually tailored acupuncture intervention was well‐tolerated and free from adverse events. Conclusion The findings from this feasibility study demonstrated a willingness by pregnant women to incorporate acupuncture in with conventional management approaches when continuing to suffer from depressive symptomologies. In addition, women who were unwilling to pursue standard therapies similarly exhibited a desire to explore acupuncture as an additional therapeutic possibility. Results obtained provided further support that acupuncture may be beneficial for the management of antenatal depression, stress and distress.