MECHANISMS OF ACUPUNCTURE ANALGESIA: A (FMRI) AND (PET) STUDY

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。针灸在亚洲用于减轻疼痛已有2000多年的历史，现在在西方国家也越来越流行。本研究的目的是利用两种不同的脑成像技术，正电子发射断层扫描（PET）和功能磁共振成像（fMRI），确定针灸减轻疼痛的特定神经机制。这项研究可能会导致针灸在科学界得到更广泛的接受，也有助于阐明这种干预背后的神经机制。所有参与者必须诊断为纤维肌痛（FM），这是一种慢性疼痛状况，并且没有PET程序，fMRI中使用的磁场或针灸针的禁忌症。所有受试者将从受试者注册表（UM IRB # 2002-0678）中招募，最初通过电话征求。将亲自获得潜在受试者的书面知情同意。所有符合条件的受试者将被随机分配接受中医针灸或安慰剂牙签干预，模仿针灸。分层随机化将被用于在基线时将参与者分为有抑郁和无抑郁两组。抑郁的参与者将被排除在本调查的PET部分之外。主要结果是通过PET或fMRI测量大脑活动的变化。将对针灸组和安慰剂牙签组激活的大脑区域进行比较。两组之间不同的活动表明针灸的独特机制，而两组之间相似的活动表明针灸主要通过安慰剂机制起作用。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Acupuncture has been used for the reduction of pain for over 2000 years in Asia and is now becoming more popular in Western countries. The aim of this study is to use two different brain imaging techniques, positron emission tomography (PET) and functional magnetic resonance imaging (fMRI), to determine acupuncture specific neural mechanisms of pain reduction. This research may result in a more widespread acceptance of acupuncture by the scientific community and also help to elucidate neural mechanisms that underlie this intervention. All participants must have the diagnosis of fibromyalgia (FM), a chronic pain condition, and have no contraindications with either the PET procedures, the magnetic fields used in fMRI, or acupuncture needles. All subjects will be recruited from a subject registry (UM IRB # 2002-0678) with an initial solicitation via telephone. A written informed consent will be obtained in person from potential subjects. All eligible subjects will be randomly assigned to receive either traditional Chinese medicine based acupuncture or a placebo toothpick intervention which mimics acupuncture. Stratified randomization will be utilized to divide participants into those with and without depression at baseline. Depressed participants will be excluded from the PET portion of this investigation. The primary outcomes are the changes in brain activity as measured with either PET or fMRI. Comparisons between brain regions that are activated in the acupuncture versus placebo toothpick groups will be made. Different activity between the two groups would suggest unique mechanisms for acupuncture whereas similar activity between the two groups would suggest that acupuncture functions primarily through placebo mechanisms.