What an absolutely amazing blog post by an acupuncture researcher, Vitaly Napadow. In it, he talks about some recent research, published in the journal Brain, he participated in. What is remarkable is it seems to answer two really big questions.
The first question is “does acupuncture really do anything centrally?” Over the years there has been a lot of research that has associated various point functions with stimulation of certain areas of the brain associated with that function using functional MRI. For example, some of this early research showed that points on the foot that are supposed to help the eyes actually stimulated visual areas in the occipital region of the brain. Wow! Same thing with points to help the ears and hearing. The only problem is this research was later retracted. And while there does seem to be this connection with other points, it has never been as clear cut.
Enter Maeda and the research team. They found that patients using “real” (verum) acupuncture locally and distally (on the leg), showed changes in the somatosensory areas of the cortex in the brain. And these were connected to improvements in median nerve function.
The second question revolves around the difference between sham and verum acupuncture. While there are many forms of sham acupuncture, they generally involve using needles in slightly different locations and/or depths than the real acupuncture. And there have been lots and lots of recent studies that show sham and verum acupuncture are better for various conditions than other interventions. But there has not been a big difference between the two.
Generally, I believe there hasn’t been a difference because sham really isn’t sham. If one uses the same point but at a shallower depth, this is very similar to Japanese style acupuncture, and therefore not sham. Researchers have used this similarity of results between sham and verum acupuncture to imply that acupuncture’s strength lies in its placebo effect.
Once again, enter the research team. What they found was that sham and verum acupuncture did have similar effects right after treatment. However, sham acupuncture did not cause changes in the somatosensory cortex, nor did it show long term benefit. Verum acupuncture did both.
So, this research showed two things: acupuncture affects the brain and can actually rewire it and verum acupuncture is different and better than sham acupuncture. These are really amazing results. And this was a good study: it was randomly controlled, involved 80 patients, and was well constructed. Of course more research is always needed…