Acupuncture Treatment Compensated the Altered Functional Connectivity in the Pain Modulation System on Primary Dysmenorrhea: A Pilot Study
Abstract BackgroundPrimary dysmenorrhea (PDM) is the most commonly encountered gynecological problem in reproductive-age women. We previously reported altered functional connectivity between periaqueductal gray matter and other pain-related brain regions in women with PDM, indicating a maladaptation in the descending pain modulation system. Clinically, acupuncture has been suggested as an effective treatment of PDM. Previous animal studies revealed that acupuncture on specific acupoint can produced analgesic effect via descending pain modulation system. In the present study, we used resting-state functional magnetic resonance imaging to investigate possible changes in descending pain modulation after acupuncture treatment in women with PDM. MethodsThirty-four right-handed adult women with PDM participated in this randomized, single-blinded, sham-controlled study. Each patient was randomly allocated to an 8-week verum or sham acupuncture intervention on the bilateral acupoint Sanyinjiao (SP6). Resting-state functional magnetic resonance imaging was conducted before, during, and after the intervention session to measure the spontaneous activity in brain. The functional connectivity maps between periaqueductal gray matter and other pain-related brain regions were generated to reveal the status of descending pain modulation systems.ResultsAfter 8 weeks, both groups reported decreased menstrual pain. However, the patterns of functional connectivity changes in descending pain modulation system were different after the verum or sham intervention. The effect of the verum acupuncture intervention may be underpinned by compensatory and/or resilience changes in descending pain modulation systems, whereas that of the sham acupuncture intervention may be underpinned by cognitive reappraisal of painConclusionsThe dissimilar pattern of the FC alterations after the verum and sham acupuncture indicating that different brain mechanisms may be responsible for the menstrual pain relief in verum or sham acupuncture intervention. These results may contribute to the discussion of whether acupuncture treatment induces therapeutic physiological alterations or its benefit is attributable to the placebo effect.