Thalamocortical Mechanisms Underlying Real and Imagined Acupuncture

Author: Qiao Kong1, Valeria Sacca1, Kathryn Walker1, Sierra Hodges1, Jian Kong1
1 Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA.
Conference/Journal: Biomedicines
Date published: 2023 Jun 26
Other: Volume ID: 11 , Issue ID: 7 , Pages: 1830 , Special Notes: doi: 10.3390/biomedicines11071830. , Word Count: 255

Both acupuncture and imagery have shown potential for chronic pain management. However, the mechanisms underlying their analgesic effects remain unclear. This study aims to explore the thalamocortical mechanisms underlying acupuncture and video-guided acupuncture imagery treatment (VGAIT), a combination of acupuncture and guided imagery, using the resting-state functional connectivity (rsFC) of three thalamic subdivisions-the ventral posterolateral thalamus (VPL), mediodorsal thalamus (MD), and motor thalamus subregion (Mthal)-associated with somatosensory, limbic, and motor circuity. Twenty-seven healthy individuals participated in a within-subject randomized crossover design study. Results showed that compared to sham acupuncture, real acupuncture altered the rsFC between the thalamus and default mode network (DMN) (i.e., mPFC, PCC, and precuneus), as well as the prefrontal and somatosensory cortex (SI/SII). Compared to the VGAIT control, VGAIT demonstrated greater rsFC between the thalamus and key nodes within the interoceptive network (i.e., anterior insula, ACC, PFC, and SI/SII), as well as the motor and sensory cortices (i.e., M1, SMA, and temporal/occipital cortices). Furthermore, compared to real acupuncture, VGAIT demonstrated increased rsFC between the thalamus (VPL/MD/Mthal) and task-positive network (TPN). Further correlations between differences in rsFC and changes in the heat or pressure pain threshold were also observed. These findings suggest that both acupuncture- and VGAIT-induced analgesia are associated with thalamocortical networks. Elucidating the underlying mechanism of VGAIT and acupuncture may facilitate their development, particularly VGAIT, which may be used as a potential remote-delivered pain management approach.

Keywords: acupuncture; e-health; functional connectivity; pain; thalamocortical; video-guided acupuncture imagery treatment.

PMID: 37509469 PMCID: PMC10377130 DOI: 10.3390/biomedicines11071830