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1、Pain130(2007)254–266www.elsevier.com/locate/painHypothalamusandamygdalaresponsetoacupuncturestimuliincarpaltunnelsyndromea,b,*baaaaV.Napadow,N.Kettner,J.Liu,M.Li,K.K.Kwong,M.Vangel,cdaN.Makris,J.Audette,K.K.S.HuiaMartinosCenterforBiomedicalImaging,De
2、partmentofRadiology,MassachusettsGeneralHospital,Charlestown,MA,UnitedStatesbDepartmentofRadiology,LoganCollegeofChiropractic,Chesterfield,MO,UnitedStatescMartinosCenterforBiomedicalImaging,DepartmentofNeurology,MassachusettsGeneralHospital,Charlestow
3、n,MA,UnitedStatesdSpauldingRehabilitationHospital,Boston,MA,UnitedStatesReceived19July2006;receivedinrevisedform21November2006;accepted4December2006AbstractBrainprocessingofacupuncturestimuliinchronicneuropathicpainpatientsmayunderlieitsbeneficialeffec
4、ts.WeusedfMRItoevaluateverumandshamacupuncturestimulationatacupointLI-4inCarpalTunnelSyndrome(CTS)patientsandhealthycontrols(HC).CTSpatientswereretestedafter5weeksofacupuncturetherapy.Thus,weinvestigatedboththeshort-termbrainresponsetoacupuncturestim
5、ulation,aswellastheinfluenceoflonger-termacupuncturetherapyeffectsonthisshort-termresponse.CTSpatientsrespondedtoverumacupuncturewithgreateractivationinthehypothalamusanddeactivationintheamygdalaascom-paredtoHC,controllingforthenon-specificeffectsofshama
6、cupuncture.AsimilardifferencewasfoundbetweenCTSpatientsatbaselineandafteracupuncturetherapy.ForbaselineCTSpatientsrespondingtoverumacupuncture,functionalconnectivitywasfoundbetweenthehypothalamusandamygdala–thelessdeactivationintheamygdala,thegreatert
7、heactivationinthehypo-thalamus,andviceversa.Furthermore,hypothalamicresponsecorrelatedpositivelywiththedegreeofmaladaptivecorticalplastic-ityinCTSpatients(inter-digitseparationdistance).Thisisthefirstevidencesuggestingthatchronicpainpatientsrespondtoa
8、cupuncturedifferentlythanHC,throughacoordinatedlimbicnetworkincludingthehypothalamusandamygdala.Ó2006InternationalAssociationfortheStudyofPain.PublishedbyElsevierB.V.Allrightsreserved.Keywords:Chronicpain;Limbic;Brain;Complementaryandalternativemedici
