Search

Chronic neck pain is a common health condition that adversely affects quality of life. Acupuncture shows promise as a potential intervention. This randomized clinical trial compares the efficacy of 2 forms of acupuncture on neck pain when compared with sham acupuncture and participants on a waitlist. Visual Abstract. Long-Term Effects of Individualized Acupuncture for Chronic Neck Pain: Chronic neck pain is a common health condition that adversely affects quality of life. Acupuncture shows promise as a potential intervention. This randomized clinical trial compares the efficacy of 2 forms of acupuncture on neck pain when compared with sham acupuncture and participants on a waitlist. Background: Long-term effects of individualized acupuncture in persons with chronic neck pain (CNP) remain unknown. Objective: To evaluate the efficacy and safety of pressure pain, sensory-based individualized acupuncture for relieving CNP. Design: A 24-week multicenter randomized controlled clinical trial. (ChiCTR1800016371) Setting: Outpatient settings at 4 clinical centers in China from May 2018 to March 2020. Participants: 716 participants with CNP. Intervention: Participants were randomly assigned to a waiting list (WL) group or to 1 of 3 interventions, which consisted of 10 sessions over 4 weeks: higher sensitive acupoints (HSA), lower sensitive acupoints (LSA), and sham acupoints (SA) acupuncture groups. Measurements: The primary outcome was the change in the visual analogue scale (VAS) score for neck pain (range, 0 to 100) from baseline to 4 weeks, with a difference of 10 points considered the minimum clinically important threshold. The VAS was also assessed every 4 weeks through 24 weeks. Results: The modified intention-to-treat population included 683 participants. The mean baseline VAS was 50.36, 50.10, 49.24, and 49.16 for HSA, LSA, SA, and WL, respectively. Compared with a mean baseline to week 4 change of −12.16 in the HSA group, the mean changes were −10.19 in the LSA group (net difference [ND], −1.97 [95% CI, −5.03 to 1.09]), −6.11 in the SA group (ND, −6.05 [CI, −9.10 to −3.00]), and −2.24 in the WL group (ND, −9.93 [CI, −12.95 to −6.90]). The intervention effects persisted at 24-week follow-up. Limitation: Lack of complete blinding and limited generalizability. Conclusion: Individualized acupuncture interventions using high- or low-sensitivity acupuncture points were more effective in reducing CNP than SA and WL control groups sustained through 24 weeks, but the magnitude of relative improvement did not reach a minimal clinically important difference. Primary Funding Source: National Natural Science Foundation of China. [ABSTRACT FROM AUTHOR]

Non‐pharmacological interventions can improve the behavioural and psychological symptoms of dementia (BPSD). However, the optimal non‐pharmacological treatments remain controversial. This study aimed to compare the efficacy of multiple non‐pharmacological methods and identify the optimal therapy for BPSD. Potential randomised controlled trials (RCTs) were searched and selected from 15 databases and sources from the inception of the databases until 1 October 2022. Two independent authors implemented study screening, data extraction, and methodological quality assessment. Primary outcome was reduction of Neuropsychiatric Inventory (NPI). The secondary outcome were changes of Cornell Scale for Depression in Dementia (CSDD), the Cohen‐Mansfield Agitation Inventory (CMAI), the Quality of Life in Alzheimer's Disease (QoL‐AD), the Abilities of Daily Living scale, and the Apathy Evaluation Scale. Meta‐analyses were performed using STATA v15.0 and ADDIS v1.16.8. The GRADE approaches were utilised to evaluate evidence quality. The present study included 43 RCTs with 4978 participants. The global methodological quality of the RCTs was moderate. Regarding NPI reduction, with moderate‐certainty evidence, exercise plus treatment as usual (TAU) outperformed TAU (mean difference [MD]: −7.13; 95% confidence interval [CI]: −13.22, −0.76) and ranked as the optimal treatment. For reduction in CSDD, with low‐ to moderate‐certainty evidence, massage plus TAU (MD: −15.26; 95% CI: −20.13, −10.52) and music plus TAU (MD: −2.40; 95% CI: −4.62, −0.12) were associated with greater reduction compared with TAU. For reduction in CMAI, with moderate‐certainty evidence, aromatherapy plus massage (MD: −15.84; 95% CI: −29.76, −2.42) and massage plus music (MD: −13.12; 95% CI: −25.43, −0.76) were significantly more effective than TAU. For improvement in QoL‐AD, with critically low‐ to low‐certainty evidence, there were no statistical differences between any of non‐pharmacological treatments and TAU. Due to the limited number of included studies, network meta‐analysis was not performed for other outcomes. In conclusion, non‐pharmacological treatments are effective for overall symptoms, depression, and agitation. Exercise plus treatment as usual may be an optimal non‐pharmacological intervention for improving the overall BPSD. This may help to guide patients, doctors, and policymakers. [ABSTRACT FROM AUTHOR]

Objective: Acupuncture has shown promise in treating neck pain. Clinical trials have shown mixed results, possibly due to heterogeneous methodologies and the lack of knowledge regarding underlying brain circuit mechanism of action. In this study, we investigated the specific contribution of the serotonergic system in treating neck pain, and the specific brain circuits involved. Methods: A total of 99 patients with chronic neck pain (CNP) were randomized to receive true acupuncture (TA) or sham acupuncture (SA) 3 times weekly for 4 weeks. Patients with CNP in each group were assessed for primary outcomes by measuring the Visual Analog Scale (VAS) and the duration of each attack; secondary outcomes were measured using the Neck Disability Index (NDI), Northwick Park Neck Pain Questionnaire (NPQ), McGill Pain Questionnaire (MPQ), Self‐rating Anxiety Scale (SAS), Self‐rating Depression Scale (SDS) and the 12‐item Short Form Quality Life Scale (SF‐12); levels of functional circuits connectivity were assessed using resting‐state functional magnetic resonance imaging in the dorsal (DR) and median (MR) raphe nucleus, before and after undergoing acupuncture. Results: Patients receiving TA showed more extensive symptom improvement compared with SA. Regarding the primary outcomes, changes observed in the TA group were as follows: VAS = 16.9 mm (p < 0.001) and the duration of each attack = 4.30 h (p < 0.001); changes in the SA group: VAS = 5.41 mm (p = 0.138) and the duration of each attack = 2.06 h (p = 0.058). Regarding the secondary outcomes, changes in the TA group: NDI = 7.99 (p < 0.001), NPQ = 10.82 (p < 0.001), MPQ = 4.23 (p < 0.001), SAS = 5.82 (p < 0.001), SDS = 3.67 (p = 0.003), and SF‐12 = 3.04 (p < 0.001); changes in the SA group: NDI = 2.97 (p = 0.138), NPQ = 5.24 (p = 0.035) and MPQ = 2.90 (p = 0.039), SAS = 1.48 (p = 0.433), SDS = 2.39 (p = 0.244), and SF‐12 = 2.19 (p = 0.038). The modulatory effect of TA exhibited increased functional connectivity (FC) between the DR and thalamus, between the MR and parahippocampal gyrus, amygdala, and insula, with decreased FC between the DR and lingual gyrus and middle frontal gyrus, between the MR and middle frontal gyrus. Furthermore, changes in the DR‐related circuit were specifically associated with the intensity and duration of pain, and the MR‐related circuit was correlated with the quality of life with CNP. Conclusion: These results demonstrated the effectiveness of TA in treating neck pain and suggested that it regulates CNP by reconfiguring the function of the raphe nucleus‐related serotonergic system. [ABSTRACT FROM AUTHOR]

Purpose: To assess the inhibitory effect of acupuncture on pain symptoms in migraine models, and to further summarize the potential mechanisms of acupuncture in regulating hyperalgesia in the treatment of migraine.Materials and Methods: Literature search in databases such as China National Knowledge Infrastructure (CNKI), PubMed, and Web of Science (WOS) etc. The quality was evaluated by the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) bias risk assessment tool and Collaborative Approach to Meta-analysis and Review of Animal Data from Experimental Studies (CAMARADES) checklist. Meta-analyses were performed using Stata 17.0 software.Results: Twenty-one studies involving 489 animals were identified. The qualitative score ranged from 3 to 9 points. Facial mechanical withdrawal threshold (FMWT) and paw mechanical withdrawal threshold (PMWT) measured by Von Frey filaments were selected as major outcomes, and serum calcitonin gene-related peptide (CGRP) levels measured by ELISA were selected as secondary outcome. Meta-analysis results revealed that true acupuncture (TA) group significantly increased FMWT, PMWT and CGRP compared to model group. TA group showed superior effect in FMWT, PMWT relative to sham acupuncture (SA) group. Subgroup analysis results showed that high risk of bias scores may be responsible for the high heterogeneity of FMWT; additionally, CGRP analysis suggests that acupoint selection and blood collection sites may be sources of heterogeneity. In the treatment of migraine pain symptoms, the underlying mechanism of acupuncture treatment is either the regulation of hyperalgesia and neurotransmitters, or the reduction of inflammatory factors.Conclusion: The results indicate that TA treatment effectively increased the pain threshold and reduced hyperalgesia in migraine rats. In summary, our study highlights the potential of TA as an effective treatment for migraine, but further investigation is required to fully comprehend its mechanism of action and optimize its clinical application. [ABSTRACT FROM AUTHOR]