Neuroimaging Somatosensory and Therapeutic Alliance Mechanisms Supporting Acupuncture

Acupuncture consists of multiple components, and neuroimaging studies are beginning to tease apart potential brain-based mechanisms supporting this nonpharmacologic intervention. Brain imaging in patient populations is important for the acupuncture neuroimaging field, and recent studies have incorporated neuroimaging into a clinical trial framework for improved ecological validity in extending results to be more relevant for clinical practice. For instance, functional magnetic resonance imaging (fMRI) research with patients suffering from carpal tunnel syndrome has suggested cortical plasticity as a mechanism supporting acupuncture analgesia. In turn, the patient-acupuncturist relationship is another important aspect of acupuncture analgesia, and recent hyperscan fMRI research has begun to explore brain-based mechanisms underlying therapeutic alliance between patient and clinician, and how this might impact acupuncture analgesia. Ultimately, neuroimaging has shown great promise in the past several decades in opening a window into brain function to better appreciate the mechanisms supporting acupuncture. As acupuncture likely operates via multiple distinct mechanisms of action, teasing apart the constituent aspects of acupuncture therapy in humans will be an important goal for current and future neuroimaging research studies.