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2014 ; 24
(4
): 873-82
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The brain circuitry mediating antipruritic effects of acupuncture
#MMPMID23222890
Napadow V
; Li A
; Loggia ML
; Kim J
; Schalock PC
; Lerner E
; Tran TN
; Ring J
; Rosen BR
; Kaptchuk TJ
; Pfab F
Cereb Cortex
2014[Apr]; 24
(4
): 873-82
PMID23222890
show ga
Itch is an aversive sensory experience and while systemic therapies, such as
acupuncture, have shown promise in alleviating itch in patients suffering from
chronic itch, their antipruritic mechanisms are unknown. As several lines of
evidence implicate brain-focused mechanisms, we applied functional magnetic
resonance imaging and our validated temperature-modulation itch model to evaluate
the underlying brain circuitry supporting allergen-induced itch reduction in
atopic dermatitis patients by acupuncture, antihistamine, and respective placebo
treatments. Brain response to allergen itch demonstrated phase dependency. During
an increasing itch phase, activation was localized in anterior insula and
striatum, regions associated with salience/interoception and motivation
processing. Once itch reached peak plateau, robust activation was noted in
prefrontal cognitive and premotor areas. Acupuncture reduced itch and itch-evoked
activation in the insula, putamen, and premotor and prefrontal cortical areas.
Neither itch sensation nor itch-evoked brain response was altered following
antihistamine or placebo acupuncture. Greater itch reduction following
acupuncture was associated with greater reduction in putamen response, a region
implicated in motivation and habitual behavior underlying the urge to scratch,
specifically implicating this region in acupuncture's antipruritic effects.
Understanding brain circuitry underlying itch reduction following acupuncture and
related neuromodulatory therapies will significantly impact the development and
applicability of novel therapies to reduce an itch.
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