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Phantom acupuncture: dissociating somatosensory and cognitive/affective components of acupuncture stimulation with a novel form of placebo acupuncture.

Lee J, Napadow V, Kim J, Lee S, Choi W, Kaptchuk TJ, Park K - PLoS ONE (2014)

Bottom Line: Autonomic and psychophysical responses were monitored.We found that PHNT can be delivered in a credible manner.In contrast, contextual effects, such as needling credibility, are instead associated with a shift toward relative cardiovagal activation (decreased heart rate) during needling and sympathetic inhibition (decreased SC) and parasympathetic activation (decreased pupil size) following acupuncture needling.

View Article: PubMed Central - PubMed

Affiliation: Department of Biomedical Engineering, Kyung Hee University, Yongin, Gyeonggi, South Korea.

ABSTRACT
In a clinical setting, acupuncture treatment consists of multiple components including somatosensory stimulation, treatment context, and attention to needle-based procedures. In order to dissociate somatosensory versus contextual and attentional aspects of acupuncture, we devised a novel form of placebo acupuncture, a visual manipulation dubbed phantom acupuncture, which reproduces the acupuncture needling ritual without somatosensory tactile stimulation. Subjects (N = 20) received both real (REAL) and phantom (PHNT) acupuncture. Subjects were retrospectively classified into two groups based on PHNT credibility (PHNTc, who found phantom acupuncture credible; and PHNTnc, who did not). Autonomic and psychophysical responses were monitored. We found that PHNT can be delivered in a credible manner. Acupuncture needling, a complex, ritualistic somatosensory intervention, induces sympathetic activation (phasic skin conductance [SC] response), which may be specific to the somatosensory component of acupuncture. In contrast, contextual effects, such as needling credibility, are instead associated with a shift toward relative cardiovagal activation (decreased heart rate) during needling and sympathetic inhibition (decreased SC) and parasympathetic activation (decreased pupil size) following acupuncture needling. Visual stimulation characterizing the needling ritual is an important factor for phasic autonomic responses to acupuncture and may undelie the needling orienting response. Our study suggests that phantom acupuncture can be a viable sham control for acupuncture as it completely excludes the somatosensory component of real needling while maintaining the credibility of the acupuncture treatment context in many subjects.

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Related in: MedlinePlus

Influence of somatosensory needling on autonomic response modulation to real and phantom acupuncture.Phasic and tonic responses for heart rate (A and D), skin conductance (B and E), and pupil size (C and F) were contrasted between real (REAL) and credible (PHNTc) phantom acupuncture. Comparisons between REAL and PHNTc were based on the data collected only from subjects who regarded phantom acupuncture as real (i.e. PHNTc) and was done using paired t-tests. n.b. *<0.05, **<0.01. Error bars represent standard error of the mean.
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pone-0104582-g005: Influence of somatosensory needling on autonomic response modulation to real and phantom acupuncture.Phasic and tonic responses for heart rate (A and D), skin conductance (B and E), and pupil size (C and F) were contrasted between real (REAL) and credible (PHNTc) phantom acupuncture. Comparisons between REAL and PHNTc were based on the data collected only from subjects who regarded phantom acupuncture as real (i.e. PHNTc) and was done using paired t-tests. n.b. *<0.05, **<0.01. Error bars represent standard error of the mean.

Mentions: Comparisons between REAL and PHNTc were based on the data collected only from subjects who regarded phantom acupuncture as real (i.e., PHNTc) and was done using paired t-tests. For phasic ANS response, there was significant phasic SC increase in response to somatosensory stimulation, for REAL (1.56±0.50 µS, P<0.001) but only trending response for PHNTc (0.47±0.23 µS, P = 0.07). We also noted significant phasic HR decreases (REAL = −5.07±0.87 BPM, P<0.001; PHNTc = −4.75±1.92 BPM, P<0.001) and PS increases (REAL = 0.70±0.10 mm, P<0.001; PHNTc = 0.64±0.10 mm, P<0.001) for both REAL and PHNTc sessions (Figure 5A–C).


Phantom acupuncture: dissociating somatosensory and cognitive/affective components of acupuncture stimulation with a novel form of placebo acupuncture.

Lee J, Napadow V, Kim J, Lee S, Choi W, Kaptchuk TJ, Park K - PLoS ONE (2014)

Influence of somatosensory needling on autonomic response modulation to real and phantom acupuncture.Phasic and tonic responses for heart rate (A and D), skin conductance (B and E), and pupil size (C and F) were contrasted between real (REAL) and credible (PHNTc) phantom acupuncture. Comparisons between REAL and PHNTc were based on the data collected only from subjects who regarded phantom acupuncture as real (i.e. PHNTc) and was done using paired t-tests. n.b. *<0.05, **<0.01. Error bars represent standard error of the mean.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4125217&req=5

pone-0104582-g005: Influence of somatosensory needling on autonomic response modulation to real and phantom acupuncture.Phasic and tonic responses for heart rate (A and D), skin conductance (B and E), and pupil size (C and F) were contrasted between real (REAL) and credible (PHNTc) phantom acupuncture. Comparisons between REAL and PHNTc were based on the data collected only from subjects who regarded phantom acupuncture as real (i.e. PHNTc) and was done using paired t-tests. n.b. *<0.05, **<0.01. Error bars represent standard error of the mean.
Mentions: Comparisons between REAL and PHNTc were based on the data collected only from subjects who regarded phantom acupuncture as real (i.e., PHNTc) and was done using paired t-tests. For phasic ANS response, there was significant phasic SC increase in response to somatosensory stimulation, for REAL (1.56±0.50 µS, P<0.001) but only trending response for PHNTc (0.47±0.23 µS, P = 0.07). We also noted significant phasic HR decreases (REAL = −5.07±0.87 BPM, P<0.001; PHNTc = −4.75±1.92 BPM, P<0.001) and PS increases (REAL = 0.70±0.10 mm, P<0.001; PHNTc = 0.64±0.10 mm, P<0.001) for both REAL and PHNTc sessions (Figure 5A–C).

Bottom Line: Autonomic and psychophysical responses were monitored.We found that PHNT can be delivered in a credible manner.In contrast, contextual effects, such as needling credibility, are instead associated with a shift toward relative cardiovagal activation (decreased heart rate) during needling and sympathetic inhibition (decreased SC) and parasympathetic activation (decreased pupil size) following acupuncture needling.

View Article: PubMed Central - PubMed

Affiliation: Department of Biomedical Engineering, Kyung Hee University, Yongin, Gyeonggi, South Korea.

ABSTRACT
In a clinical setting, acupuncture treatment consists of multiple components including somatosensory stimulation, treatment context, and attention to needle-based procedures. In order to dissociate somatosensory versus contextual and attentional aspects of acupuncture, we devised a novel form of placebo acupuncture, a visual manipulation dubbed phantom acupuncture, which reproduces the acupuncture needling ritual without somatosensory tactile stimulation. Subjects (N = 20) received both real (REAL) and phantom (PHNT) acupuncture. Subjects were retrospectively classified into two groups based on PHNT credibility (PHNTc, who found phantom acupuncture credible; and PHNTnc, who did not). Autonomic and psychophysical responses were monitored. We found that PHNT can be delivered in a credible manner. Acupuncture needling, a complex, ritualistic somatosensory intervention, induces sympathetic activation (phasic skin conductance [SC] response), which may be specific to the somatosensory component of acupuncture. In contrast, contextual effects, such as needling credibility, are instead associated with a shift toward relative cardiovagal activation (decreased heart rate) during needling and sympathetic inhibition (decreased SC) and parasympathetic activation (decreased pupil size) following acupuncture needling. Visual stimulation characterizing the needling ritual is an important factor for phasic autonomic responses to acupuncture and may undelie the needling orienting response. Our study suggests that phantom acupuncture can be a viable sham control for acupuncture as it completely excludes the somatosensory component of real needling while maintaining the credibility of the acupuncture treatment context in many subjects.

Show MeSH
Related in: MedlinePlus