Chronic low back pain (CLBP) is associated with changes in connectivity in the brain’s default mode network (DMN), but acupuncture can reverse these changes as well as provide pain relief. The DMN, which is associated with pain and emotional processing, consists of brain regions that are more active during rest than during active task performance. Previous studies have shown that disruptions of the DMN may underlie the cognitive and behavioural impairments that accompany chronic pain. Chinese scientists used resting-state functional MRI (rsfMRI) to scan the brains of 20 patients with CLBP, before and after four weeks of acupuncture treatment. They compared the scans with those from 10 age- and gender-matched healthy controls. Less connectivity was found within the DMN in patients with CLBP compared with healthy controls (mainly in the dorsolateral prefrontal cortex, medial prefrontal cortex, anterior cingulate gyrus and precuneus). After acupuncture, connectivities in the patients’ DMNs were restored almost to the levels seen in the healthy controls. Furthermore, reductions in clinical pain were correlated with increases in DMN connectivity.

Acupuncture treatment of chronic low back pain reverses an abnormal brain default mode network in correlation with clinical pain relief. Acupunct Med. 2013 Dec 3. doi: 10.1136/acupmed-2013-010423