Modulation effects of different treatments on periaqueductal gray resting state functional connectivity in knee osteoarthritis knee pain patients

作者：Jun Zhou, Fang Zeng, Shirui Cheng, Xiaohui Dong, Nannan Jiang, Xinyue Zhang, Chenjian Tang, Wenhua He, Yang Chen, Ning Sun, Yuanfang Zhou, Xinling Li, Shengjie Hu, Ruirui Sun, Max Wintermark, Weihua Yang, Fanrong Liang, Zhengjie Li · 发表于：CNS Neuroscience & Therapeutics · 年份：2023 · DOI：10.1111/cns.14153 · 被引用次数：31 · 研究领域：Acupuncture Treatment Research Studies、Pain Mechanisms and Treatments、Traditional Chinese Medicine Studies

BACKGROUND: The analgesic effect of acupuncture is widely recognized, but the mechanical characteristics of acupuncture for pain relief, compared to non-steroidal anti-inflammatory (NSAIDs) and placebo medication, remain unknown. AIMS: To compare the modulation effects of acupuncture treatment with NSAIDs and placebo medication on descending pain modulation system (DPMS) in knee osteoarthritis (KOA) patients. METHODS: This study recruited 180 KOA patients with knee pain and 41 healthy controls (HCs). Individuals with KOA knee pain were divided randomly into groups of verum acupuncture (VA), sham acupuncture (SA), celecoxib (SC), placebo (PB), and waiting list (WT), with 36 patients in each group. VA and SA groups included ten sessions of puncturing acupoints or puncturing non-acupoints acupuncture treatment for two successive weeks. Celecoxib capsules were continuously given orally to patients in the SC group at a dosage of 200 mg daily for 2 weeks. In the PB group, patients received a placebo capsule once a day for 2 weeks at the same dosage as celecoxib capsules. In the WL group, patients did not receive any treatment. Patients underwent a resting-state BOLD-fMRI scan pre- and post-receiving the therapy, whereas HCs only underwent a baseline scan. Seed (ventrolateral periaqueductal gray, vlPAG, a key node in DPMS) based resting-state functional connectivity (rs-FC) was applied in the data analysis. RESULTS: All groups demonstrated improved knee pain scores relative to the i...