The modulation effect of longitudinal acupuncture on resting state functional connectivity in knee osteoarthritis patients

Xiaoyan Chen, Rosa B. Spaeth, Sonya G. Freeman, Moxley D. Scarborough, Javeria A. Hashmi, Hsiao Ying Wey, Natalia Egorova, Mark Vangel, Jianren Mao, Ajay D. Wasan, Robert R. Edwards, Randy L. Gollub, Jian Kong

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


Recent advances in brain imaging have contributed to our understanding of the neural activity associated with acupuncture treatment. In this study, we investigated functional connectivity across longitudinal acupuncture treatments in older patients with knee osteoarthritis (OA). Over a period of 4 weeks (six treatments), we collected resting state functional magnetic resonance imaging (fMRI) scans from 30 patients before and after their first, third and sixth treatments. Clinical outcome showed a significantly greater pain subscore on the Knee Injury and Osteoarthritis Outcome Score (KOOS) (indicative of improvement) with verum acupuncture than with sham acupuncture. Independent component analysis (ICA) of the resting state fMRI data showed that the right frontoparietal network (rFPN) and the executive control network (ECN) showed enhanced functional connectivity (FC) with the rostral anterior cingulate cortex/medial prefrontal cortex, a key region in the descending pain modulatory system, in the verum groups as compared to the sham group after treatments. We also found that the rFPN connectivity with the left insula is (1) significantly associated with changes in KOOS pain score after treatments, and (2) significantly enhanced after verum acupuncture treatments as compared to sham treatment. Analysis of the acupuncture needle stimulation scan showed that compared with sham treatment, verum acupuncture activated the left operculum/insula, which also overlaps with findings observed in resting state analysis. Our results suggest that acupuncture may achieve its therapeutic effect on knee OA pain by modulating functional connectivity between the rFPN, ECN and the descending pain modulatory pathway. Clinical trial number: NCT01079390

Original languageEnglish (US)
Article number67
Pages (from-to)1
Number of pages1
JournalMolecular Pain
Issue number1
StatePublished - Oct 29 2015
Externally publishedYes


  • Acupuncture
  • Chronic pain
  • Executive control network
  • Independent component analysis (ICA)
  • Knee injury and Osteoarthritis Outcome Score (KOOS)
  • Knee osteoarthritis
  • Resting state fMRI
  • Right frontoparietal network

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Molecular Medicine
  • Cellular and Molecular Neuroscience


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