Effects of Acupuncture on Sensory Perception: A Systematic Review and Meta-Analysis

PLOS ONE, Dec 2014

Background The effect of acupuncture on sensory perception has never been systematically reviewed; although, studies on acupuncture mechanisms are frequently based on the idea that changes in sensory thresholds reflect its effect on the nervous system. Methods Pubmed, EMBASE and Scopus were screened for studies investigating the effect of acupuncture on thermal or mechanical detection or pain thresholds in humans published in English or German. A meta-analysis of high quality studies was performed. Results Out of 3007 identified articles 85 were included. Sixty five studies showed that acupuncture affects at least one sensory threshold. Most studies assessed the pressure pain threshold of which 80% reported an increase after acupuncture. Significant short- and long-term effects on the pressure pain threshold in pain patients were revealed by two meta-analyses including four and two high quality studies, respectively. In over 60% of studies, acupuncture reduced sensitivity to noxious thermal stimuli, but measuring methods might influence results. Few but consistent data indicate that acupuncture reduces pin-prick like pain but not mechanical detection. Results on thermal detection are heterogeneous. Sensory threshold changes were equally frequent reported after manual acupuncture as after electroacupuncture. Among 48 sham-controlled studies, 25 showed stronger effects on sensory thresholds through verum than through sham acupuncture, but in 9 studies significant threshold changes were also observed after sham acupuncture. Overall, there is a lack of high quality acupuncture studies applying comprehensive assessments of sensory perception. Conclusions Our findings indicate that acupuncture affects sensory perception. Results are most compelling for the pressure pain threshold, especially in pain conditions associated with tenderness. Sham acupuncture can also cause such effects. Future studies should incorporate comprehensive, standardized assessments of sensory profiles in order to fully characterize its effect on sensory perception and to explore the predictive value of sensory profiles for the effectiveness of acupuncture.

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Effects of Acupuncture on Sensory Perception: A Systematic Review and Meta-Analysis

Editor: Bing Hou, Beijing Institute of Radiation humans published in English or German. A meta-analysis of high quality studies Medicine, China was performed. Received: June Effects of Acupuncture on Sensory Perception: A Systematic Review and Meta-Analysis Petra I. Baeumler * 0 Johannes Fleckenstein 0 Shin Takayama 1 Michael Simang 0 2 Takashi Seki 1 Dominik Irnich 0 0 Multidisciplinary Pain Center, Department of Anaesthesiology, University of Munich (LMU) , Munich, Germany, 1 Department of Traditional Asian Medicine, Tohoku University , Sendai , Japan, 2 Institute for Medical Information Sciences , Biometry and Epidemiology , University of Munich (LMU) , Munich , Germany - Introduction 2 / 40 Materials and Methods Literature Search Selection Criteria Article Selection 3 / 40 Quality Assessment Data Extraction 4 / 40 Results General Aspects 5 / 40 Fig. 1. 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F M n m m O k X B k X T f E S (a C In 16 / 40 3 S 3 m p M c p & o BG ,15 li(b n d in ts ts T n n lize po ion ion DM ito pu a la p p ; ra u ivud lco .,) ta ta ldo ivb ;cA l l id o lta isd isd sh :T gn In tw ib 2 2 re D li h V d t e 17 / 40 Threshold Heat Pain Cold Pain Pressure Pain Mechanical Pain Warm Detection Cold Detection Thermal Sensory Limen Mechanical Detection Vibration Detection Quality of Included Studies 18 / 40 19 / 40 s t n i o P x x x - x x x x x x x x x x x x x x x - - x x x x x x x - - x x x x x x x x 20 / 40 h w it t n io d w P e e im s T x x x - x x x x k r e u A o /y fo t r IC rceenuq itranou teaenm lg R F D rT x x x - x x x x o T r t S n e o freob issno c th um se a h N S x x x - x x x x t i g a s i d iton b a e lau f d y m it o e la S - x x x x x x x t k a p i/q is ic is e r (D d d e r s no )h a in is sp itc e e R Tw - x x x - - x x l e s r c a p n u r c h e n t ts i p ion y s P - x - - x x x - ? r o re n f c iasB o e je reh k m b t O + + + ? ? + + + irs ss u ig s o iltvece itrngop h a re e e d S R ? ? ? ? ? ? ? ? s b n taa a n u lteep eDm ic io n om tco d t e Icn uO ? + + + + + + + in n h e t 21 / 40 Procedures 22 / 40 23 / 40 Heat Pain Threshold (HPT) 24 / 40 Cold Pain Threshold (CPT) Thermal Detection Thresholds 25 / 40 Pressure Pain Threshold (PPT) 26 / 40 27 / 40 information was given about the characteristics of the algometer [22, 43, 63, 77, 78]. 28 / 40 Discussion Result Interpretation 29 / 40 30 / 40 Limitations 31 / 40 Future Perspectives 32 / 40 Supporting Information Acknowledgments 33 / 40 34 / 40 35 / 40 36 / 40 37 / 40 38 / 40 39 / 40 1. 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Petra I. Baeumler, Johannes Fleckenstein, Shin Takayama, Michael Simang, Takashi Seki, Dominik Irnich. Effects of Acupuncture on Sensory Perception: A Systematic Review and Meta-Analysis, PLOS ONE, 2014, DOI: 10.1371/journal.pone.0113731