Functional Brain Imaging - Acupuncture and Osteoarthritis

Recent experimental studies in both animal and humans have begun to demonstrate some measurable physiologic effects that are associated with acupuncture, suggesting the possibility of a neurophysiologic explanation. In addition, brain research continues to uncover a complex set of endogenous neurologic control systems, such that it has become clear that the brain plays a major role in the modulation of pain perception and control. If acupuncture can be demonstrated to have a consistent effect on specific areas of the brain, it will become possible to explore the potential efficacy of acupuncture based on measurable neurophysiologic responses.

Inclusion criteria

• Seen in an outpatient clinical setting
• Have active knee OA of >6 months including Kellgren x-ray changes >2 from an x-ray report <12 months old or new x-ray interpretation
• Moderate unilateral only pain (average >4/10 on a 0-10 likert scale) for more than 5 out of 7 days
• Have the capacity to understand the requirements of the study and complete the baseline studies in a reasonable time frame, as determined by the interviewer

Exclusion criteria

• Having had acupuncture before (must be acupuncture naïve)
• Any history of claustrophobia that could affect the subject's ability to tolerate the f-MRI study
• Hip or ankle disease by history or exam severe enough to cause pain >2/10 daily
• Bleeding disorder or current use of warfarin or heparin by patient history
• Other primary causes of chronic knee pain, per the referring physician, including chondromalacia patella, torn meniscus or ligament injury.