Question :
Placebo administration has been shown to cause the release of dopamine in the brain of patients with Parkinson’s disease. Is the placebo effect disease specific? What is the best way to perform sham acupuncture in research studies?
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A placebo is a sham medical intervention.
Placebo-control of acupuncture is used to evaluate and distinguish between the specific effects and the non-specific ones. During ‘true’ acupuncture treatment in general, the needles are inserted into acupoints and stimulated until deqi is evoked. In contrast, during placebo acupuncture, the needles are inserted into non-acupoints and/or superficially (so-called minimal acupuncture).
A sham acupuncture needle with a blunt tip may be used in placebo acupuncture. Both minimal acupuncture and the placebo acupuncture with the sham acupuncture needle touching the skin would evoke activity in cutaneous afferent nerves. This afferent nerve activity has pronounced effects on the functional connectivity in the brain resulting in a ‘limbic touch response’. Clinical studies showed that both acupuncture and minimal acupuncture procedures induced significant alleviation of migraine and that both procedures were equally effective. In other conditions such as low back pain and knee osteoarthritis, acupuncture was found to be more potent than minimal acupuncture and conventional non-acupuncture treatment. It is probable that the responses to ‘true’ acupuncture and minimal acupuncture are dependent on the aetiology of the pain. Furthermore, patients and healthy individuals may have different responses. In this paper, we argue that minimal acupuncture is not valid as an inert placebo-control despite its conceptual brilliance.
Minimal acupuncture is not a valid placebo control in randomised controlled trials of acupuncture: a physiologist’s perspective
Chin Med. 2009 Jan 30;4:1. Open Access article.
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A case report of a modern pentathlon treated with acupuncture over seven years.
The stimulation of acupuncture points in this athlete was strongly associated with rapid significant improvement in his performance. This article discusses the placebo effect and sport doping.
Goal-directed Acupuncture in Sports–Placebo or Doping?
Evid Based Complement Alternat Med.
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