Abstract
Acupuncture-induced analgesia depends on the activation of endogenous pain modulation
pathways. In this study, we asked whether ascending nociceptive control (ANC), a form
of pain-induced analgesia, contributes to the antinociceptive effect of acupuncture.
To answer this question, we tested the ability of procedures that block ANC-induced
analgesia, at peripheral, spinal, nucleus accumbens and rostral ventral medulla levels,
to block acupuncture-induced analgesia. Acupuncture at ST36 (Zusanli), a widely used acupoint located in the hind limb, induced potent heterosegmental
antinociception in the orofacial formalin test. The magnitude of this antinociceptive
effect was similar to that induced by an intraplantar injection of capsaicin, a procedure
classically used to activate ANC. The antinociceptive effect of acupuncture was blocked
by sciatic C-fibers depletion (1% perineural capsaicin), spinal administration of
a μ-opioid (Cys2,Tyr3,Orn5,Pen7amide, .2 μg) or of a GABAA (bicuculline, .3 μg) receptor antagonist, intra–nucleus accumbens administration
of a μ-opioid receptor antagonist (Cys2,Tyr3,Orn5,Pen7amide, 1 μg), or intrarostral
ventral medulla administration of a nicotinic acetylcholine receptor antagonist (mecamylamine,
.6 μg). In addition, acupuncture at ST36 and/or upper lip formalin induced c-Fos expression
in the nucleus accumbens and in rostral ventral medulla. On the basis of these results,
we propose that ANC contributes to the antinociceptive effect of acupuncture.
Perspective
This article presents a novel mechanism of acupuncture analgesia, contributing to
the understanding of its scientific basis. Because ANC is a pain modulation pathway
activated by peripheral noxious stimulation that ascends to supraspinal regions, it
could be the link between acupoint stimulation and the central mechanisms underlying
acupuncture analgesia.
Key words
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Article info
Publication history
Published online: January 13, 2014
Accepted:
December 31,
2013
Received in revised form:
December 27,
2013
Received:
April 5,
2013
Footnotes
This study was supported by grants from CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior) and CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico), Brazil. G.T. was recipient of a master fellowship from CAPES–Brazil (Master of Science). L.F. and M.M.S.L. are recipient of a fellowship from Fundação Araucária, Governo do Estado do Paraná, Brazil.
The authors declare no conflicts of interest.
Identification
Copyright
© 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.
