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The clinical effects and brain mechanisms involved differ between stimulation given at the contralateral and ipsilateral Tiaokou ST-38 point in patients with unilateral chronic shoulder pain (CSP). In a pilot fMRI trial 24 patients with CSP were randomised to a contralateral or ipsilateral acupuncture group. All patients completed resting-state fMRI scans before and after acupuncture treatment. Clinical improvement in pain intensity and shoulder function was found in both groups, with better functional improvement in the contralateral group. The brain mechanism involved in contralateral acupuncture was distinguishable from that of ipsilateral acupuncture on fMRI imaging. The results suggested that the anterior cingulate cortex may be the most important area in contralateral acupuncture treatment, whereas the brainstem-thalamus-cortex pathway may be more important in the mechanism of ipsilateral acupuncture treatment.

Different mechanisms of contralateral- or ipsilateral-acupuncture to modulate the brain activity in patients with unilateral chronic shoulder pain: a pilot fMRI study. J Pain Res. 2018 Mar 7;11:505-514.


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