Acupuncture Effectiveness Increases with Patient-Therapist Mutual Interaction

Institute of Korean Medicine Research Uses MRI for Simultaneous Imaging Analysis

Acupuncture procedure scene. Photo by Korea Institute of Oriental Medicine

[Asia Economy Reporter Kim Bong-su] A joint research team from Korea and the United States scientifically identified through brain science that the interaction between patient and practitioner positively influences acupuncture treatment and clarified the related mechanisms. It is expected that this could be utilized as a new convergent treatment technology that enhances acupuncture effects by regulating brain regions in the future.

The Korea Institute of Oriental Medicine announced on the 24th that, in order to develop technology to enhance acupuncture treatment effects, it conducted research with Harvard Medical School to elucidate the mechanisms of the central nervous system, including the brain and spinal cord, related to acupuncture treatment, and obtained these results in the first phase clinical trial at the end of last year.

To measure brain responses altered by interaction in real time, the research team synchronized two magnetic resonance imaging (MRI) devices and simultaneously measured and analyzed the brains of both the patient and the practitioner. Patients and practitioners were able to interact in real time by viewing each other's facial expressions and eye contact through cameras and monitors installed in each MRI. The experiment involved 23 patients who had suffered from fibromyalgia for at least one year and 22 acupuncture practitioners.

The research team applied pressure to the patient's left leg to induce pain, then administered electroacupuncture stimulation to Yanggu (LI4) and Hegu (LI11) points, which are used for pain relief. Subsequently, the brain responses of both patient and practitioner were simultaneously measured in their respective MRIs, during which the practitioner remotely performed treatment on the patient via a button connected to the electroacupuncture device, and changes in the patient's perceived pain were observed accordingly.

When a significant positive correlation is observed between the facial expression changes of the patient and the practitioner during the acupuncture treatment process, it can be considered that a mirroring effect has occurred. At this time, the mirroring index of facial expressions between the practitioner and the patient showed a significant negative correlation with pain changes due to acupuncture treatment (r = 0.52, p = 0.031). Provided by Korea Institute of Oriental Medicine

The experiment results showed that acupuncture treatment improved the patient's pain, and analysis of the correlation between pain levels and interaction (facial expressions) revealed that the greater the interaction, the less pain the patient felt, showing a significant negative correlation. In particular, the more the facial expressions of the patient and practitioner mirrored each other, the stronger the interaction.

MRI measurements also showed activation responses in the temporoparietal junction (TPJ) of both patient and practitioner brains, which is associated with interaction (social mirroring). Social mirroring refers to the unconscious imitation of another person's behavior. In this experiment, it corresponded to the patient and practitioner influencing each other by mimicking facial expressions.

The greater the interaction, the higher the similarity of activation responses in the TPJ of both practitioner and patient, and the greater the similarity, the more significant the pain relief effect. Thus, not only facial expression analysis but also brain activation analysis confirmed that interaction influences acupuncture treatment.

The research team further investigated how TPJ activation affects acupuncture treatment efficacy by comparing and analyzing other brain regions showing activation responses. They discovered that the prefrontal cortex, a brain region related to pain in the patient's brain, was activated together with the TPJ, mediating the analgesic effect.

In follow-up studies, the research team plans to additionally verify the relationship between patient-practitioner interaction and treatment effects using longitudinal research methods that reflect actual clinical treatment over time. This result was published in the international academic journal Science Advances.

The Korea Institute of Oriental Medicine has been conducting research with Harvard Medical School to elucidate the mechanisms of the central nervous system, including the brain and spinal cord, related to acupuncture treatment to develop technology that enhances acupuncture effects. So far, the research team has established scientific evidence for Korean medicine treatments by revealing differences in brain structures between chronic low back pain patients and healthy individuals, as well as brain structural changes in patients who received acupuncture treatment.

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