Functional connectivity changes in the thalamocortical network due to neck pain and the multiscale regulatory effects of acupuncture: a cross-scale multi-omics neuroimaging study.

Researchers in China studied how acupuncture affects brain networks in people suffering from neck pain, using advanced brain imaging and genetic analysis. The study involved 98 neck pain patients who received either real acupuncture or sham (placebo) acupuncture twice weekly for two weeks. Both groups experienced pain reduction, but real acupuncture provided significantly better relief. Using functional MRI brain scans, scientists discovered that real acupuncture specifically changed how the thalamus (a key pain-processing brain region) communicated with other brain areas, particularly the anterior cingulate cortex, which is involved in pain perception and emotional responses. These connectivity changes were not seen in the sham acupuncture group. What makes this study unique is that researchers also analyzed gene expression patterns in these brain regions and found that the pain relief from acupuncture appears to work through two main biological mechanisms: reducing inflammation and immune responses, and increasing inhibitory nerve signaling (involving GABA, a calming brain chemical). This is the first study to connect brain imaging changes with underlying genetic and molecular processes during acupuncture treatment. The findings suggest that acupuncture for neck pain works through measurable biological mechanisms rather than placebo effects alone, affecting both brain network communication and cellular-level processes. This multi-scale evidence strengthens the scientific foundation for acupuncture as a legitimate pain treatment option. If considering acupuncture for neck pain, seek a qualified, licensed acupuncturist trained in traditional techniques.

This randomized controlled trial (n=98) compared verum versus sham acupuncture for neck pain using multimodal neuroimaging and transcriptomics. Patients received treatment twice weekly for 2 weeks. Both groups showed significant VAS reduction (p<0.001), with verum acupuncture demonstrating superior analgesic effects (Z=-6.877, p<0.001). Resting-state fMRI revealed verum acupuncture specifically decreased functional connectivity between right thalamus and left anterior cingulate cortex (T=-4.498) and right Rolandic operculum (T=-4.532, voxel p<0.01, cluster p<0.05)—changes absent in sham group. Gene-FC association analysis using Allen Human Brain Atlas data identified 809 genes enriched in innate immune response and phosphorylation pathways, plus 1,222 genes in GABAergic synapse pathways, explaining 39.83% of FC variance. Clinical implication: Acupuncture analgesia operates through thalamocortical network modulation involving immune-inflammatory regulation and neural inhibitory mechanisms, providing biological validation beyond placebo effects.