Atwood Et Al. Respond
Bibliographic Data
The article to which Ulett is responding took a historical perspective, and the biological issues he raises are somewhat tangential to the point of the original. Nonetheless, we believe that he is incorrect in stating that there is no validity to ancient Chinese approaches to the practice of acupuncture. Indeed, the very references he cites strongly support the biological basis for acupuncture, over and above a nonspecific placebo effect. Thus, 2 of the references he cites1,2 and others by the same authors3,4 indicate that both neuropeptides and growth factors are released centrally in response to electrical acupuncture, and specific neuroendocrine systems are also activated by electrical stimulation. Ulett neglects to cite other work by the same authors showing that stimulation of specific acupoints results in activation of specific brain regions as detected by functional magnetic resonance imaging, while stimulation of points 2 to 5 cm distant does not5 (see also review by Cho et al.6). From this developing literature there appear to be several underlying biological mechanisms by which acupuncture might exert its effects—some specific to the location of the acupoints and others specific to the method used, whether pressure, needle, or electrical. In the case of electrical stimulation, frequency of stimulation rather than location may be a stronger inducer of some neuropeptides and growth factors, as Ulett suggests. However, this does not negate the importance of the location of the points, as shown in other studies of needle use alone.5,6 Finally, some of the effects of acupuncture may also be related to general nonspecific placebo effects. This should not detract from the value of the method when it is used appropriately as an adjunct to medical therapy. Most medical treatments derive at least some of their benefits from the placebo effect. Indeed, the neuroendocrine and neural basis of the placebo effect is an important area of study to elucidate the many ways in which the central nervous system regulates other defense systems in the body.7 In this regard, we agree with Ulett that the biological basis of this form of therapy certainly should be further studied to inform its judicious use in the Western medical armamentarium
Acupuncture · Acupuncture point · Alternative medicine · Cognitive psychology · Functional magnetic resonance imaging · Pathology · Stimulation · Acupuncture Treatment Research Studies · Axon Guidance and Neuronal Signaling · Medicine · Neuroscience · Pain Management and Placebo Effect · Psychology
| Citation velocity | historical |
|---|---|
| Highly cited | No |