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. 2007 Aug 27;6(1):11–17. doi: 10.1093/ecam/nem090

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© 2007 The Author(s).

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Figure 1. — Schematic of the central mechanism of AA. Low-frequency acupuncture stimulation to the acupoint activates AA afferent pathways in the spinal cord, which ascend into dorsal periaqueductal gray (D-PAG), LH and (M-HARN) through the contra-anterolateral tract. Furthermore, the pituitary gland is activated through the POA and ME. Humoral factor(s) (β-endorphin) is released from the pituitary gland. This humoral factor is essential for connection between the afferent and efferent P-HARN pathways for AA. The efferent pathway passes through the (HVM) and divides into two descending pain inhibitory systems in the brain stem. One is a serotonergic pain inhibitory system in the raphe dorsalis and raphe magnus. The other is a noradrenergic pain inhibitory system in reticular paragigantocellular nucleus. Two descending pathways in the DLF block the input of pain sensation in the spinal dorsal horn. [Modified from Takeshige et al. (11–18)].