Table 1.
Characteristics of the included studies.
| No. | Author (year) country | Diseases | Design | N (intervention/control) | Age | Treatment courses | Intervention/control (acupoints) | Manipulation modality | Needle sensation | Imaging modality | Analytical approaches |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Ji et al. (2007) China | Sciatica | Non-RCT | 12 | 32–45 | 30 min | (A) Affected leg (B) Healthy leg (GB34, GB39) |
EA | Not Depicted | ts-fMRI | Brain activation |
| 2 | Junhai et al. (2008) China | Low back and leg pain | Non-RCT | 12 | 32–45 | 30 min | (A) Palm temperature increased B) Palm temperature decreased (GB34, GB39) | EA | Deqi | ts-fMRI | Brain activation |
| 3 | Yongsong et al. (2011) China | Lumbar disc herniation | Non-RCT | 20 (10/10) | 35–69 | Not depicted | (A) Patients (B) HC (the lumbago acupoint) |
MA | Deqi | rs-fMRI | Voxel-wise FC |
| 4 | Li et al. (2012) China | Chronic sciatica | Non-RCT | 20 (10/10) | 32–45 | 22 d | (A) Patients (acupoint selection by syndrome differentiation) B) HC | EA | Deqi | rs-fMRI | ICA |
| 5 | Li et al. (2014) China | Chronic low back pain | Non-RCT | 30 (20/10) | LBP 38.1 ± 6.4 HC 37.7 ± 5.1 | 30 min | (A) Patients (BL23, ashi point, GV3, BL40 and KI3) (B) HC |
MA | Deqi | rs-fMRI | ICA, correlation with VAS |
| 6 | Jialiang et al. (2014) China | Lumbar disc herniation | RCT | 15 (7/8) | 35–75 | 25 min | (A) Balanced acupuncture (the lumbago acupoint) (B) Body acupuncture (BL25, BL26, ashi point) |
MA | Not depicted | rs-fMRI | ReHo |
| 7 | Guoqiang et al. (2014) China | Lumbar disc herniation | Non-RCT | 12 | 55–70 | 3 min 45 s | (A) Acupuncture (GB41) | MA | Not depicted | ts-fMRI | Brain activation |
| 8 | Tao et al. (2015) China | Lumbar disc herniation | RCT | 30 (14/16) | 30–70 | 20 min | (A) Balanced acupuncture (the lumbago acupoint) (B) Body acupuncture (BL25, BL26, ashi point) |
MA | Not depicted | rs-fMRI | ReHo |
| 9 | Yijun et al. (2017) China | L5 nerve root pain | Non-RCT | 10 | 20–65 | 3 min | (A) Acupuncture (gentong 2) | MA | Deqi | rs-fMRI and ts-fMRI | Brain activation |
| 10 | Lin and Xianmo (2017) China | Lumbar disc herniation | RCT | 92 (42/50) | 25–60 | 15 min | (A) Yaosanzhen acupuncture (BL23, BL25, BL40) (B) Body acupuncture (BL25, BL26, ashi point) |
MA | Not depicted | rs-fMRI | ReHo |
| 11 | Makary et al. (2018) South Korea | Non-specific low back pain | RCT | 56 (33/23) | 38.4 ± 12.7 | 7 min | (A) Verum (B) Phantom acupuncture (ST36, SP11, SP13) |
MA | Deqi | ts-fMRI | Brain activation, correlation with ANS response, belief in acupuncture effectiveness, VAS, and MASS Index |
| 12 | Tu et al. (2019) USA | Chronic low back pain | RCT | 50 (24/26) | Verum 39.0 ± 12.6 Sham 40.0 ± 13.7 | 4 w | (A) Verum (GV3, BL23, BL40, KI3, ashi points) (B) Sham (non-acupoints treated by a Streitberger placebo acupuncture needle) |
MA | Deqi | rs-fMRI | ROI-wise FC, MVPA |
| 13 | Xiang et al. (2019) China | Chronic low back pain | Non-RCT | 12 | 18–65 | 8 min | (A) Verum (ankle zone 5) (B) Sham (tactile stimulation) |
MA | Not deqi | rs-fMRI | ALFF/fALFF, correlation with VAS |
| 14 | Lee et al. (2019)South Korea | Non-specific low back pain | RCT | 56 (33/23) | 38.4 ± 12.7 | 7 min | (A) Verum (B) Phantom acupuncture (ST36, SP11, SP13) |
MA | Deqi | rs-fMRI | ICA, correlation with VAS |
| 15 | Yan et al. (2019) China | Chronic low back pain | Non-RCT | 57 (16/16/25) | LBP 46.4 ± 10.0 HC 40.0 ± 9.8 | 4 w | (A) Kidney deficiency patients (B) Non-kidney deficiency patients (acupoint selection by syndrome differentiation) C) HC |
EA | Not depicted | rs-fMRI | ReHo |
| 16 | Yu et al. (2020) USA | Chronic low back pain | RCT | 54 (14/13/14/13) | 18–60 | 15 min | (A) “Augmented context” (interaction with the acupuncturist) verum (B) “Limited context” (converse with patients as little as possible) verum (GV3, BL23, BL40, KI3, ashi points) (C) “Augmented context” sham D) “Limited context” sham (non-acupoints treated by a Streitberger placebo acupuncture needle) |
MA | Deqi | rs-fMRI | ROI-wise FC, correlation with VAS |
| 17 | Liu et al. (2020) China | Chronic sciatica | Non-RCT | 27 (12/15) | 35–85 | 4 w | (A) Patients (acupoint selection by syndrome differentiation) (B) HC |
MA | Deqi | rs-fMRI | ReHo/Voxel-wise FC, correlation between VAS, SBI, and RDQS |
| 18 | Kim et al. (2020) USA | Chronic low back pain | RCT | 128 (18/18/19/23/50) | 18–60 | 4 w | (A) Verum (GV3, BL23, BL40, KI3, ashi points) (B) Sham (using a Streitberger placebo acupuncture needle) (C) Mock laser acupuncture (D) usual care E) HC |
MA | Not depicted | VBM, DTI | GMV, FA |
| 19 | Lan et al. (2020) China | L5 nerve root pain | RCT | 40 (20/20) | 18–60 | 1 w | (A) Acupuncture 1 (gentong 2) (B) Lumbar traction + acupuncture 2 (acupoint selection by syndrome differentiation) |
MA | Deqi | DTI | AD, FA |
AD, axial diffusivity; ANS, autonomic nervous system; (f)ALFF, (functional) amplitude of low-frequency fluctuations; d, day; DTI, diffusion tensor imaging; EA, electroacupuncture; FA, fractional anisotropy; FC, functional connectivity; HC, healthy controls; ICA, independent component analysis; LBP, low back pain; MA, manual acupuncture; MASS, Massachusetts general hospital acupuncture sensation scale; min, minute; MVPA, multivariate pattern analysis; n, number; RCT: randomized controlled trial; ReHo, regional homogeneity; rs-fMRI, resting-state fMRI; s, second; SBI, sciatica bothersomeness index; sham, sham acupuncture; ts-fMRI, task-state fMRI; VAS, visual analog scale; VBM, voxel-based morphometry; verum, verum acupuncture; w, week.