Evidence map›Paper›PMID 41520025›Full record

ArticleCommunications medicine2026

Brain sensory network activity underlies reduced nociceptive initiated and nociplastic pain via acupuncture in fibromyalgia.

Apeksha Sridhar, Ishtiaq Mawla, Eric Ichesco, Brock Pluimer, Steven E Harte, Robert Edwards, Vitaly Napadow, Richard E Harris

Registry-linked trialAbstract read
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In one paragraph

Article in Communications medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02064296 (Neuroimaging Approaches to Deconstructing Acupuncture for Chronic Pain), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02064296 nacompletednot on this map

Neuroimaging Approaches to Deconstructing Acupuncture for Chronic Pain

TypeinterventionalSponsorUniversity of MichiganRan2014 to 2019Enrolled121ConditionsFibromyalgiaArmsNeedle acupuncture (Traditional Acupuncture), Laser acupuncture (Non-traditional Acupuncture)
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Apeksha SridharSusan Samueli Integrative Health Institute, School of Medicine, University of California at Irvine, Irvine, CA, USA. agsridha@hs.uci.edu.ORCID http://orcid.org/0000-0002-4205-6243
Ishtiaq MawlaSusan Samueli Integrative Health Institute, School of Medicine, University of California at Irvine, Irvine, CA, USA.
Eric IchescoChronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
Brock PluimerSusan Samueli Integrative Health Institute, School of Medicine, University of California at Irvine, Irvine, CA, USA.
Steven E HarteChronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
Robert EdwardsDepartment of Anesthesiology, Critical Care and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Vitaly NapadowDepartment of Anesthesiology, Critical Care and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Richard E HarrisSusan Samueli Integrative Health Institute, School of Medicine, University of California at Irvine, Irvine, CA, USA.ORCID http://orcid.org/0000-0002-2067-8447

Funding

Neuroimaging Approaches to Deconstructing Acupuncuture for Chronic PainR01AT007550 · NCCIH · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HARRIS, RICHARD E, NAPADOW, VITALY · 2013 to 2019
$3.4M
NCCIH NIH HHS R01 AT007550U.S. Department of Health & Human Services | NIH | National Center for Complementary and Integrative Health (NCCIH) 5R01AT007550
6 · The paper itself

Abstract

backgroundChronic pain may involve both nociceptive pain driven by peripheral tissue damage and nociplastic pain reflecting central nervous system dysregulation, as in fibromyalgia. Electroacupuncture has been shown to modulate these pathways, but the underlying brain mechanisms remain unclear. This study investigated how electroacupuncture influences nociceptive-initiated and centrally maintained pain via changes in brain activation and functional connectivity.

methodsIn this randomized controlled trial (NCT02064296), female adults with fibromyalgia received either electroacupuncture (n = 19) or sham treatment with inactive laser stimulation (n = 25) over four weeks. Changes in brain activation and connectivity during evoked pressure-pain stimulation were assessed using functional magnetic resonance imaging before and after treatment. Here, we present a secondary analysis of data from the trial. Clinical outcomes assessed include pressure-pain tolerance and widespread pain, and analyses tested whether brain measures mediated treatment-related effects.

resultsHere we show that in the electroacupuncture group, reductions in widespread pain are associated with increases in pressure-pain tolerance. This relationship is mediated by greater activation of the primary somatosensory cortex and stronger connectivity between somatosensory and insular regions, consistent with a bottom-up mechanism linking peripheral nociceptive-initiated input to central nociplastic pain modulation. In contrast, the sham group shows reductions in widespread pain linked to decreased precuneus activity and precuneus-insula connectivity, consistent with a top-down process.

conclusionsElectroacupuncture and sham treatments engage distinct neural pathways to influence pain perception. These findings highlight that electroacupuncture modulates nociceptive-initiated and nociplastic pain through a bottom-up sensory pathway, whereas sham treatment engages top-down control. This mechanistic dissociation may inform patient selection and optimization of acupuncture-based therapies for chronic pain.

Identifiers

PMID41520025
PMCPMC12808314

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.