Atualização neurocientífica dos mecanismos de ação da acupuntura em dor crônica
Neuroscientific update on the mechanisms of action of acupuncture in chronic pain
Marcus Yu Bin Pai, Bruno Fu Lon Chen, Hong Jin Pai
Resumo
A acupuntura é um método de tratamento que surgiu na China Antiga segundo conceitos filosóficos específicos da Medicina Tradicional Chinesa, que tem seus próprios sistemas de diagnóstico e tratamento de doenças. Desde que a acupuntura se disseminou pelo Ocidente, teorias e conceitos surgiram para explicar seus efeitos, incluindo o possível papel de mecanismos fisiológicos. Por exemplo, uma dessas teorias postula que a acupuntura promove o fenômeno da neuromodulação ao aplicar estímulos nos chamados acupontos, que seriam transmitidos pelos sistemas nervosos periférico e central por vastas redes neurais. Uma das aplicações clínicas da acupuntura é o tratamento da dor crônica, embora seus mecanismos de ação não sejam completamente compreendidos. Recentemente, porém, estudos têm contribuído para aprofundar o conhecimento sobre o tema, sugerindo que vias neurais centrais e mecanismos moleculares e humorais estão envolvidos na percepção da dor crônica e em seu tratamento pela acupuntura. Esses estudos sugerem, entre outros mecanismos de ação, possíveis efeitos neuroquímicos nos sistemas nervosos central e periférico, assim como alterações da atividade de áreas somatossensoriais, afetivas e cognitivas do cérebro, observadas em estudos de neuroimagem. Esta revisão tem o objetivo de fornecer uma visão geral sobre os efeitos e mecanismos de ação da acupuntura na dor crônica, com base em evidências neurocientíficas recentes.
Palavras-chave
Abstract
Acupuncture is a treatment method that emerged in Ancient China according to specific philosophical concepts of Traditional Chinese Medicine, which has its own systems of diagnosis and treatment of diseases. Since the use of acupuncture spread throughout the West, theories and concepts have emerged to explain its effects, including the possible role of physiological mechanisms. For instance, one of these theories states that acupuncture promotes neuromodulation by applying stimuli to the so-called acupoints, which are transmitted throughout the peripheral and central nervous systems by vast neural networks. One of the clinical applications of acupuncture is the treatment of chronic pain, but its mechanisms of action are not completely understood. Recently, however, studies have contributed to deepening the knowledge about the topic, suggesting that central neural pathways and molecular and humoral mechanisms are involved in the perception of chronic pain and in its treatment using acupuncture. These studies suggest, among other mechanisms of action, possible neurochemical effects of acupuncture on central and peripheral nervous systems, as well as modulation of somatosensory, affective and cognitive areas of the brain, observed in neuroimaging studies. This review aims to provide an overview of the effects and mechanisms of action of acupuncture in chronic pain, based on recent neuroscientific evidence.
Keywords
References
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Submitted date:
12/07/2021
Accepted date:
01/27/2023
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