Neuroanatomische Grundlagen der Akupunktur - Anhaltspunkte für eine segmentbezogene und segmentübergreifende Schmerzbehandlung
Journal/Book: Deutsche Zeitschrift für Akupunktur. 1987; 2: 32-39.
Abstract: Neuroanatomy as a guide to understand segment-related- and -unrelated effects of pain inhibition induced by acupuncture.The whole organism as well as single parts of a complex system can be influenced by acupuncture therapy. The underlying mechanisms of action are poorly understood. However, the segmental and descending systems for pain inhibition are partially elucidated by recent studies, stressing the importance of pain control by neural and humoral mechanisms.The present overview tries to explain segmental- and non-segmental distribution of acupuncture-mediated pain inhibition on a neuroanatomic basis. Obviously the different tissues supplied by one pair of spinal nerves (e.g. the dermatome, myotome, viscerotome, sklerotome) interact via spinal segmental reflex arcs. Acupuncture induced hypalgesia is transmitted to the spinal cord by the peripheral nervous system. The projection neurons of the spino-thalamic tract in the dorsal columns are important sites for spinal as well as supraspinal pain modulation. The corresponding afferent and efferent (descending inhibitory) pathways are stimulated by the different methods of counter-irritation (including TENS and [electro-]acupuncture).However, additional working-hypotheses are needed to explain the characteristic (non-segmental bound) somatotopic distribution of acupuncture effects. Ascending afferent input from acupuncture points may converge to supraspinal levels in characteristic somatotopic patterns. The brain stem formatio reticularis may be a candidate for a topologic central projection which could agree to the acupuncture system.