Acupuncture’s neuroanatomic and neurophysiologic basis

: Ever since acupuncture’s tenets were first delineated in the Huangdi Neijing (Neijing) treatise ~200 BCE, theorists and researchers have sought to define the anatomic and physiologic bases for acupuncture’s beneficial clinical effects in treating pain and non-pain medical conditions. In the last century, technical advances in both the basic biomedical sciences (including anatomy, biochemistry, pharmacology, electrophysiology, and radiology) and also clinical research methodologies have led to publication of an extensive body of basic science and clinical research publications on the topics of acupuncture anatomy, physiology, and clinical effects. This body of literature demonstrates that the beneficial clinical effects of acupuncture derive from the activation of peripheral nerves by needling, with resulting secondary modulatory effects on the peripheral nervous system, the central nervous system (CNS) (including the limbic system), the autonomic nervous system, and the immunologic and endocrinologic systems. A neuroanatomic and neurophysiologic model of acupuncture’s mechanisms and effects is the only theory that can be reconciled with research findings of the efficacy of laser acupuncture and the positive randomized clinical trial results in studies that used non-penetrating or minimally penetrating “sham” needle control interventions, and this model is also consistent with anatomic and physiologic descriptions contained in the Neijing . This review article summarizes the anatomic, basic science, and clinical evidence that demonstrates acupuncture signaling and its myriad clinical benefits can be understood as arising from and transduced by neural mechanisms.