Hello!

I’d been meaning to compile a list of Dr Napadow’s articles to review - and Linda Stone asked for a some references as well - so he’s what I’ve gathered from his 435 listed publications. The images I’ve included are slides from Napadow's 2014 plenary session I attended  - where I first encountered his work. (I don’t believe these are published, so kindly do not share them without Dr Napadow’s permission)

While I’ve focused here on his pain/acupuncture-related research due my interests & the elegance/robustness of these studies (esp the 2021 fibromyalgia publication, below) — Dr Napadow has made significant contributions to the study, elucidation and/or analysis of

  • CNS processing, modulation and derangements resulting from/related to chronic pain (somatic and visceral pain sources)

  • the nexus of pain processing and emotional considerations

  • central nervous system processing of autonomic inputs — central processing of autonomic functions

  • the default mode network

  • the placebo effect — pragmatic ways to avoid its confounding research studies, and practical ways to engage it ethically and effectively in clinical practice

  • the role of microglia in pain processing

  • the role of Lyrica (pregabalin) in neurochemical and CNS functional connectivity modulation

  • numerous consensus panel review committees re: neurological research policies, procedures and best practices

As I mentioned, to me, his revelatory work was using fMRI to demonstrate neuroplastic/somatotopic changes re: pain processing for carpel tunnel syndrome (CTS) and fibromyalgia —  in the somatosensory cortex and default mode network, respectively. Later, he goes on to demonstrate how acupuncture can rewire these aberrant functional connections

The reason these two are good examples with which to study pain is that CTS is a compression neuropathy, and usually has little psychoemotional overlay  — while fibromyalgia has ‘aberrant’ psychoemotional overlay, with pain processing through portions of the insula

The older articles are the more cited ones, some of which are well accepted/foundational

Carpel Tunnel Syndrome & Low Back Pain

Fibromyalgia (FM)

This robust, remarkable & elegant series of experiments demonstrates

  • neuroplastic changes (primarily) in the right anterior insula correlate with pain improvements during/after acupuncture in FM patients

  • GABA-ergic / neurotransmitter changes - pre and post acupuncture that complement the functional connectivity changes

  • robust control for placebo effect-confounders (protocolized electroacupuncture vs mock laser acupuncture)

'Cumulatively, these results allow us to establish a mechanistic model for the role of somatic sensation in acupuncture therapy: somatosensory afference leads to increased (S1) leg-to-aINS [anterior insula] signaling, resulting in increased GABA-ergic inhibition in the aINS [anterior insula], ultimately reducing clinical pain'

**Greater Somatosensory Afference with Acupuncture Increases Primary Somatosensory Connectivity and Alleviates Fibromyalgia Pain via Insular GABA: A Randomized Neuroimaging Trial - 2021

*Painful After-Sensations in Fibromyalgia are Linked to Catastrophizing and Differences in Brain Response in the Medial Temporal Lobe - 2017

Intrinsic brain connectivity in fibromyalgia is associated with chronic pain intensity - 2010

Acupuncture Modulates Resting State Connectivity in Default and Sensorimotor Brain Networks 2008    

Effects of electroacupuncture versus manual acupuncture on the human brain as measured by fMRI - 2005

The integrated response of the human cerebro-cerebellar and limbic systems to acupuncture stimulation at ST 36 as evidenced by fMRI   2005

ANS & Central Processing

*The autonomic brain: an activation likelihood estimation meta-analysis for central processing of autonomic function 2013

Evidence for brain glial activation in chronic pain patients

Implications of Placebo and Nocebo Effects for Clinical Practice: Expert Consensus 2020 

International Consensus Based Review and Recommendations for Minimum Reporting Standards in Research on Transcutaneous Vagus Nerve Stimulation (Version 2020)  

If you’ve not visited The Society for Acupuncture Research’s website - he’s on the board and I believe he may its co-founder -the group is interested in both clinical/phenomenological and mechanistic investigations of acupuncture’s effects and mechanisms

Hope that makes some sense - and more of his slides are included below - Lynnea

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Lynnea Villanova MD | Owner, Kireina Medical PLLC | 116 Chambers St, 4th flr | New York, NY 10007 |917-756-2312

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