Abstracts from Society for Acupuncture Research Acupuncture Research, Health Care Policy, & Community Health...Closing the Loop June 27–29, 2019 Burlington, VT

The Journal of Alternative and Complementary MedicineVol. 25, No. 10 AbstractsFree AccessAbstracts from Society for Acupuncture Research Acupuncture Research, Health Care Policy, & Community Health...Closing the Loop June 27–29, 2019 Burlington, VTPublished Online:21 Oct 2019https://doi.org/10.1089/acm.2019.29074.abstractsAboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail 1‐22 A consumer satisfaction approach to acupuncture for oncology patients at an academic cancer centerLanie Francis, UPMC; Karen Donoughe, UPMCPurpose: A consumer satisfaction approach is employed for symptom‐guided acupuncture in a population of oncology patients at an academic cancer center.Methods: Acupuncture was suggested by an oncologist for symptom management in the outpatient setting of an academic cancer center. All patients had a cancer diagnosis and experienced one or more of the following symptoms: pain, nausea, neuropathy, anxiety, insomnia, or hot flashes. Symptoms were typically refractory to pharmaceuticals or patients wanted to avoid additional pharmaceuticals due to side effects. Fundraising was employed so every patient could experience 3 one‐hour sessions prior to deciding to pay a fee for service for ongoing acupuncture.Results: Over a 2‐year period of time, 267 patients experienced acupuncture as recommended by an oncologist. The most common symptoms as reported by the patients and elicited by the oncologist were: pain, nausea, and neuropathy. Out of 267 patients who tried acupuncture, 46 continued for up to 3 additional treatments. This translates into over 17% that continued to pay for acupuncture services for their refractory symptoms in the context of a cancer diagnosis.Conclusion: A consumer driven principle of satisfaction can drive a medical acupuncture model. When patients experience acupuncture for refractory symptoms without the burden of cost, the commitment to pay for service represents demand. Quantifying this demand may help model return on investment and help expand the use of acupuncture as an integrative modality used with conventional medical practitioners. Given the complexity of defining the benefits to of acupuncture and integrative care to patients and society and limited insurance coverage, this is a practical approach to whole systems research.2‐59 A mixed methods study investigating acupuncture and health coaching on fall prevention in older adultsCarla Wilson, CIIS; Mirie Levy, CIIS; Tara Spalty, CIIS; Michel Lau, CIIS1. This study seeks to examine the less commonly understood factors that influence falling in Seniors, with the hope of contributing to the scientific literature around effective preventive care for mitigating fall risk. While exercising is known to be one of the best ways to reduce fall risk, little research has been done on the impact of acupuncture and health coaching on fall prevention. The Balance Project investigates acupuncture's effectiveness in mitigating fall risk combined with health coaching techniques. 2. The research design utilized a Repeat Measures Design, also known as a Crossover Design, in which subjects serve as their own control groups. The study participants were randomly assigned into two groups, to receive either weekly acupuncture or weekly health coaching over the duration of 16 weeks (Phase I). Baseline testing was conducted prior to the start of the program and midtest assessments were administered after the first 16 weeks. After Phase I, the groups that had previously received acupuncture were exposed to a second treatment option, receiving health coaching along with acupuncture for an additional 16 weeks (Phase II). In order to collect qualitative data in addition to the quantitative assessments, focus groups were held at the end of the 32 weeks. 3. Collaboration with the Biostatistical Department at Emory University's School of Medicine is underway, and will provide data analyst to investigate the primary, secondary and exploratory research outcomes 4. Preliminary results from the study pilot will be available March 2019 and available to be presented at the 2019 SAR conference.3‐51 A novel correlation between electroacupuncture and the control of inflammatory pain: the role of pro‐resolution mechanisms triggered by formyl peptide receptorsDaniel F. Martins, Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina at Palhoça, Santa Catarina, Brazil.; Cintia Vieira, Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina at Palhoça, Santa Catarina, Brazil.; Anna P. Piovezan, Postgraduate Program in Health Sciences, University of Southern Santa Catarina, at Palhoça, Santa Catarina, Brazil; Daiana C. Salm, Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina at Palhoça, Santa Catarina, Brazil.; Verônica V. Horewics, Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina at Palhoça, Santa Catarina, Brazil.; Daniela D. Ludtke, Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina at Palhoça, Santa Catarina, Brazil.; Aline A. Emer, Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina at Palhoça, Santa Catarina, Brazil.; Júlia F. Koerich, Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina at Palhoça, Santa Catarina, Brazil.; Gustavo Mazzardo, Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina at Palhoça, Santa Catarina, Brazil.; Sayron Elias, Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina at Palhoça, Santa Catarina, Brazil.; Leidiane Mazzardo‐Martins, Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil; Francisco J. Cidral‐Filho, Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina at Palhoça, Santa Catarina, Brazil.; Ari O. O. Moré, University Hospital, Service of Integrative Medicine, Federal University of Santa Catarina ‐ BrazilPro‐resolution is a recently described endogenous process that controls inflammation. A type of formyl peptide receptor (ALX/FPR2R) is involved in this process and not yet studied in the acupuncture field. This study evaluated the correlations between the ALX/FPR2R and the antihyperalgesic effect induced by electroacupuncture (EA) in an animal model of persistent inflammatory pain.Method: Swiss male mice underwent intraplantar (i.pl.) injection with complete Freund's adjuvant (CFA). Mechanical hyperalgesia was assessed by von Frey test and paw edema was evaluated with a digital micrometer. Animals were treated with EA (2‐10Hz, ST36‐SP6) or subcutaneous BML‐111 injection (ALX/FPR2R agonist) for 5 consecutive days. In another set of experiments, on the first and fifth days after CFA injection, animals received i.pl. and intrathecal (i.t.) WRW4 (ALX/FPR2R antagonist) or naloxone (non‐selective opioid receptor antagonist) before EA or BML‐111 treatment. Expression of the ALX/FPR2R in the paw and spinal cord was performed on the second day after CFA injection by the Western Blotting technique.Results: EA and BML‐111 reduced mechanical hyperalgesia but did not inhibited paw edema. The i.pl. or i.t. pre‐treatment of animals with WRW4 or naloxone prevented the antihyperalgesic effect induced either by EA or BML‐111. The CFA injection increased ALX/FPR2R expression in the paw, but not in the spinal cord. Treatment with EA or BML‐111 did not alter ALX/FPR2R expression in the paw or spinal cord. On the other hand, the group of animals pretreated with WRW4 that received BML‐111 had lower ALX/FPR2R expression in the spinal cord and those that received EA had lower ALX/FPR2R expression in the spinal cord and the paw.Conclusion: The results of this study suggest a novel correlation between the EA antihyperalgesic effects and pro‐resolution mechanisms. This seems to be triggered by the modulation of formyl peptide receptors and a cross‐talk with the opioid system.4‐9 A pilot study of acupuncture augmentation of lidocaine for the treatment of provoked localized vulvodynia—an exploratory analysis of changes in pain based on Traditional Chinese Medicine (TCM) diagnosisLee Hullender Rubin, Osher Center for Integrative Medicine, University of California San Francisco; Scott Mist, Oregon Health & Science University; Rosa Schnyer, University of Texas; Catherine Leclair, Oregon Health & Science UniversityPurpose: Assess acupuncture augmentation of lidocaine for the treatment of provoked, localized vulvodynia (PLV) pain based on Traditional Chinese Medicine (TCM) diagnosis.Methods: In a randomized, single‐blind, controlled pilot over 12 weeks, 19 women with moderate to severe PLV pain were randomized to either 18 sessions each of classical acupuncture (CA) or non‐classical acupuncture (NCA) and completed TCM diagnostic assessment. Women in the CA group received alternating sessions of manual or electro‐acupuncture. The NCA group received minimal needling with no stimulation. All participants applied lidocaine 5% cream four times daily to the vestibule. Participants were assigned one of three TCM patterns: Qi and Blood stagnation in the Liver Channel (Stagnation); Fire in the Liver Channel (Fire); and Cold in the Liver channel engendering Fire (Cold). An exploratory aim was to estimate the relative frequency of TCM diagnosis and assess change in Tampon Test scores from baseline to Weeks 12 and 24, stratified according to TCM diagnosis.Results: The most common diagnosis was Fire (n = 10), followed by Stagnation (n = 6), then Cold (n = 3). Follow up scores were obtained in 14 women at week 24. Five withdrew due to: lidocaine reaction (n = 2); unable to insert tampon (n = 1); started new medication (n = 1), and change in vulvar diagnosis (n = 1). Women diagnosed with Stagnation experienced a within group mean difference (MD) of −47.8 ± 20.7 at 12 weeks, and −45.4 ± 11.3 at 24 weeks. Women diagnosed with Fire experienced MD −41.2 ± 10.2 at 12 weeks, and −23.0 ± 14.1. While women with the Cold diagnosis experienced MD 0.4 ± 19.8 at 12 weeks, and −41.0 ± 11.6 at 24 weeks.Conclusions: The most prevalent TCM diagnosis in women with PLV was Fire in the Liver Channel, but the pattern most responsive to treatment was Qi and Blood Stagnation in the Liver Channel.5‐109 A randomized wait‐list controlled trial examining the effect of acupuncture for insomnia in breast cancer patients undergoing chemotherapy: a study protocolJialing Zhang, School of Chinese Medicine, The University of Hong Kong; Mingxiao Yang, School of Chinese Medicine, The University of Hong Kong; Lam Wing Lam, School of Chinese Medicine, The University of Hong Kong; Haiyong Chen, School of Chinese Medicine, The University of Hong Kong; Tsz Him So, Department of Clinical Oncology, The University of Hong Kong; Lixing Lao, School of Chinese Medicine, The University of Hong KongBackground: Studies suggest that chemotherapy is one of the major causes of insomnia in cancer patients. Acupuncture is widely used for insomnia. This study aims to examine whether acupuncture is effective, safe and feasible for alleviating insomnia in breast cancer patients undergoing chemotherapy.Methods: We plan to conduct a randomized, wait‐list controlled, assessor‐blinded clinical trial. Thirty patients with nonmetastatic breast cancer, who have insomnia onset after chemotherapy, will be randomly allocated to either acupuncture group or wait‐list control group at a 1:1 ratio. The acupuncture group will receive acupuncture twice a week for 6 weeks in addition to routine care. The wait‐list control group will receive routine care only. They will receive 12 sessions acupuncture after the waiting period. The primary outcome measurement will be Insomnia Severity Index. The secondary outcomes include Pittsburgh Sleep Quality Index, sleep diary, actiwatch, Functional Assessment of Cancer Therapy‐Breast Cancer, and adverse events. Follow‐up assessment will be performed at week 9 and 12.Discussion: This clinical trial will expand our knowledge about the effect, safety and feasibility of acupuncture for insomnia in breast cancer patients undergoing chemotherapy. The study findings will provide useful information for designing a larger clinical trial. Ethics: This study protocol has been approved by the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster (No. UW 18‐526). Trial Registration: This trial is registered with ClinicalTrials.gov (ID: NCT03762694).6‐121 A retrospective acupuncture chart review in a primary care clinic within a public teaching hospitalByron Lu, ACMC/Highland Hospital; Tin Ngo, University of California Berkeley; Chase Waters, ACMC/Highland Hospital; Lyn Berry, ACMC/Highland Hospital; Gabrielle LeCompte, ACMC/Highland Hospital; Amy Matecki, ACMC/Highland HospitalObjectives: (1) Assess the sociodemographic characteristics of patients seen in Highland Hospital K6 Adult Medicine Acupuncture Clinic. (2) Describe the implementation of paper chart documentation to Electronic Medical Records (EMR). (3) Demonstrate the feasibility of integrating Acupuncture practice in a primary care hospital setting.Design: Retrospective Descriptive Study. Setting/Location: Alameda Health System Highland Hospital, a public teaching hospital.Subjects: Patients were referred from all medical subspecialties between July 1, 2015, to June 30, 2016, to a 4‐hour half‐day clinic per week.Intervention: Acupuncture treatments were given to patients for pain management. All treatments were 30 minutes in length.Outcome Measures: Primary outcomes included sex, age, race, primary payer, Emergency Department visits and hospital visits. Secondary outcomes include a review of patient medications and Traditional Chinese Medicine (TCM) diagnoses and successfully transitioned from paper charts to NextGen (EMR).Results: 155 total patients were seen with a total of 442 treatment visits within a one‐year period. Of the patients seen, 27.1% (N = 42) male, 72.9% (N = 113) female, the average age was 57. The average number of visits per patient was 2.9. African‐American ethnicity represented the largest population subset at 37.4% (N = 58) follow by Asian 17.4% (27) and White 16.1% (25), while those individuals identified as Other ethnicity represented 29.0% (N = 45). The three predominate chief complaints were back pain 54.8% (N = 85), lower extremity pain 53.5% (N = 83), and neck/shoulder pain 27.7% (N = 27.7). Top comorbidities were hypertension 14.3%, diabetes 10.3%, and arthritis 6.5%. There were no complications noted from Acupuncture treatments.Conclusion: Very diverse populations of patients were receptive to receiving Acupuncture for treatment of pain in a public safety net primary care setting. Conditions most commonly treated were pain from musculoskeletal conditions. EMR implementation was completed within the study period. Patients, clinical staff and referral services expressed their appreciation for the availability of this service.7‐114 A retrospective study of acupuncture in the emergency department in a public safety net hospitalYuwen Cen, ACMC/Highland Hospital; Byron Lu, ACMC/Highland Hospital; Scott Phelps, ACMC/Highland Hospital; Heidi Bartlett, ACMC/Highland Hospital; Tehea Robie, ACMC/Highland Hospital; Kara Romanko, ACMC/Highland Hospital; Cheng‐Ping Butler, University of California Berkeley; Francis Yang, University of California Berkeley; Brandon Toy, University of California Berkeley; Teshu Teng, ACMC/Highland Hospital; Amy Matecki, ACMC/Highland Hospital; Gabrielle LeCompte, ACMC/Highland HospitalObjectives: Evaluate the acceptability and response to acupuncture in a safety net Emergency Department (ED).Methods: A retrospective descriptive study of ED patients who were referred for treatment to the Division of Integrative Medicine (DIM), Highland Hospital, between February 23, 2017, and February 23, 2018. Acupuncture effectiveness was measured through patient‐reported, visual analog pain scales (VAS). Demographics, insurance, Traditional Chinese Medicine (TCM) diagnosis, and analgesics were also collected.Results: 109 patients received 111 treatments. Male patients comprised 46 (41%), female patients 63 (59%). Ethnicities included: African American 43 (40%), Caucasian 14 (12%), Hispanic American 12 (11%), Asian American 8 (7%), Pacific Islander 2 (2%) and other 30 (28%). Insurance coverage from three public, not‐for‐profit insurance companies: Alameda Alliance 34 (15%), Medical 68 (30%) and Medicare 49 (22%). The chief complaint of pain was categorized into five types: extremity pain, head/neck pain, back pain, abdominal pain (with/without nausea/vomiting) and chest pain. Some cases reported multiple pain. Most common TCM pattern diagnosis was qi and blood stasis, in 102 cases (94%). 104 cases reported pain; 81 (78%) VAS pain scores were recorded. Pain reduction in 69 cases (85%) with 12 (15%) indicated no pain reduction. No adverse events reported. Average pre‐acupuncture pain score was 8.0 (variance 4.90). Average post‐acupuncture pain score was 4.4 (variance 10.74), with pain reduction of 3.6 ± 0.57 (95% CI). Wilcoxon Signed‐Rank tests show statistically significant pain reduction after acupuncture treatment.Conclusion: Our study, acupuncture was accepted by all ethnicities and covered by many types of insurance, in a safety net hospital ED. VAS pain score analysis indicated acupuncture was effective and well accepted by most patients for pain control. The significant reduction in VAS scores suggests that acupuncture might reduce the need for conventional analgesics as has been demonstrated in some prior studies.8‐104 A review of perioperative acupuncture outcomes in pre‐surgery, O.R. acupuncture assisted anesthesia, and post‐surgeryFrancis Yurasek, Director of Acupuncture; Lisa Seaman, Attending AcupuncturistAcupuncture has been used in Stroger Hospital, Chicago, for the treatment of nausea and pain in Post Anesthesia Care Unit (PACU), in 2018, with 48 hour patient satisfaction survey follow‐ups conducted by phone on a small representative number of patients. Pre‐surgical patients have also been treated with acupuncture for pain, as well as a history of nausea. In addition patients are currently being reviewed for treatment with acupuncture pre‐surgery, to prevent Bladder & Bowel retention issues, common particularly in older populations. The later group will be compared with outcomes following surgery with the same conditions who will not receive pre‐surgical acupuncture. Finally, outcomes will be reviewed in a 2 arm randomized study of patients undergoing elective lumbar open surgery, using electro‐acupuncture stimulation on preselected points, 30 patients chosen randomly to receive stimulation on verum points and 30 to receive stimulation on sham points. This last study will also be conducted at Gansu Hospital of Traditional Chinese Medicine PRC, on 120 patients randomly selected, using identical points, stimulated by identical acupuncture e‐stim devices, at identical settings. The same exclusion criteria and suspension criteria will be used in both locations. Data will be collected and shared from both locations, and reviewed, for the possibility of bundling results from both studies, or using them as stand‐alone studies of Acupuncture Assisted Anesthesia. Future studies are also being considered in Chicago to follow patients through pre‐surgery, surgery, and post surgery using Acupuncture Assisted Acupuncture, to see how it might effect both the strength, dosage frequency, and length of usage time for pain medication on discharge.9‐107 Accessibility, affordability and viability of AOM in primary care: A retrospective cohort study protocolAmelia Zahm, Oregon College of Oriental MedicineBackground: While numerous studies demonstrate the effectiveness of acupuncture, there is little research examining the integration of AOM with primary care. The question arises, if AOM services are available in a primary care clinic, can AOM become an accepted, accessible, affordable treatment modality for all populations?Objectives: This retrospective analysis will investigate the implementation of AOM within a Patient Centered Primary Care Home (PCPCH) and Federally Qualified Healthcare Center (FQHC) located in a frontier community and will assess: 1) demographics of patients utilizing AOM services, 2) percentage of patients using commercial insurance, Medicaid, private payment or sliding fee scale, 3) financial viability, 4) patient and provider perceptionsMethods: Primary objective data will be gathered from electronic medical records, health care billing files, and clinic financial documents. Qualitative data will be gathered from focus groups to determine levels of satisfaction and areas of challenge with regard to AOM services.Expected Outcomes: Objective and qualitative data will show how underserved populations benefit from fully integrated care, how medical and AOM providers collaborate to serve patients, and how primary care clinics offer AOM services in financially sustainable ways. The location and demographics of the study population will show positive outcomes and challenges of providing AOM services in a rural community, offer evidence that integrated care will benefit such populations, and suggest ways in which clinics might provide these services.Conclusion: This study will lay the groundwork for further study into the integration of AOM and primary care to improve patient outcomes, enhance patient experiences, and provide AOM services in affordable, accessible ways to underserved populations. Data will support the successful integration of AOM into other primary care sites, and inform the design of future prospective studies conducted in a variety of primary care settings, including other FQHC's in both rural and urban environments.10‐29 Acudetox users in New Mexico – Demographic and drug use profiles of a sample of 7000+ acudetox usersNityamo Lian, Public Health Acupuncture of NM; Pamela Arenella, UNM Dept of Psychiatry; Anna Ponce, Public Health Acupuncture of NM; Kristine Tollestrup, UNM College of Population HealthIntro Acudetox refers to the National Acupuncture Detoxification Association's (NADA) protocol of five ear acupuncture points used for the amelioration of symptoms due to alcohol or other drug use withdrawal. This presentation describes the demographic, substance‐use, and risk factor profile for more than 7000 treatments given to clients in substance‐use treatment and prevention programs associated with the non‐profit organization Public Health Acupuncture of New Mexico (PHANM). Methods Staff of 23 programs operating at 32 sites in NM gave 7652 acudetox treatments between July 2017‐ June 2018. Staff were trained in the administration of a standardized client self‐report form to collect demographic, drug use, and risk factor information monthly. For this study we used data collected from all programs in the four months of July and November 2017; January and April, 2018. Results 7652 treatments were given over 1671 clinic days. A sample of four months of patient treatment data resulted in the following profiles: Sex/Gender: 48.9% men, 50.8% women and 0.3% Transgender. Average age: 40.7 years; Range: 9‐92 years Ethnicity: Hispanic 47.6%; White 17.3%; Native American 31.9%; African‐American 2.3%; Asian American 1.5%; Other 3.4%; Multi‐Ethnic 3.5% Substances of choice: Alcohol 54.5%; Tobacco 28.2%; Marijuana 28.1%; Heroin and Opiates 25.0%; Methamphetamine and Speed 26.9%; Cocaine/Crack 28.2%; Risk factors for substance use: A family member used 65.5%; Works with substance users 22.2%; Has health or mental health problems 36.4%; Has money or home problems 37.1%; is on disability 18.3%. Over a third of clients (38.6%) reported multiple substance use excluding tobacco and 51.1% reported multiple risk factors for substance use. Conclusion Acudetox clients in NM represent a diverse demographic with multiple substance use and risk factors for substance use. This population differs from the typical acupuncture client and should be included as a separate patient profile for acupuncture users.11‐113 Acupuncture alters primary somatosensory cortex functional connectivity in Carpal Tunnel SyndromeHarrison Fisher, Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Yumi Maeda, Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Department of Radiology, Logan University, Chesterfield, MO, USA; Norman Kettner, Department of Radiology, Logan University, Chesterfield, MO, USA; Roberta Sclocco, Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA;2Department of Radiology, Logan University, Chesterfield, MO, USA; Jieun Kim, Korean Institute of Oriental Medicine, Daejeon, Korea; Cristina Malatesta, Department of Physical Health and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, USA; Jessica Gerber, Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Joseph Audette, Department of Pain Medicine, Harvard Vanguard Medical Associates, Atrium Health, Boston, MA, USA; Vitaly Napadow, Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Department of Radiology, Logan University, Chesterfield, MO, USAOur prior studies have shown that Carpal Tunnel Syndrome (CTS), an entrapment neuropathy of the median nerve, alters the brain's primary somatosensory cortex (S1), which electro‐acupuncture, both local and remote/distal to the wrist, can modulate S1 somatotopy. However, the mechanisms linking neuroplasticity with improved outcomes are unknown. We investigated altered resting functional S1 connectivity and potential acupuncture modulation. Sixty‐one (N = 61) CTS subjects were randomized to local (N = 19), distal (N = 16, opposite ankle), or sham (N = 20) acupuncture groups for 16 treatments over 8 weeks. Before and after the treatment, 6 minutes of resting fMRI was performed at 3T. Data for CTS, and N = 27 healthy controls, were preprocessed with the CONN toolbox and Freesurfer. Connectivity analysis used contralesional seeds for median‐nerve (index finger, D2; middle, D3) and ulnar‐nerve innervated (pinky, D5) S1 representations, and contralateral S1 local/distal acupuncture‐activated regions. Both D2 and D3, but not D5, seeds showed decreased resting connectivity to other S1 subregions for CTS compared to HC (pFDR <0.05), and were negatively correlated with pain scores (Pearson r = ‐0.29 and ‐0.30 for D2 and D3 seeds, respectively, p < 0.05). After local acupuncture, connectivity increased between D3 and right S1, mid cingulate, and left insula (pFDR <0.05). Additionally, the S1 hand region activated by local acupuncture showed increased connectivity to ventromedial prefrontal cortex (vmPFC, pFDR <0.05). Similarly, after distal acupuncture, connectivity increased between the activated S1 ankle region and both left S1 and posterior cingulate cortex (PCC, pFDR <0.05). Reduced intra‐S1 connectivity was consistent with our previous studies for other chronic pain conditions. Acupuncture, either local or distal to the lesioned hand, increased S1 connectivity to the acupuncture‐targeted S1 subregion. Additionally, acupuncture also increased S1 connectivity to different default mode network subregions, vmPFC and PCC, potentially modulating autonomic neurovascular control at the wrist.12‐55 Acupuncture analgesia for low back pain is associated with greater pressure pain‐evoked activation in dorsolateral prefrontal cortex and a reduction in hyperalgesiaKylie Isenburg, Massachusetts General Hospital; Ishtiaq Mawla, Massachusetts General Hospital; Jeungchan Lee, Massachusetts General Hospital; Jessica Gerber, Massachusetts General Hospital; Jieun Kim, Korea Institute of Oriental Medicine; Hyungjun Kim, Korea Institute of Oriental Medicine; Suk‐Tak (Phoebe) Chan, Massachusetts General Hospital; Ana Ortiz, Massachusetts General Hospital; Ajay Wasan, University of Pittsburgh; Robert Edwards, Brigham and Women's Hospital; Randy Gollub, Massachusetts General Hospital; Jian Kong, Massachusetts General Hospital; Bruce Rosen, Massachusetts General Hospital; Vitaly Napadow, Massachusetts General HospitalPurpose Chronic low back pain (cLBP) has been associated with aberrant brain processing and hyperalgesia, assessed by evoked, experimental pain testing. Due to a lack of effective pharmacological treatment, alternative therapies (e.g., acupuncture) have shown promise for cLBP. However, the central mechanisms supporting reduced hyperalgesia and clinical outcomes are unclear. We conducted a longitudinal neuroimaging study with brain response to painful mechanical pressure before and after 4 weeks (6 treatments) of real or sham acupuncture. Methods We enrolled 63 cLBP patients (33 male, 40.3 ± 11.7 years old) and 33 matched healthy controls, with patients randomized to verum (manual acupuncture) or sham acupuncture with variable somatosensory afference (Streitberger sham, mock‐laser acupuncture), or a no‐treatment/usual care control. LBP bothersomeness over the prior week (0‐100, VAS) and LBP intensity ratings (0‐100, NRS) prior to and after each treatment were collected. Changes in brain response to evoked leg cuff pain (calibrated to 40/100) was assessed with BOLD fMRI at baseline an