Brain responses to acupuncture stimulation in the prosthetic hand of an amputee patient.

This report describes the brain responses to acupuncture in an upper limb amputee patient. A 62-year-old male had previously undergone a lower left arm amputation following an electrical accident. Using functional MRI, we investigated brain responses to acupuncture stimulation in the aforementioned amputee under three conditions: (a) intact hand, (b) prosthetic hand (used by the patient), and (c) fake fabric hand. The patient described greater de qi sensation when he received acupuncture stimulation in his prosthetic hand compared to a fake hand, with both stimulations performed in a similar manner. We found enhanced brain activation in the insula and sensorimotor cortex in response to acupuncture stimulation in the amputee's prosthetic hand, while there was only minimal activation in the visual cortex in response to acupuncture stimulation in a fake hand. The enhanced brain responses to acupuncture stimulation of the patient's prosthetic hand might be derived from cortical reorganisation, as he has been using his prosthetic hand for over 40 years. Our findings suggest the possible use of acupuncture stimulation in a prosthetic hand as an enhanced sensory feedback mechanism, which may represent a new treatment approach for phantom limb pain. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.