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Randomized Controlled Trial
. 2023 Feb;197(3):535-545.
doi: 10.1007/s10549-022-06846-3. Epub 2022 Dec 17.

Mechanistic and thermal characterization of acupuncture for chemotherapy-induced peripheral neuropathy as measured by quantitative sensory testing

W Iris Zhi  1 , Raymond E Baser  2 , Dristi Talukder  3 , Ying Zi Mei  4 , Steven E Harte  5 , Ting Bao  6   7
Affiliations
Randomized Controlled Trial

Mechanistic and thermal characterization of acupuncture for chemotherapy-induced peripheral neuropathy as measured by quantitative sensory testing

W Iris Zhi et al. Breast Cancer Res Treat. 2023 Feb.

Abstract

Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) is a common and debilitating side effect of chemotherapy. Acupuncture is a promising non-pharmacological intervention for CIPN. However, the physiological effects of acupuncture treatment remain poorly understood. We examined the effects of acupuncture on CIPN using semi-objective quantitative sensory testing (QST).

Methods: We conducted a randomized controlled trial of real acupuncture (RA) and sham acupuncture (SA) compared to usual care (UC) in cancer survivors with moderate-to-severe CIPN. Treatment response was assessed with QST measures of tactile and vibration detection thresholds in hands and feet, thermal detection, and pain thresholds at weeks 0, 8, and 12. Constrained linear mixed model (cLMM) regression was used for statistical analysis.

Results: 63 patients completed QST testing. At week 8, vibrational detection thresholds in feet were significantly lower in RA and SA (p = 0.019 and p = 0.046) than in UC, with no difference between RA and SA (p = 0.637). Both RA and SA also showed significantly higher cool thermal detection than UC (p = 0.008 and p = 0.013, respectively), with no difference between RA and SA (p = 0.790). No differences in tactile detection, vibrational detection in hands, warm thermal detection, and thermal pain thresholds were detected among the three arms at weeks 8 and 12.

Conclusion: QST demonstrated different patterns in RA, SA, and UC. After eight weeks of RA, we observed significant improvements in the vibrational detection threshold in feet and cool thermal detection threshold in hands compared to UC. No significant differences were seen when compared to SA.

Trial registration: ClinicalTrials.gov (NCT03183037); June 9, 2017.

Keywords: Acupuncture; Breast cancer; Chemotherapy; Neuropathy; Quantitative sensory testing; Sensory loss.

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Conflict of interest statement

Conflict of Interest: We certify that there are no affiliations with or involvement in any organization or entity with any financial interest or other equity interests or non-financial interests that influenced the design, outcome, and submission of this study.

Figures

Figure 1.
Figure 1.
Model-estimated changes in Vibration Detection Threshold (VDT) means and 95% confidence intervals in feet in Real acupuncture, Sham acupuncture, and Usual care arms Abbreviations: VDT – Vibration Detection Threshold, CI – Confidence Interval
Figure 2.
Figure 2.
Model-estimated changes in Cool Thermal Detection Threshold (TDTH) means and 95% confidence intervals in Real acupuncture, Sham acupuncture, and Usual care arms Abbreviations: TDTH – Thermal Detection Threshold, CI – Confidence Interval
See this image and copyright information in PMC

References

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