Chronic shoulder pain (CSP) is the third most common musculoskeletal problem. For maximum treatment effectiveness, most acupuncturists usually choose acupoint in the nonpainful side, to alleviate pain or improve shoulder function. This method is named opposite needling, which means acupuncture points on the right side are selected for diseases on the left side and vice versa. However, the underlying neural mechanisms related to treatment are currently unclear. The purpose of this study was to determine whether different mechanisms were observed with contralateral and ipsilateral acupuncture at Tiaokou (ST 38) in patients with unilateral CSP. Twenty-four patients were randomized to the contralateral acupuncture group (contra-group) and the ipsilateral acupuncture group (ipsi-group). The patients received one acupuncture treatment session at ST 38 on the nonpainful or painful sides, respectively. Before and after acupuncture treatment, they underwent functional magnetic resonance scanning. The treatment-related changes in degree centrality (DC) maps were compared between the two groups. We found alleviated pain and improved shoulder function in both groups, but better shoulder functional improvement was observed in the contra-group. Increased DC in the anterior/paracingulate cortex and decreased DC in bilateral postcentral gyri were found in the contra-group, while decreased DC in the bilateral cerebellum and right thalamus was observed in the ipsi-group. Furthermore, the DC value in the bilateral anterior/paracingulate cortex was positively correlated with the treatment-related change in the Constant–Murley score. The current study reveals different changes of DC patterns after acupuncture at contralateral or ipsilateral ST 38 in patients with CSP. Our findings support the hypothesis of acupoint specificity and provide the evidence for acupuncturists to select acupoints for CSP.

中文翻译：

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慢性肩痛患者针刺对侧或同侧穴位后脑部不同程度的中心度变化：一项静止状态功能磁共振成像研究。

慢性肩痛（CSP）是第三种最常见的肌肉骨骼问题。为了获得最大的治疗效果，大多数针灸师通常在无痛的一侧选择穴位，以减轻疼痛或改善肩部功能。这种方法称为对面针刺，这意味着针对左侧疾病选择右侧的穴位，反之亦然。但是，目前尚不清楚与治疗有关的潜在神经机制。这项研究的目的是确定对于单侧CSP患者在调口对侧和同侧针灸是否观察到不同的机制（ST 38）。24例患者被随机分为对侧针刺组（对比组）和同侧针刺组（ipsi组）。患者在ST 38分别在非疼痛或疼痛侧接受了一次针灸治疗。在针灸治疗前后，他们进行了功能磁共振扫描。在两组之间比较了与治疗相关的度数中心度（DC）图的变化。我们发现两组患者均减轻了疼痛并改善了肩部功能，但相反组的患者肩部功能得到了更好的改善。相反组发现前/顶突皮质的DC增加，而双侧中央后回的DC降低，而ipsi组则观察到双侧小脑和右丘脑的DC降低。此外，双侧前/丘脑皮质的DC值与Constant-Murley评分与治疗相关的变化呈正相关。当前的研究揭示了针刺CSP患者对侧或同侧ST 38后DC模式的不同变化。我们的发现支持穴位特异性假说，并为针灸师选择CSP穴位提供证据。