EDITORIAL THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE Volume 8, Number 4, 2002, pp. 399–401 © Mary Ann Liebert, Inc. Acupuncture: The Search for Biologic Evidence with Functional Magnetic Resonance Imaging and Positron Emission Tomography Techniques ZANG-HEE CHO, Ph.D., 1 TERRENCE DALE OLESON, Ph.D., 2 DAVID ALIMI, M.D., 3 and RICHARD C. NIEMTZOW, M.D., Ph.D., M.P.H. 4 399 T he subject of acupuncture is surrounded, in some circles, with notions of mysticism and movements of energy through meridian chan- nels invisible to the naked eye and a nomen- clature for the internal organs that perplexes many Western-trained scientists confronted with the Chinese literature. While a large num- ber of randomized controlled trials provides growing evidence of the clinical efficacy of acupuncture for treating a variety of medical conditions (National Institutes of Health, 1997; Ernst and White, 1999; Stux and Hammer- schlag, 2001) a reliance on apparently unveri- fiable concepts of energy gives rise to consid- erable skepticism of this alternative medical modality. Anecdotal reports of patient im- provement may be sufficient to persuade the health care consumer but failure to completely demonstrate the relationship of Oriental Med- icine to known physiologic systems limits the acceptance of acupuncture in mainstream med- icine. Physicians who practice medical acupunc- ture often provide considerable benefit to pa- tients who have reportedly “failed” to respond to contemporary Western medicine. Thus, these physicians appreciate the enormous clin- ical value of acupuncture. Nonetheless, histor- ical accounts in Europe and America of such supposedly effective medical cures as “blood- letting” and “mysterious elixirs” led Western physicians to doubt medical procedures not grounded in well-researched, biologic mecha- nisms and continue to fuel Western cynicism toward Oriental Medicine. However, advances in sophisticated technology utilized in the fields of neuroscience and molecular biology have the potential to lead to greater under- standing of the mechanisms underlying the ef- fects of acupuncture. In their paper “A Pilot Study of Functional Magnetic Resonance Imaging of the Brain Dur- ing Manual and Electroacupuncture Stimula- tion of Acupuncture Point (LI-4 Hegu) in Nor- mal Subjects Reveals Differential Brain Activation Between Methods” (pages 411–419), Jian Kong et al. demonstrate the complexity of researching even the basic process of needling a major acupuncture point, Large Intestine 4 (LI 4). Nevertheless, their endeavor to explore the centrally mediated effects of acupuncture us- ing functional magnetic resonance (fMRI) brain imaging techniques takes advantage of an op- portunity that Chinese doctors from the past 1 University of California, Irvine, Irvine, CA. 2 American University for Complementary Medicine, Los Angeles, CA. 3 Auricular Acupuncture Department of Faculty of Medicine of Paris XIII. Researcher at Gustave Roussy Institute Hospital, France. 4 Malcolm Grow U.S. Air Force Medical Center, Andrews Air Force Base, Washington, DC.