DISCUSSION
KOA pain, KOA knee pain, pain
This study explored the vlPAG rs‐FC alternations and the modulation effects of verum, sham acupuncture, celecoxib, placebo, and waiting list treatment in KOA knee pain patients. The clinical and vlPAG rs‐FC results showed no significant difference between VA and SA groups. Acupuncture (VA + SA) and celecoxib groups had similar clinical effects on pain relief in KOA knee pain patients. Furthermore, the acupuncture group showed a significantly increased vlPAG rs‐FC with the right DLPFC and right angular, compared with celecoxib treatment, placebo, and waiting list groups. Interestingly, these vlPAG rs‐FC changes were correlated with a decreasing KOA pain intensity in the acupuncture group. To our knowledge, this is an initial study exploring the mechanical characteristics of acupuncture on DPMS compared with NSAIDs and placebo medications for KOA knee pain relief.