More like this please.  I like this study, not because of any definitive conclusions, but because of its ambition and intent to include more nuanced aspects of patient (or subject) response.  They compared low dose acupuncture, one single point, versus “high dose” (arguable) that added 4 more nonacupoints.  The stratified according to patients tendency to “reduce” or “augment” incoming stimuli.  But their conclusion is very intriguing. “ After needle insertion subjects who tend to augment incoming stimuli might show a lack of psychological relaxation when receiving high dose stimulation.”   So in reference to my own research, I can’t help but wonder if this tendency to “augment” incoming stimuli and no decrease in stress response (called “psychological relaxation” by the authors)  is another indicator of a “non-responder.”  In my clinic I have never noticed, and I have looked, a tendency of patients who are sensitive to needles having poorer outcomes than those who are less sensitive.  Indeed, if pressed, I would say exactly the opposite is true.

Impact of stimulation dose and personality on autonomic and psychological effects induced by acupuncture.
Bäcker M, Schaefer F, Siegler N, Balzer S, Michalsen A, Langhorst J, Dobos GJ.
Department of Complementary and Integrative Medicine, University of Duisburg-Essen, Kliniken Essen Mitte, Germany.

Acupuncture has been shown to exhibit distinct effects on the autonomic nervous system. We tested whether the autonomic and psychological response to acupuncture depends on the stimulation dose and the personality of the treated subjects. 52 healthy subjects were randomized to receive either low dose (one needle at point Hegu bilaterally) or high dose (additional 4 needles at non-acupoints bilaterally) acupuncture stimulation after stratification according to their personality to “reduce” or “augment” incoming stimuli. Outcomes were changes of electrodermal activity (EDA), high frequency component of heart rate variability, heart rate, mean arterial blood pressure, respiration rate and subjective parameters for psychological well being and perceived intensity of needling. Electrodermal activity increased during needle insertion and decreased under baseline when subjects were resting with the needles in the body for 20min. The initial EDA increase was significantly (GEE ANCOVA p<0.001) more pronounced during high dose stimulation and independent of personality. All other physiological parameters did not show any significant group effect. Strong stimulated augmenters perceived acupuncture most painful and increased with their psychological activation after the acupuncture session in contrast to the other groups, which showed a decrease of activation in the pre-post comparison (overall group effect p=0.032). The data indicate that during needle insertion high dose acupuncture stimulation leads to a higher increase of sympathetic nerve activity than low dose stimulation independent of personality. After needle insertion subjects who tend to augment incoming stimuli might show a lack of psychological relaxation when receiving high dose stimulation.