In the world of acupuncture, Dr. Helene Langevin is such a celebrity that even the Chinese have taken notice of her quest to understand exactly how the ancient healing art works.
Lying on a beige table in the stark orthopedics lab at the University of Vermont College of Medicine in Burlington, subject after subject endures the insertion of hair-thin acupuncture needles mid-thigh and just below the knee, while five researchers monitor a body of machinery: ultrasound scanner, torque sensor, electrocardiograph, and laptop, on which the volunteers rate the needling sensations. All very high-tech, this ongoing study led by Dr. Helene Langevin largely aimed at investigating needle torque is the latest in her quest to pinpoint the scientific basis behind the Chinese healing art that has been practiced for millenniums but whose physiology has never been fully understood. Demystifying acupuncture could eventually mean better diagnosis and treatment of ailments like chronic pain. While it's gaining devotees all the time, only an estimated 4 percent of US adults have tried acupuncture. "Unless we understand the mechanism of these treatments," Langevin says, "it's going to be very hard for them to get integrated into our healthcare system, including insurance reimbursements."
This third-generation physicians innovative research into the ancient therapy has gained nationwide, even worldwide, attention. Last month, Langevin an internist and acupuncturist who is a research associate professor of neurology and orthopedics won a grant worth an expected $1.9 million from the National Institutes of Healths National Center for Complementary and Alternative Medicine, bringing her grant-funding total over the past seven years to more than $4.4 million. "Shes one of the highest-funded acupuncture researchers in the country," says Ted Kaptchuk, an assistant professor of medicine at Harvard Medical School and an authority on Chinese medicine. "In the acupuncture field, shes a celebrity."
Seated at a gray steel desk in her austere, cramped office in the Given Medical Building, dwarfed by medical tomes and piles of esoteric articles and abstracts, the pixieish 50-year-old Langevin analyzes data and cross-sectional ultrasound images of needles inserted into the tissue of live human subjects and sacrificial rats. She muses: "Its really like solving a big puzzle, you know?"
As far back as 300 BC, Chinese texts have described acupuncture and de qi, a reaction to the needling thats thought to be important in achieving its therapeutic effect. During de qi, the patient usually experiences a slight ache in the area surrounding the needle, while the acupuncturist may feel the needle being grasped by the tissue a tug often described as akin to a fish biting on a line. Langevin grabbed headlines when, in 2001, the Journal of Applied Physiology published the results of a study in which she and her colleagues quantified de qis biomechanical component, or needle grasp, by measuring the force necessary to pull an acupuncture needle out of the skin. Her findings showed something else: Gently manipulating the needles back and forth or twisting them increased the grasp significantly. Since then, Langevins research has proved that the connective tissue that winds around acupuncture needles much like spaghetti wadded around a fork is responsible for needle grasp. Further study has revealed that needle manipulation transmits a signal to fibroblasts, the cells that make up such tissue, causing them to spread and flatten. "The needle is, in fact, stretching the tissue from the inside," Langevin explains. "The tissue is not just being pulled; its actively responding to the stimulus."
Next month, using needling and ultrasound imaging, Langevin and her team will begin to test her newest hypothesis that connective-tissue abnormalities occur more frequently in patients with low back pain than in others. "So far, we dont know that theres anything wrong with the connective tissue in people with low back pain," she says. "But if we determine the winding is abnormal, that would be a hint that the connective tissue may cause or perpetuate this pain."
Langevins attempt to elucidate the mechanism of acupuncture by looking at the cellular changes in connective tissue is novel. "There are Western scientists who think its all about nerve stimulation," says Peter Wayne, research director at the New England School of Acupuncture in Watertown. "But shes opened up a whole new model." A West-meets-East trailblazer, Langevin recently presented research at scientific meetings in Barcelona and Munich, among a number of foreign cities, and is scheduled to lecture soon at the Shanghai University of Traditional Chinese Medicine.
In Vermont, the French-Canadian professor walks or bikes to campus from the nearby home she shares with her American husband, Ty Danco, an investment manager, and their children, Alex, 18, and Dominique, 12. Though a practicing Catholic, Langevin adheres to a Taoist philosophy for balance in her life. She typically works an 8½-hour day, strives to maintain proper posture and breathing, and eats healthy lunches at her desk. She avoids caffeine and chitchat. "Shes like a laser beam," says Jim Fox, a colleague at the University of Vermont.
Her intellectual curiosity is born of personal experience. During her residency at Johns Hopkins Hospital in 1985, Langevin sought acupuncture for nerve-injury pain after exhausting all that Western medicine had to offer. After three months of treatments on her leg, her pain was gone. "I was intrigued by this strange way of looking at the anatomy in terms of the meridians," she says of the 12 main energy channels that acupuncturists believe run through the body. "The fact that I got better was almost irrelevant in my decision to study it."
Her fellow researchers applaud that decision. "Helene has single-handedly rescued acupuncture research from the dead end it had reached because of findings that had been inconclusive or contradictory," Kaptchuk says. "I dont know if Helene is going to solve the acupuncture riddle, but she has the best chance of anybody."
Stacey Chase is a freelance writer in Portland, Maine. E-mail her at firstname.lastname@example.org.