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Wang J, Wu B, Tong Y, Wang X, Lu Z, Wang W. Effect of acupuncture combined with rehabilitation training on sensory impairment of patients with stroke: a network meta-analysis. BMC Complement Med Ther 2024; 24:102. [PMID: 38409065 PMCID: PMC10898000 DOI: 10.1186/s12906-024-04401-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 02/13/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND The refractory and disabling nature of sensory disorders after stroke seriously affects patients' daily lives and reduces hospital turnover. Acupuncture, as an alternative therapy, is commonly used in combination with rehabilitation training to improve sensory disorders. To compare the effects of different acupuncture-related treatments combined with rehabilitation training on sensory impairment and the daily living ability of patients with stroke, we conducted a network meta-analysis to provide evidence-based findings for clinical practice. METHODS Randomized controlled trials on the treatment of sensory disorders in patients with stroke were systematically retrieved from several databases, including China National Knowledge Infrastructure (CNKI), China Science and Technology Journal(VIP), Wanfang Database, Chinese Biological Medical (CBM), PubMed, Embase, Web of Science, Cochrane Library, and Clinical trials. The retrieval period ranged from January 2012 to December 2023. Two independent reviewers screened the included literature, extracted the data, and assessed the risk quality using Cochrane Handbook 5.1.0 and ReviewManager 5.4.1. Stata16.0 software was employed for data analysis. The study protocol was registered in PROSPERO: CRD42023389180. RESULTS After screening, 20 studies were included, involving a total of 1999 subjects. The network meta-analysis results indicate that, compared to standard rehabilitation, acupuncture plus massage plus rehabilitation showed the most significant reduction in Numbness Syndrome Scores (MD = -0.71(-1.11,-0.31)). Acupuncture combined with rehabilitation demonstrated the most substantial improvement in Sensory Impairment Scores (MD = -0.59,(-0.68,-0.51)) and daily living ability of patients (MD = 17.16,(12.20,22.12)). CONCLUSIONS In comparison to standard rehabilitation, the combination of acupuncture-related treatments and modern rehabilitation training not only improves the symptoms of sensory impairment and numbness after stroke but also enhances the daily living ability of patients, especially when acupuncture is combined with rehabilitation. However, further demonstration is required to strengthen these conclusions.
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Affiliation(s)
- Jiaqi Wang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Bangqi Wu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.
| | - Yuanyuan Tong
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Xuhui Wang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Zhaojun Lu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Wenqing Wang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
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Ma Y, Li B, Cui Y, Zhang Z, Jiang S, Yan X, He J, Du Y. The Top 100 Cited Articles on Acupuncture in the Last 20 Years: A Bibliometric Analysis. Complement Med Res 2023; 30:393-407. [PMID: 37263232 DOI: 10.1159/000530778] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 04/14/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Acupuncture has gained increasing international attention in recent decades. The act of incorporating acupuncture treatment into the routine treatment of COVID-19 in China drove us to review the 100 most influential articles of the last 20 years to learn about the current status and trends of acupuncture. METHOD Articles related to acupuncture from January 1, 2001, to July 4, 2022, were searched in the Clarivate Analytics Web of Science Core Collection database. The top 100 most cited publications were selected, and information was extracted. Software such as VOSviewer, GraphPad Prism, Scimago Graphica, and CiteSpace were used to visualize and analyze the extracted data. RESULT The 100 most cited articles were identified, with an average of 218 citations (range: 131-625). The majority of the top 100 articles were from the USA (n = 53). The institution that published the most highly cited papers was Harvard University (n = 16). The most influential team was Klaus Linde's group. Pain was the top-ranked journal in terms of the number of publications. The largest clusters for co-occurrence keyword analysis focused on acupuncture and electroacupuncture analgesia and brain imaging responses to acupuncture stimulation via functional MRI. The two highest strength burst keywords were "randomized controlled trials" and "osteoarthritis," with "randomized controlled trials" being a consistent burst keyword from 2011 to the present. CONCLUSION This study provides insight into articles of historical significance in the field of acupuncture through bibliometric analysis. These data should provide clinicians and researchers with insight into future directions related to acupuncture. Hintergrund Die Akupunktur hat in den vergangenen Jahrzehnten zunehmend die internationale Aufmerksamkeit auf sich gezogen. Die Einbeziehung der Akupunktur in die Routinebehandlung von COVID-19 in China hat uns dazu veranlasst, die 100 einflussreichsten Artikel der letzten 20 Jahre zu überprüfen, um etwas über den aktuellen Stand und die Trends in der Akupunktur zu erfahren. Methode Artikel mit Bezug zu Akupunktur vom 1. Januar 2001 bis 4. Juli 2022 wurden in der Clarivate Analytics Web of Science Core Collection Datenbank gesucht. Die 100 am häufigsten zitierten Veröffentlichungen wurden ausgewählt und die Informationen wurden extrahiert. Visualisierung und Analyse der extrahierten Daten erfolgten mithilfe der Software VOSviewer, GraphPad Prism, Scimago Graphica und CiteSpace. Ergebnis Es wurden die 100 am häufigsten zitierten Artikel ermittelt mit durchschnittlich 218 Zitierungen (Spanne: 131 bis 625). Der Großteil der 100 meistzitierten Artikel stammte aus den Vereinigten Staaten ( n = 53). Die Institution, die die meisten zitierten Artikel veröffentlichte, war die Harvard-Universität ( n = 16). Das einflussreichste Team war die Gruppe von Klaus Linde. Was die Zahl der Veröffentlichungen betrifft, war Pain die am häufigsten zitierte Zeitschrift. Bei der Analyse der Koinzidenz von Schlüsselwörtern lag der Fokus der größten Cluster auf Akupunktur-und Elektroakupunktur-Analgesie sowie auf den Reaktionen auf Akupunkturstimulation in den bildgebenden Untersuchungen des Gehirns mittels funktioneller MRT. Die beiden stärksten Burst-Schlüsselwörter waren “randomisierte kontrollierte Studien” und “Osteoarthritis,” wobei “randomisierte kontrollierte Studien” von 2011 bis heute durchgängig ein Burst-Schlüsselwort ist. Schlussfolgerung Diese Studie bietet einen Einblick in historisch bedeutsame Artikel auf dem Gebiet der Akupunktur mittels bibliometrischer analyse. Diese Daten sollen Klinikern und Forschern einen Einblick in zukünftige Richtungen im Zusammenhang mit Akupunktur geben.
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Affiliation(s)
- Yuping Ma
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China,
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China,
| | - Bo Li
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Ying Cui
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Zixing Zhang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Shiyi Jiang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Xiong Yan
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Junpeng He
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yuzheng Du
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
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Lu M, Du Z, Zhao J, Jiang L, Liu R, Zhang M, Xu T, Wei J, Wang W, Xu L, Guo H, Chen C, Yu X, Tan Z, Fang J, Zou Y. Neuroimaging mechanisms of acupuncture on functional reorganization for post-stroke motor improvement: a machine learning-based functional magnetic resonance imaging study. Front Neurosci 2023; 17:1143239. [PMID: 37274194 PMCID: PMC10235506 DOI: 10.3389/fnins.2023.1143239] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/03/2023] [Indexed: 06/06/2023] Open
Abstract
Objective Motor recovery is crucial in stroke rehabilitation, and acupuncture can influence recovery. Neuroimaging and machine learning approaches provide new research directions to explore the brain functional reorganization and acupuncture mechanisms after stroke. We applied machine learning to predict the classification of the minimal clinically important differences (MCID) for motor improvement and identify the neuroimaging features, in order to explore brain functional reorganization and acupuncture mechanisms for motor recovery after stroke. Methods In this study, 49 patients with unilateral motor pathway injury (basal ganglia and/or corona radiata) after ischemic stroke were included and evaluated the motor function by Fugl-Meyer Assessment scores (FMA) at baseline and at 2-week follow-up sessions. Patients were divided by the difference between the twice FMA scores into one group showing minimal clinically important difference (MCID group, n = 28) and the other group with no minimal clinically important difference (N-MCID, n = 21). Machine learning was performed by PRoNTo software to predict the classification of the patients and identify the feature brain regions of interest (ROIs). In addition, a matched group of healthy controls (HC, n = 26) was enrolled. Patients and HC underwent magnetic resonance imaging examination in the resting state and in the acupuncture state (acupuncture at the Yanglingquan point on one side) to compare the differences in brain functional connectivity (FC) and acupuncture effects. Results Through machine learning, we obtained a balance accuracy rate of 75.51% and eight feature ROIs. Compared to HC, we found that the stroke patients with lower FC between these feature ROIs with other brain regions, while patients in the MCID group exhibited a wider range of lower FC. When acupuncture was applied to Yanglingquan (GB 34), the abnormal FC of patients was decreased, with different targets of effects in different groups. Conclusion Feature ROIs identified by machine learning can predict the classification of stroke patients with different motor improvements, and the FC between these ROIs with other brain regions is decreased. Acupuncture can modulate the bilateral cerebral hemispheres to restore abnormal FC via different targets, thereby promoting motor recovery after stroke. Clinical trial registration https://www.chictr.org.cn/showproj.html?proj=37359, ChiCTR1900022220.
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Affiliation(s)
- Mengxin Lu
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhongming Du
- Department of Acupuncture, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jiping Zhao
- Department of Acupuncture, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Lan Jiang
- Department of Chinese Medicine, Peking Union Medical College Hospital, Beijing, China
| | - Ruoyi Liu
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Muzhao Zhang
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Tianjiao Xu
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jingpei Wei
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Wei Wang
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Lingling Xu
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Haijiao Guo
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Chen Chen
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xin Yu
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhongjian Tan
- Department of Radiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jiliang Fang
- Department of Radiology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yihuai Zou
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
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Wong KKL, Xu J, Chen C, Ghista D, Zhao H. Functional magnetic resonance imaging providing the brain effect mechanism of acupuncture and moxibustion treatment for depression. Front Neurol 2023; 14:1151421. [PMID: 37025199 PMCID: PMC10070747 DOI: 10.3389/fneur.2023.1151421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 02/22/2023] [Indexed: 04/08/2023] Open
Abstract
The efficacy of acupuncture and moxibustion in the treatment of depression has been fully recognized internationally. However, its central mechanism is still not developed into a unified standard, and it is generally believed that the central mechanism is regulation of the cortical striatum thalamic neural pathway of the limbic system. In recent years, some scholars have applied functional magnetic resonance imaging (fMRI) to study the central mechanism and the associated brain effects of acupuncture and moxibustion treatment for depression. This study reviews the acupuncture and moxibustion treatment of depression from two aspects: (1) fMRI study of the brain function related to the acupuncture treatment of depression: different acupuncture and moxibustion methods are summarized, the fMRI technique is elaborately explained, and the results of fMRI study of the effects of acupuncture are analyzed in detail, and (2) fMRI associated "brain functional network" effects of acupuncture and moxibustion on depression, including the effects on the hippocampus, the amygdala, the cingulate gyrus, the frontal lobe, the temporal lobe, and other brain regions. The study of the effects of acupuncture on brain imaging is not adequately developed and still needs further improvement and development. The brain function networks associated with the acupuncture treatment of depression have not yet been adequately developed to provide a scientific and standardized mechanism of the effects of acupuncture. For this purpose, this study analyzes in-depth the clinical studies on the treatment of anxiety and depression by acupuncture and moxibustion, by depicting how the employment of fMRI technology provides significant imaging changes in the brain regions. Therefore, the study also provides a reference for future clinical research on the treatment of anxiety and depression.
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Affiliation(s)
- Kelvin K. L. Wong
- The Research Center for Medical AI, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Jinping Xu
- The Research Center for Medical AI, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Cang Chen
- The Research Center for Medical AI, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Dhanjoo Ghista
- The Research Center for Medical AI, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Hong Zhao
- Acupuncture and Moxibustion Department, Luohu District Hospital of Traditional Chinese Medicine, Shenzhen, China
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Peng J, Su J, Song L, Lv Q, Gao Y, Chang J, Zhang H, Zou Y, Chen X. Altered Functional Activity and Functional Connectivity of Seed Regions Based on ALFF Following Acupuncture Treatment in Patients with Stroke Sequelae with Unilateral Limb Numbness. Neuropsychiatr Dis Treat 2023; 19:233-245. [PMID: 36744205 PMCID: PMC9890273 DOI: 10.2147/ndt.s391616] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/28/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE Limb numbness is a frequent symptom of post-stroke somatosensory dysfunction, which may be alleviated by non-invasive therapy such as acupuncture. However, the precise mechanism via acupuncture remains unknown. The goal of this study was to investigate how the amplitude of low-frequency fluctuations (ALFF) and functional connectivity (FC) changed between stroke patients with limb numbness and healthy people, as well as how acupuncture might work. METHODS 24 stroke sequelae patients with unilateral limb numbness and 14 matched healthy controls were enrolled in the study. The patients with limb numbness received acupuncture therapy three days a week for four weeks. We mainly assessed the clinical outcomes via the visual analogue scale (VAS). In addition, fMRI data from patients with unilateral limb numbness at baseline and after treatment (4th week) were collected, as well as data from healthy controls at baseline. RESULTS Compared with the healthy subjects, the patient group demonstrated significantly decreased ALFF in several brain regions, mainly associated with the sensorimotor network (SMN) and default mode network (DMN), including left superior frontal gyrus (SFG), right temporal fusiform cortex (TFC), right middle frontal gyrus (MFG), bilateral middle temporal gyrus (MTG), right putamen (PUT), right precentral gyrus (preCG), right planum polare (PP), and left supplementary motor area (SMA). These regions were chosen as the seeds for investigating the FC alteration induced by acupuncture. Several sensorimotor-related brain regions were activated by acupuncture, and the FC of the left supramarginal gyrus (SMG) with right MTG, as well as brain-stem, cerebellum vermis 9 with right MFG showed enhancement following acupuncture in the patient group, which had a significant correlation with clinical outcomes. CONCLUSION Acupuncture treatment may be used to stimulate brain areas associated with somatosensory processing and to strengthen the FC of sensorimotor and cognitive brain networks in order to achieve therapeutic effect.
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Affiliation(s)
- Jing Peng
- Department of Encephalopathy, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Jiaming Su
- Department of Nephrology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Lei Song
- Department of Encephalopathy, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Qiuyi Lv
- Department of Encephalopathy, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Ying Gao
- Department of Encephalopathy, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Jingling Chang
- Department of Encephalopathy, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Hua Zhang
- Department of Encephalopathy, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Yihuai Zou
- Department of Encephalopathy, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Xing Chen
- Department of Brain Function Examination, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, People's Republic of China
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Xu M, Gao Y, Zhang H, Zhang B, Lyu T, Tan Z, Li C, Li X, Huang X, Kong Q, Xiao J, Kranz GS, Li S, Chang J. Modulations of static and dynamic functional connectivity among brain networks by electroacupuncture in post-stroke aphasia. Front Neurol 2022; 13:956931. [PMID: 36530615 PMCID: PMC9751703 DOI: 10.3389/fneur.2022.956931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 10/10/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Post-stroke aphasia (PSA) is a language disorder caused by left hemisphere stroke. Electroacupuncture (EA) is a minimally invasive therapeutic option for PSA treatment. Tongli (HT5) and Xuanzhong (GB39), two important language-associated acupoints, are frequently used in the rehabilitation of patients with PSA. Preliminary evidence indicated functional activation in distributed cortical areas upon HT5 and GB39 stimulation. However, research on the modulation of dynamic and static functional connectivity (FC) in the brain by EA in PSA is lacking. Method This study aimed to investigate the PSA-related effects of EA stimulation at HT5 and GB39 on neural processing. Thirty-five participants were recruited, including 19 patients with PSA and 16 healthy controls (HCs). The BOLD signal was analyzed by static independent component analysis, generalized psychophysiological interactions, and dynamic independent component analysis, considering variables such as age, sex, and years of education. Results The results revealed that PSA showed activated clusters in the left putamen, left postcentral gyrus (PostCG), and left angular gyrus in the salience network (SN) compared to the HC group. The interaction effect on temporal properties of networks showed higher variability of SN (F = 2.23, positive false discovery rate [pFDR] = 0.017). The interaction effect on static FC showed increased functional coupling between the right calcarine and right lingual gyrus (F = 3.16, pFDR = 0.043). For the dynamic FC, at the region level, the interaction effect showed lower variability and higher frequencies of circuit 3, with the strongest connections between the supramarginal gyrus and posterior cingulum (F = 5.42, pFDR = 0.03), middle cingulum and PostCG (F = 5.27, pFDR = 0.036), and triangle inferior frontal and lingual gyrus (F = 5.57, pFDR = 0.026). At the network level, the interaction effect showed higher variability in occipital network-language network (LN) and cerebellar network (CN) coupling, with stronger connections between the LN and CN (F = 4.29, pFDR = 0.042). Dynamic FC values between the triangle inferior frontal and lingual gyri were anticorrelated with transcribing, describing, and dictating scores in the Chinese Rehabilitation Research Center for Chinese Standard Aphasia Examination. Discussion These findings suggest that EA stimulation may improve language function, as it significantly modulated the nodes of regions/networks involved in the LN, SN, CN, occipital cortex, somatosensory regions, and cerebral limbic system.
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Affiliation(s)
- Minjie Xu
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China,Key Laboratory of Chinese Internal Medicine Ministry of Education, Beijing University of Chinese Medicine, Beijing, China
| | - Ying Gao
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China,Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China,Ying Gao
| | - Hua Zhang
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Binlong Zhang
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Tianli Lyu
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhongjian Tan
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Changming Li
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaolin Li
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xing Huang
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Qiao Kong
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Juan Xiao
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Georg S. Kranz
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China,Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Shuren Li
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Jingling Chang
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China,Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China,*Correspondence: Jingling Chang
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Sun Y, Li L, Chen Y, Wang L, Zhai L, Sheng J, Liu T, Jin X. Feasibility and positive effects of scalp acupuncture for modulating motor and cerebral activity in Parkinson's disease: A pilot study. NeuroRehabilitation 2022; 51:467-479. [PMID: 35871374 DOI: 10.3233/nre-220048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND A variety of acupuncture therapies have shown efficacy in Parkinson's disease (PD). OBJECTIVE To evaluate scalp acupuncture (SA) effects on motor and cerebral activity by using gait equipment and resting-state functional magnetic resonance imaging (rs-fMRI). METHODS Twelve patients with PD received SA. They underwent the first functional-imaging scan after tactile stimulation and the second scan following needle removal. Gait test and local sensation assessment were performed immediately after each functional scan. Gait parameter differences between pre- and post-SA were analyzed using a paired t-test and altered brain areas in degree centrality (DC) and fractional amplitude of low-frequency fluctuation (fALFF) were identified between the two scans. RESULTS Eight patients completed the experiment. Stride length, maximum ankle height, maximum ankle horizontal displacement, gait speed, and range of shank motion significantly increased post-treatment (P < 0.05). fALFF in left middle frontal gyrus and DC in left cerebellum (corrected) increased, while fALFF in left inferior parietal lobule (corrected) during SA decreased, compared with those in tactile stimulation. A positive correlation was observed between right limb swings and both fALFF areas. CONCLUSIONS Differences in gait and brain analyses presented modulation to motor and brain activity in PD, thus, providing preliminary evidence for SA efficacy.
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Affiliation(s)
- Yingying Sun
- Department of Acupuncture, Ningbo Zhenhai People's Hospital, Ningbo, China
| | - Lihong Li
- Department of Acupuncture, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Xinhua Hospital of Zhejiang Province, Hangzhou, China
| | - Yao Chen
- Department of Radiology, Zhejiang Hospital, Hangzhou, China
| | - Lei Wang
- The State Key Laboratory of Fluid Power and Mechatronic Systems, School of Mechanical Engineering, Zhejiang University, Hangzhou, China
| | - Lihao Zhai
- Department of Radiology, Zhejiang Hospital, Hangzhou, China
| | - Jili Sheng
- Department of Acupuncture, Zhejiang Hospital, Hangzhou, China
| | - Tao Liu
- The State Key Laboratory of Fluid Power and Mechatronic Systems, School of Mechanical Engineering, Zhejiang University, Hangzhou, China
| | - Xiaoqing Jin
- Department of Acupuncture, Zhejiang Hospital, Hangzhou, China
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Neuroplasticity of Acupuncture for Stroke: An Evidence-Based Review of MRI. Neural Plast 2021; 2021:2662585. [PMID: 34456996 PMCID: PMC8397547 DOI: 10.1155/2021/2662585] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 07/06/2021] [Accepted: 08/02/2021] [Indexed: 02/07/2023] Open
Abstract
Acupuncture is widely recognized as a potentially effective treatment for stroke rehabilitation. Researchers in this area are actively investigating its therapeutic mechanisms. Magnetic resonance imaging (MRI), as a noninvasive, high anatomical resolution technique, has been employed to investigate neuroplasticity on acupuncture in stroke patients from a system level. However, there is no review on the mechanism of acupuncture treatment for stroke based on MRI. Therefore, we aim to summarize the current evidence about this aspect and provide useful information for future research. After searching PubMed, Web of Science, and Embase databases, 24 human and five animal studies were identified. This review focuses on the evidence on the possible mechanisms underlying mechanisms of acupuncture therapy in treating stroke by regulating brain plasticity. We found that acupuncture reorganizes not only motor-related network, including primary motor cortex (M1), premotor cortex, supplementary motor area (SMA), frontoparietal network (LFPN and RFPN), and sensorimotor network (SMN), as well as default mode network (aDMN and pDMN), but also language-related brain areas including inferior frontal gyrus frontal, temporal, parietal, and occipital lobes, as well as cognition-related brain regions. In addition, acupuncture therapy can modulate the function and structural plasticity of post-stroke, which may be linked to the mechanism effect of acupuncture.
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Zhang J, Li Z, Li Z, Li J, Hu Q, Xu J, Yu H. Progress of Acupuncture Therapy in Diseases Based on Magnetic Resonance Image Studies: A Literature Review. Front Hum Neurosci 2021; 15:694919. [PMID: 34489662 PMCID: PMC8417610 DOI: 10.3389/fnhum.2021.694919] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/21/2021] [Indexed: 01/18/2023] Open
Abstract
The neural mechanisms of acupuncture are not well-understood. Over the past decades, an increasing number of studies have used MRI to investigate the response of the brain to acupuncture. The current review aims to provide an update on acupuncture therapy in disease. The PubMed, Embase, Web of Science, and Cochrane Library databases were searched from inception to January 31, 2021. Article selection and data extraction were conducted by two review authors. A total of 107 publications about MRI in acupuncture were included, the collective findings of which were as follows: (1) stroke and GB34 (Yanglingquan) are the most studied disease and acupoint. Related studies suggested that the mechanism of acupuncture treatment for stroke may associate with structural and functional plasticity, left and right hemispheres balance, and activation of brain areas related to movement and cognition. GB34 is mainly used in stroke and Parkinson's disease, which mainly activates brain response in the premotor cortex, the supplementary motor area, and the supramarginal gyrus; (2) resting-state functional MRI (rs-fMRI) and functional connectivity (FC) analysis are the most frequently used approaches; (3) estimates of efficacy and brain response to acupuncture depend on the type of sham acupuncture (SA) used for comparison. Brain processing after acupuncture differs between patients and health controls (HC) and occurs mainly in disorder-related areas. Factors that influence the effect of acupuncture include depth of needling, number and locations of acupoints, and deqi and expectation effect, each contributing to the brain response. While studies using MRI have increased understanding of the mechanism underlying the effects of acupuncture, there is scope for development in this field. Due to the small sample sizes, heterogeneous study designs, and analytical methods, the results were inconsistent. Further studies with larger sample sizes, careful experimental design, multimodal neuroimaging techniques, and standardized methods should be conducted to better explain the efficacy and specificity of acupuncture, and to prepare for accurate efficacy prediction in the future.
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Affiliation(s)
- Jinhuan Zhang
- Department of Acupuncture, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Zihan Li
- Department of Acupuncture, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Zhixian Li
- Department of Acupuncture, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Jiaying Li
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Qingmao Hu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Chinese Academy of Sciences (CAS) Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Jinping Xu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Haibo Yu
- Department of Acupuncture, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
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Zhang L, Chen B, Yao Q, Chen W, Yang W, Yang W, He L, Zhang Y. Comparison between acupuncture and antidepressant therapy for the treatment of poststroke depression: Systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25950. [PMID: 34087835 PMCID: PMC8183854 DOI: 10.1097/md.0000000000025950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 02/04/2021] [Accepted: 04/27/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND In this paper, a systematic review and meta-analysis of published randomized controlled trials (RCTs) was conducted to compare the efficacies of acupuncture and antidepressant therapy for the treatment of poststroke depression (PSD). METHODS The research team searched RCTs published on PubMed; Medline; Cochrane library; Chinese National Knowledge Infrastructure (CNKI); Wanfang; Embase; Scopus, and Sinomed from their respective establishments to January 2019. We evaluated the Hamilton Depression Rating Scale (HAMD) scores, Treatment Emergent Symptom Scale (TESS) scores, National Institute of Health Stroke Scale (NIHSS) scores, and total clinical efficacy using fixed effects models. RESULTS Fourteen RCTs, representing a total of 1124 patients, were studied. Results showed that acupuncture was more effective in improving HAMD scores at 3 weeks after administration (mean difference [MD] = -1.17, 95%CI = -2.18 to -0.16), at 4 weeks (MD = -4.44, 95% CI = -5.64 to -3.23), at 6 weeks (MD = -1.02, 95% CI = -1.68 to -0.36), and at 8 weeks (MD = -4.33, 95% CI = -4.96 to -3.70). Similarly, acupuncture more dramatically decreased NIHSS scores (MD = -2.31, 95% CI = -2.53 to -2.09), and TESS scores (MD = -4.70, 95% CI = -4.93 to -4.48) than conventional Western medicinal therapy. Further, the total clinical efficacy in the acupuncture group was significantly higher than in the antidepressants group (risk ratio [RR] = 1.15, 95% CI = 1.08-1.21). CONCLUSIONS The results of this study suggest that acupuncture not only can reduce the severity of PSD, but also has significant effects on decreasing the appearance of other adverse events.
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Affiliation(s)
| | - Bing Chen
- College of Life Sciences, Zhejiang Chinese Medical University, Zhejiang
| | - Qigu Yao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University
| | - Weiyan Chen
- College of Basic medical, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | | | - Weiji Yang
- College of Life Sciences, Zhejiang Chinese Medical University, Zhejiang
| | - Lan He
- Second Clinical Medical College
| | - Yuyan Zhang
- College of Life Sciences, Zhejiang Chinese Medical University, Zhejiang
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11
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Lu KY, Yuen KF, Luo JY, Hong CZ, Chou LW. Therapeutic effects of acupuncture on sensory ataxia after a cerebral hemorrhage: A case report. Medicine (Baltimore) 2020; 99:e21124. [PMID: 32702864 PMCID: PMC7373561 DOI: 10.1097/md.0000000000021124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Sensory ataxia is a dysfunction of dynamic balance due to impairment of sensory input into the control of movement. The sequelae of stroke, such as hemiplegia, somatosensory impairment, and impaired balance may cause significant disability and may affect patients' quality of life. In addition to rehabilitation programs, acupuncture therapy has been applied to stroke patients and is recommended as a complementary therapy in stroke rehabilitation. PATIENT CONCERNS A 70-year-old male had a sudden onset of conscious loss. The brain computed tomography showed intracerebral hemorrhage with subdural hemorrhage and subarachnoid hemorrhage. DIAGNOSIS Intracerebral hemorrhagic stroke was diagnosed. INTERVENTIONS He received craniotomy with hematoma evacuation immediately and waked up 3 weeks with bilateral hemiparesis (right side weaker than left), impaired position sensation and tactile perception in the right lower limb. He then began to receive rehabilitation therapy and had significant improvement in muscle strength and static balance, but no improvement in tactile perception of position sense in the right lower limbs and reached plateau. Then he received acupuncture therapies to Yongquan (KI1), Tongtien (BL7) and Houxi (SI3). OUTCOMES The patient's walking ability recovered after receiving rehabilitation programs for 3 years, but the impairment in proprioception and dynamic balance persisted. The perception and dynamic balance had significantly improved after patient received acupuncture therapy, especially the acupuncture point of Yongquan (KI1). CONCLUSION The clinical effect of acupuncture in combination with conventional rehabilitation therapy for neurological impairment recovery, improving activity of daily living performance and improving post-stroke imbalance was explored. We hope that this report can facilitate further well controlled quantitative objective studies on a big size of samples.
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Affiliation(s)
- Kuan-Yu Lu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chiayi
| | - Ka-Fai Yuen
- Department of Rehabilitation, Ton-Yen General Hospital, Tsinchu County
| | - Jia-Yuan Luo
- Department of Physical Medicine and Rehabilitation, Puzi Hospital, Ministry of Health and Welfare, Chiayi, Taiwan
| | - Chang-Zern Hong
- Retired professor, Department of Physical Medicine and Rehabilitation, University of California Irvine, CA, USA
| | - Li-Wei Chou
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital
- Department of Physical Therapy and Graduate Institute of Rehabilitation Science, China Medical University
- Department of Rehabilitation, Asia University Hospital, Taichung, Taiwan
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12
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Xiang A, Yu Y, Jia X, Ma H, Liu H, Zhang Y, Rong J, Liu S. The low-frequency BOLD signal oscillation response in the insular associated to immediate analgesia of ankle acupuncture in patients with chronic low back pain. J Pain Res 2019; 12:841-850. [PMID: 30881095 PMCID: PMC6400126 DOI: 10.2147/jpr.s189390] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Purpose The present study evaluated the modulation effect of a painless acupuncture technique, ankle acupuncture (AA), on resting-state functional change in patients with chronic low back pain (CLBP). Patients and methods Fourteen participants diagnosed with CLBP received AA and underwent one brain functional image scan after tactile stimulation and another one following the insertion of the needle. The needling sensations and clinical pain intensities were evaluated after the end of each functional image scan. The significance levels of Visual Analog Scales/Scores (VASs) before and after acupuncture were determined using paired t-test. The brain areas showing differences in the amplitude of low-frequency fluctuation (ALFF) and fractional ALFF (fALFF) between the two scans were identified. We also explored the relationship between mean ALFF values in brain areas identified and VAS scores based on Pearson correlation coefficient. Results A complete-case analysis was performed on 12 participants. Neither different needling sensations nor any local sensations during the two scans was found. The clinical findings indicated that the scores of VAS scores were significantly lower after AA intervention (P<0.001). Compared with those after tactile stimulation, ALFF decreased in the left insular and increased in the left precuneus and right precentral gyrus, and fALFF decreased in the left insular, during retaining of AA (corrected). Moreover, there was a positive correlation found between mean ALFF change in the left insular and that of VAS values (P<0.05). Conclusion The present study demonstrated the low-frequency BOLD signal oscillation response in the left insular in brain activity was associated with an immediate analgesia of AA in patients with CLBP, which provides new insights into intrinsic connections between low-frequency brain signals and analgesic effects of acupuncture.
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Affiliation(s)
- Anfeng Xiang
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China,
| | - Yang Yu
- Department of Psychiatry, the Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China
| | - Xize Jia
- Center for Cognition and Brain Disorders, Institutes of Psychological Sciences, Hangzhou Normal University, Zhejiang, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Zhejiang, China
| | - Huibin Ma
- School of Information and Electronics Technology, Jiamusi University, Heilongjiang, China.,Integrated Medical Research School, Jiamusi University, Heilongjiang, China
| | - Hui Liu
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China,
| | - Yu Zhang
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China,
| | - Jun Rong
- Department of Sports Rehabilitation, Hangzhou Red Cross Hospital, Zhejiang, China,
| | - Sheng Liu
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China,
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13
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Huang Y, Chen JQ, Lai XS, Tang CZ, Yang JJ, Chen H, Wu JX, Xiao HL, Qu SS, Zhang YD, Zhang ZJ. Lateralisation of Cerebral Response to Active Acupuncture in Patients with Unilateral Ischaemic Stroke: An Fmri Study. Acupunct Med 2018; 31:290-6. [DOI: 10.1136/acupmed-2012-010299] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective Acupuncture is beneficial in treating stroke neuropsychiatric symptoms. The present study aimed to identify functional brain response to active acupuncture in patients with unilateral ischaemic stroke using functional MRI (fMRI). Methods A total of 10 patients aged 47–65 years with left hemispheric ischaemic stroke received single-session manual acupuncture at the TE5 point of the affected (right) forearm. A 6-min tactile control procedure in which an acupuncture needle tip was alternately touched and removed from the skin at the acupuncture point for 30 s each was performed first, followed by active acupuncture in a blocking paradigm consisting of six 30-s twist blocks of rotation interspersed between six 30-s blocks of rest. A whole brain scan was simultaneously conducted on a 3.0-T imager. Activated and deactivated brain regions during tactile stimulation and active acupuncture relative to rest were obtained via group analysis. Results Compared to tactile stimulation, needling with twist manipulation modulated many more widespread brain areas. All the brain areas activated and deactivated by active acupuncture relative to tactile stimulation were distributed in the primary sensorimotor and medial frontal cortex of the unaffected, but not the affected hemisphere. Conclusions Active acupuncture results in lateralisation of functional cerebral response to the contralateral unaffected hemisphere in patients with unilateral stroke. This lateralisation may represent an effect of acupuncture in enhancing a compensatory process by redistributing functions into the intact cortex, particularly in the unaffected hemisphere.
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Affiliation(s)
- Yong Huang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Jun-Qi Chen
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Xin-Sheng Lai
- School of Acupuncture and Rehabilitation, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Chun-Zhi Tang
- School of Acupuncture and Rehabilitation, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Jun-Jun Yang
- School of Acupuncture and Rehabilitation, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Hua Chen
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China
| | - Jun-Xian Wu
- Department of Acupuncture and Moxibustion, Shantou Central Hospital, Shantou, China
| | - Hui-Ling Xiao
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Shan-Shan Qu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Yi-Dan Zhang
- First Clinic Medical School, Southern Medical University, Guangzhou, China
| | - Zhang-Jin Zhang
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China
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14
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Li XB, Wang J, Xu AD, Huang JM, Meng LQ, Huang RY, Xu J. Clinical effects and safety of electroacupuncture for the treatment of post-stroke depression: a systematic review and meta-analysis of randomised controlled trials. Acupunct Med 2018; 36:284-293. [PMID: 29776950 DOI: 10.1136/acupmed-2016-011300] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2017] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The aim of this systematic review was to assess the efficacy/effectiveness and safety of electroacupuncture (EA) in the treatment of post-stroke depression (PSD). METHODS A comprehensive literature search in the Pubmed, Embase, CENTRAL, ISI Web of Science, CNKI and Wanfang databases was conducted, and all relevant randomised controlled trials (RCTs) were screened for eligibility by two independent reviewers. The Cochrane Collaboration's tool and Jadad score were used to assess the risk of bias of included studies, and only RCTs scoring ≥3 were included in a meta-analysis. RESULTS 18 RCTs involving a total of 813 participants (mean age 61.6 years) in the EA groups and 723 participants (mean age 61.9 years) in the control groups were included. The included studies had an average 3 point Jadad score. PSD was diagnosed according to the Chinese Classification of Cerebrovascular Disease (CCCD) and the Chinese Classification of Mental Disease (CCMD) criteria. There was no significant difference between EA and antidepressants (fluoxetine 10-40 mg/day, citalopram 20 mg/day, sertraline 50 mg/day) in terms of the Hamilton Depression Rating Scale (HAMD) scores at week 4 after treatment (standardised mean difference (SMD) -0.11, 95% CI -0.31 to 0.10), at week 6 after treatment (SMD 0.04, 95% CI -0.43 to 0.51) or at week 8 after treatment (SMD -0.01, 95% CI -0.23 to 0.22). However, the combined incidence of adverse events in the EA groups was significantly lower than in the antidepressant groups (RR 0.21, 95% CI 0.14 to 0.33). CONCLUSION There was no significant difference between EA and antidepressants in the severity of depression, however EA caused fewer adverse events than antidepressants. Additional larger scale RCTs with rigorous study design are required.
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Affiliation(s)
- Xue-Bin Li
- Stroke Center & Neurology Division, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province 510630, China.,Department of Neurology, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi Zhuang Autonomous Region 533000, China
| | - Jie Wang
- Department of Nephrology, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi Zhuang Autonomous Region 533000, China
| | - An-Ding Xu
- Stroke Center & Neurology Division, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province 510630, China
| | - Jian-Min Huang
- Department of Neurology, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi Zhuang Autonomous Region 533000, China
| | - Lan-Qing Meng
- Department of Neurology, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi Zhuang Autonomous Region 533000, China
| | - Rui-Ya Huang
- Department of Neurology, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi Zhuang Autonomous Region 533000, China
| | - Jing Xu
- Department of Traditional Chinese Medicine, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi Zhuang Autonomous Region 533000, China
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15
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Liang S, Lin Y, Lin B, Li J, Liu W, Chen L, Zhao S, Tao J. Resting-state Functional Magnetic Resonance Imaging Analysis of Brain Functional Activity in Rats with Ischemic Stroke Treated by Electro-acupuncture. J Stroke Cerebrovasc Dis 2017; 26:1953-1959. [PMID: 28687422 DOI: 10.1016/j.jstrokecerebrovasdis.2017.06.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 05/10/2017] [Accepted: 06/07/2017] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To evaluate whether electro-acupuncture (EA) treatment at acupoints of Zusanli (ST 36) and Quchi (LI 11) could reduce motor impairments and enhance brain functional recovery in rats with ischemic stroke. MATERIALS AND METHODS A rat model of middle cerebral artery occlusion (MCAO) was established. EA at ST 36 and LI 11was started at 24 hours (MCAO + EA group) after ischemic stroke. The nontreatment (MCAO) and sham-operated control (SC) groups were included as controls. The neurologic deficits of all groups were assessed by Zea Longa scores and the modified neurologic severity scores on 24 hours and 8 days after MCAO. To further investigate the effect of EA on infract volume and brain function, magnetic resonance imaging was used to estimate the brain lesion and brain neural activities of each group at 8 days after ischemic stroke. RESULTS Within 1 week after EA treatment, the neurologic deficits were significantly alleviated, and the cerebral infarctions were improved, including visual cortex, motor cortex, striatum, dorsal thalamus, and hippocampus. Furthermore, whole brain neural activities of auditory cortex, lateral nucleus group of dorsal thalamus, hippocampus, motor cortex, orbital cortex, sensory cortex, and striatum were decreased in MCAO group, whereas that of brain neural activities were increased after EA treatment, suggesting these brain regions are in accordance with the brain structure analysis. CONCLUSION EA at ST 36 and LI 11 could enhance the neural activity of motor function-related brain regions, including motor cortex, dorsal thalamus, and striatum in rats, which is a potential treatment for ischemia stroke.
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Affiliation(s)
- Shengxiang Liang
- College of Physical Science and Technology, Zhengzhou University, Zhengzhou, China; College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China; Division of Nuclear Technology and Applications, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China; Beijing Engineering Research Center of Radiographic Techniques and Equipment, Beijing, China
| | - Yunjiao Lin
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Bingbing Lin
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jianhong Li
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Weilin Liu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Lidian Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Shujun Zhao
- College of Physical Science and Technology, Zhengzhou University, Zhengzhou, China.
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
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Mechanisms of Acupuncture Therapy for Cerebral Ischemia: an Evidence-Based Review of Clinical and Animal Studies on Cerebral Ischemia. J Neuroimmune Pharmacol 2017; 12:575-592. [DOI: 10.1007/s11481-017-9747-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Accepted: 04/13/2017] [Indexed: 12/20/2022]
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17
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de Souza LL, de Araujo FLB, da Silva FAM, Mucciaroni TS, de Araujo JE. Unilateral and Immediate Stimulation of Acupuncture Points Xiaohai (SI8) and Jianwaishu (SI14) of the Small Intestine Meridian Increases Electromyographic Activity and Strength in the Ipsilateral and Contralateral Upper Trapezius Muscle. J Acupunct Meridian Stud 2016; 9:250-256. [PMID: 27776763 DOI: 10.1016/j.jams.2016.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 07/21/2016] [Accepted: 07/22/2016] [Indexed: 01/24/2023] Open
Abstract
We previously showed that a yin meridian of the upper limb decreased electromyographic activity (root mean square) and muscle strength ipsilateral and contralateral to the side of stimulation. Here, we tested the upper trapezius (UT) muscle response after stimulation of a yang meridian of the upper limb, the small intestine (SI). Thirty-eight healthy volunteers were randomized into the following groups: UT muscle (SI14), distant of the UT muscle (SI8), without stimulation (CG), and sham (R3). An acupuncturist certificated by the Brazilian Society of Physical Therapists and Acupuncturists performed the needle insertion. Each volunteer received only one stimulation to the right upper limb. The evaluation occurred before, 5 minutes after, and 20 minutes after needle withdrawal. The root mean square activity increased on the right side in the UT muscle for the SI8 and SI14 groups (F3,37 = 4.67; p < 0.025) at the 20-minute evaluation. The most vigorous response occurred on the contralateral side because the effects were maintained for 5 minutes after withdrawal (F3,37 = 4.52; p < 0.025). Both groups showed an increase in the UT muscle strength at the 20-minute evaluation (F3,37 = 3.41; p < 0.025). The CG and R3 groups did not show any changes. Our data indicate that SI a yang meridian increases the UT muscle response.
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Affiliation(s)
- Leandro L de Souza
- Laboratory of Neuropsychobiology and Motor Behavior, Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, Ribeirão Preto Medical School of the University of São Paulo, São Paulo, Brazil; Instituto Paulista de Estudos Sistêmicos (IPES), Ribeirão Preto, São Paulo, Brazil
| | | | - Fernanda A M da Silva
- Laboratory of Neuropsychobiology and Motor Behavior, Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, Ribeirão Preto Medical School of the University of São Paulo, São Paulo, Brazil; Instituto Paulista de Estudos Sistêmicos (IPES), Ribeirão Preto, São Paulo, Brazil
| | - Thaís S Mucciaroni
- Laboratory of Neuropsychobiology and Motor Behavior, Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, Ribeirão Preto Medical School of the University of São Paulo, São Paulo, Brazil; Instituto Paulista de Estudos Sistêmicos (IPES), Ribeirão Preto, São Paulo, Brazil
| | - João E de Araujo
- Laboratory of Neuropsychobiology and Motor Behavior, Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, Ribeirão Preto Medical School of the University of São Paulo, São Paulo, Brazil.
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The Status of the Quality Control in Acupuncture-Neuroimaging Studies. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:3685785. [PMID: 27242911 PMCID: PMC4875991 DOI: 10.1155/2016/3685785] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 03/03/2016] [Accepted: 03/27/2016] [Indexed: 12/31/2022]
Abstract
Using neuroimaging techniques to explore the central mechanism of acupuncture gains increasing attention, but the quality control of acupuncture-neuroimaging study remains to be improved. We searched the PubMed Database during 1995 to 2014. The original English articles with neuroimaging scan performed on human beings were included. The data involved quality control including the author, sample size, characteristics of the participant, neuroimaging technology, and acupuncture intervention were extracted and analyzed. The rigorous inclusion and exclusion criteria are important guaranty for the participants' homogeneity. The standard operation process of acupuncture and the stricter requirement for acupuncturist play significant role in quality control. More attention should be paid to the quality control in future studies to improve the reproducibility and reliability of the acupuncture-neuroimaging studies.
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The Effect of Acupuncture on the Motor Function and White Matter Microstructure in Ischemic Stroke Patients. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:164792. [PMID: 26576189 PMCID: PMC4630387 DOI: 10.1155/2015/164792] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 09/16/2015] [Accepted: 10/04/2015] [Indexed: 01/21/2023]
Abstract
Evidence shows that ischemic stroke can induce brain structural reorganization. Acupuncture is advised as an adjunct to mainstream rehabilitation after stroke. However, the effectiveness of acupuncture is inconsistent among previous studies. Fourteen ischemic patients were collected and divided into two groups: conventional treatment group (CG) and acupuncture treatment group (AG). The results of a Fugl-Meyer Assessment (FMA) and diffusion tensor imaging were collected before and after treatment. The AG exhibited a higher improvement in FMA than the CG. Repeated measures analysis of variance on diffusion data only found a significant main effect for scanning time point in all diffusion indices. In each group, a postpair t-test revealed that diffusion indices values were changed significantly after treatment intervention in the body of the corpus callosum and bilateral corticospinal tracts, the inferior longitudinal fasciculus, the inferior frontooccipital fasciculus, the superior longitudinal fasciculus, the forceps minor, the cingulum gyrus, and the thalamic radiation. However, there was no significant difference in the diffusion indices between the two groups. In conclusion, acupuncture had a better behavioral score than traditional medicine treatment. However, acupuncture did not significantly change WM in the AG compared to the CG as expected within one month after the intervention.
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Scheffold BE, Hsieh CL, Litscher G. Neuroimaging and Neuromonitoring Effects of Electro and Manual Acupuncture on the Central Nervous System: A Literature Review and Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2015; 2015:641742. [PMID: 26339269 PMCID: PMC4538975 DOI: 10.1155/2015/641742] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 09/15/2014] [Indexed: 11/18/2022]
Abstract
The aim of this review is to provide an overview of the different effects of manual and electroacupuncture on the central nervous system in studies with different neuroimaging interventions. The Database PubMed was searched from 1/1/2000 to 1/6/2014 with restriction to human studies in English language. Data collection for functional magnetic resonance (fMRI) studies was restricted to the period from 1/1/2010 to 1/6/2014 due to a recently published review which included all published randomized and nonrandomized controlled clinical studies as well as observational studies with control groups, no blinding required. Only studies comparing manual or electroacupuncture with sham acupuncture were eligible. All participants were healthy adult men and women. A majority of 25 studies compared manual versus sham, a minority of 7 trials compared electro versus sham and only 1 study compared electro versus manual acupuncture. In 29 out of 33 studies verum acupuncture results were found to present either more or different modulation effects on neurological components measured by neuroimaging and neuromonitoring methods than sham acupuncture. Only four studies reported no effects of verum in comparison to sham acupuncture. Evaluation of the very heterogeneous results shows evidence that verum acupuncture elicits more modulation effects on neurological components than sham acupuncture.
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Affiliation(s)
- Brigitte Elisabeth Scheffold
- Graduate Institute of Acupuncture Science, International Master Program, China Medical University, Taichung 40402, Taiwan
| | - Ching-Liang Hsieh
- Graduate Institute of Integrated Medicine, China Medical University, Taichung 40402, Taiwan
| | - Gerhard Litscher
- China Medical University, Taichung 40402, Taiwan
- Research Unit for Complementary and Integrative Laser Medicine, Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, and TCM Research Center Graz, Medical University of Graz, 8036 Graz, Austria
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Gao Y, Lin Z, Tao J, Yang S, Chen R, Jiang C, Dong K, Huang J, Chen L. Evidence of timing effects on acupuncture: A functional magnetic resonance imaging study. Exp Ther Med 2014; 9:59-64. [PMID: 25452777 PMCID: PMC4247279 DOI: 10.3892/etm.2014.2056] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 10/22/2014] [Indexed: 12/30/2022] Open
Abstract
According to Traditional Chinese Medicine there is an optimum time to administer acupuncture at a particular acupoint. The present study used functional magnetic resonance imaging to investigate the timing effects of acupuncture at the Zusanli (ST36) acupoint. A total of 10 healthy volunteers and 10 post-stroke patients were recruited. The subjects received acupuncture stimulation at ST36 during two time periods: between 7:00 a.m. and 9:00 a.m. (the AM condition) and between 3:00 p.m. and 5:00 p.m. (the PM condition), seven days later. Blood oxygenation level-dependent signals were captured while the patient was receiving the acupuncture stimulation. The results showed a stronger activation in the AM condition than in the PM condition in both healthy and stroke subjects. The significant regions in the healthy subjects included the prefrontal cortex, cingulum, thalamus and cerebellum; for the stroke patients, the significant regions were the cuneus, supplementary motor area and inferior parietal gyrus. Timing can therefore modulate brain activation patterns during acupuncture in healthy subjects and stroke patients; however, the modulation effect appears to differ between the two subject groups. Further studies are required to explore the timing effects of acupuncture at different acupoints in different populations.
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Affiliation(s)
- Yanling Gao
- Department of Rehabilitation Medicine, Rehabilitation Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350001, P.R. China
| | - Zhicheng Lin
- Department of Rehabilitation Medicine, Rehabilitation Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350001, P.R. China
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350108, P.R. China
| | - Shanli Yang
- Department of Rehabilitation Medicine, Rehabilitation Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350001, P.R. China
| | - Ri Chen
- Department of Rehabilitation Medicine, The First Hospital of Quanzhou, Quanzhou, Fujian 362000, P.R. China
| | - Cai Jiang
- Fujian Provincial Rehabilitation Engineering Research Center, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350108, P.R. China
| | - Keng Dong
- Department of Rehabilitation Medicine, Rehabilitation Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350001, P.R. China
| | - Jia Huang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350108, P.R. China
| | - Lidian Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350108, P.R. China
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Yeo S, Choe IH, van den Noort M, Bosch P, Jahng GH, Rosen B, Kim SH, Lim S. Acupuncture on GB34 activates the precentral gyrus and prefrontal cortex in Parkinson's disease. Altern Ther Health Med 2014; 14:336. [PMID: 25220656 PMCID: PMC4175221 DOI: 10.1186/1472-6882-14-336] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 06/23/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Acupuncture is increasingly used as an additional treatment for patients with Parkinson's disease (PD). METHODS In this functional magnetic resonance imaging study, brain activation in response to acupuncture in a group of 12 patients with PD was compared with a group of 12 healthy participants. Acupuncture was conducted on a specific acupoint, the right GB 34 (Yanglingquan), which is a frequently used acupoint for motor function treatment in the oriental medical field. RESULTS Acupuncture stimulation on this acupoint activates the prefrontal cortex, precentral gyrus, and putamen in patients with PD; areas that are known to be impaired in patients with PD. Compared with healthy participants, patients with PD showed significantly higher brain activity in the prefrontal cortex and precentral gyrus, especially visible in the left hemisphere. CONCLUSIONS The neuroimaging results of our study suggest that in future acupuncture research; the prefrontal cortex as well as the precentral gyrus should be treated for symptoms of Parkinson's disease and that GB 34 seems to be a suitable acupoint. Moreover, acupuncture evoked different brain activations in patients with Parkinson's disease than in healthy participants in our study, stressing the importance of conducting acupuncture studies on both healthy participants as well as patients within the same study, in order to detect acupuncture efficacy. TRIAL REGISTRATION KCT0001122 at cris.nih.go.kr (registration date: 20140530).
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Huang SW, Wang WT, Yang TH, Liou TH, Chen GY, Lin LF. The Balance Effect of Acupuncture Therapy Among Stroke Patients. J Altern Complement Med 2014; 20:618-22. [DOI: 10.1089/acm.2014.0003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Wei-Te Wang
- Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, Changhua, Taiwan
| | - Tsung-Hsien Yang
- Department of Chinese Acupuncture and Traumatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Injury Prevention, Taipei Medical University, Taipei, Taiwan
| | - Guan-Yu Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Li-Fong Lin
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
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Li C, Yang J, Park K, Wu H, Hu S, Zhang W, Bu J, Xu C, Qiu B, Zhang X. Prolonged repeated acupuncture stimulation induces habituation effects in pain-related brain areas: an FMRI study. PLoS One 2014; 9:e97502. [PMID: 24821143 PMCID: PMC4018444 DOI: 10.1371/journal.pone.0097502] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 04/16/2014] [Indexed: 12/13/2022] Open
Abstract
Most previous studies of brain responses to acupuncture were designed to investigate the acupuncture instant effect while the cumulative effect that should be more important in clinical practice has seldom been discussed. In this study, the neural basis of the acupuncture cumulative effect was analyzed. For this experiment, forty healthy volunteers were recruited, in which more than 40 minutes of repeated acupuncture stimulation was implemented at acupoint Zhusanli (ST36). Three runs of acupuncture fMRI datasets were acquired, with each run consisting of two blocks of acupuncture stimulation. Besides general linear model (GLM) analysis, the cumulative effects of acupuncture were analyzed with analysis of covariance (ANCOVA) to find the association between the brain response and the cumulative duration of acupuncture stimulation in each stimulation block. The experimental results showed that the brain response in the initial stage was the strongest although the brain response to acupuncture was time-variant. In particular, the brain areas that were activated in the first block and the brain areas that demonstrated cumulative effects in the course of repeated acupuncture stimulation overlapped in the pain-related areas, including the bilateral middle cingulate cortex, the bilateral paracentral lobule, the SII, and the right thalamus. Furthermore, the cumulative effects demonstrated bimodal characteristics, i.e. the brain response was positive at the beginning, and became negative at the end. It was suggested that the cumulative effect of repeated acupuncture stimulation was consistent with the characteristic of habituation effects. This finding may explain the neurophysiologic mechanism underlying acupuncture analgesia.
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Affiliation(s)
- Chuanfu Li
- Laboratory of Digital Medical Imaging, Medical Imaging Center, First Affiliated Hospital, Anhui University of Chinese Medicine, Hefei, Anhui, China
| | - Jun Yang
- Department of Acupuncture and Moxibustion, First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui, China
| | - Kyungmo Park
- Department of Biomedical Engineering, Kyung Hee University, Yongin, Republic of Korea
| | - Hongli Wu
- College of Medical Information engineering, Anhui University of Chinese Medicine, Hefei, Anhui, China
| | - Sheng Hu
- School of Information Science and Technology, University of Science and Technology of China, Hefei, Anhui, China
| | - Wei Zhang
- Laboratory of Digital Medical Imaging, Medical Imaging Center, First Affiliated Hospital, Anhui University of Chinese Medicine, Hefei, Anhui, China
| | - Junjie Bu
- CAS Key Laboratory of Brain Function & Disease and School of Life Sciences, University of Science and Technology of China, Hefei, Anhui, China
| | - Chunsheng Xu
- Laboratory of Digital Medical Imaging, Medical Imaging Center, First Affiliated Hospital, Anhui University of Chinese Medicine, Hefei, Anhui, China
| | - Bensheng Qiu
- School of Information Science and Technology, University of Science and Technology of China, Hefei, Anhui, China
| | - Xiaochu Zhang
- CAS Key Laboratory of Brain Function & Disease and School of Life Sciences, University of Science and Technology of China, Hefei, Anhui, China
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Acupuncture modulates the functional connectivity of the default mode network in stroke patients. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:765413. [PMID: 24734113 PMCID: PMC3963376 DOI: 10.1155/2014/765413] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Revised: 01/23/2014] [Accepted: 01/27/2014] [Indexed: 01/18/2023]
Abstract
Abundant evidence from previous fMRI studies on acupuncture has revealed significant modulatory effects at widespread brain regions. However, few reports on the modulation to the default mode network (DMN) of stroke patients have been investigated in the field of acupuncture. To study the modulatory effects of acupuncture on the DMN of stroke patients, eight right hemispheric infarction and stable ischemic stroke patients and ten healthy subjects were recruited to undergo resting state fMRI scanning before and after acupuncture stimulation. Functional connectivity analysis was applied with the bilateral posterior cingulate cortices chosen as the seed regions. The main finding demonstrated that the interregional interactions between the ACC and PCC especially enhanced after acupuncture at GB34 in stroke patients, compared with healthy controls. The results indicated that the possible mechanisms of the modulatory effects of acupuncture on the DMN of stroke patients could be interpreted in terms of cognitive ability and motor function recovery.
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Abstract
BACKGROUND There is debate concerning the effect of acupuncture on rehabilitation following stroke, with key reviews unable to find evidence of benefit. This lack of evidence may be due to poor study design, small sample size, and insufficient theoretical background. OBJECTIVE The present study was designed to determine whether acupuncture combined with conventional physical therapy improves motor function and activities of daily living in patients with subacute stroke compared with conventional physical therapy alone. DESIGN A multicenter, single-blinded, randomized study was conducted. SETTING Four rehabilitation centers in the Jiangsu province of China participated in this study. PATIENTS One hundred eighty-eight patients with subacute stroke admitted to the hospital were randomized into an acupuncture group and a conventional rehabilitation group. INTERVENTIONS A combination of body and scalp acupuncture was used for 3 months in the acupuncture group. All patients underwent conventional stroke rehabilitation. MEASUREMENTS The Fugl-Meyer Assessment (FMA) and Barthel Index (BI) were performed at baseline and at 1, 3, and 6 months after inclusion in the study. RESULTS No statistically significant differences were found at baseline between the groups. No statistically significant differences were found between the groups using the FMA motor scores and the BI scores at baseline or at 1, 3, or 6 months. Significant improvements were found in each group following treatment. CONCLUSIONS In patients with subacute stroke, the addition of body and scalp acupuncture to a regimen of conventional physical therapy does not result in further improvement in either motor function or ADL beyond the effect of conventional physical therapy alone.
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Molecular imaging in traditional Chinese medicine therapy for neurological diseases. BIOMED RESEARCH INTERNATIONAL 2013; 2013:608430. [PMID: 24222911 PMCID: PMC3814075 DOI: 10.1155/2013/608430] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 08/21/2013] [Indexed: 02/08/2023]
Abstract
With the speeding tendency of aging society, human neurological disorders have posed an ever increasing threat to public health care. Human neurological diseases include ischemic brain injury, Alzheimer's disease, Parkinson's disease, and spinal cord injury, which are induced by impairment or specific degeneration of different types of neurons in central nervous system. Currently, there are no more effective treatments against these diseases. Traditional Chinese medicine (TCM) is focused on, which can provide new strategies for the therapy in neurological disorders. TCM, including Chinese herb medicine, acupuncture, and other nonmedication therapies, has its unique therapies in treating neurological diseases. In order to improve the treatment of these disorders by optimizing strategies using TCM and evaluate the therapeutic effects, we have summarized molecular imaging, a new promising technology, to assess noninvasively disease specific in cellular and molecular levels of living models in vivo, that was applied in TCM therapy for neurological diseases. In this review, we mainly focus on applying diverse molecular imaging methodologies in different TCM therapies and monitoring neurological disease, and unveiling the mysteries of TCM.
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Quah-Smith I, Williams MA, Lundeberg T, Suo C, Sachdev P. Differential brain effects of laser and needle acupuncture at LR8 using functional MRI. Acupunct Med 2013; 31:282-9. [PMID: 23920052 PMCID: PMC3786613 DOI: 10.1136/acupmed-2012-010297] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 05/30/2013] [Indexed: 12/19/2022]
Abstract
OBJECTIVE While needle acupuncture is a well-accepted technique, laser acupuncture is being increasingly used in clinical practice. The differential effects of the two techniques are of interest. We examine this in relation to brain effects of activation of LR8, a putative acupuncture point for depression, using functional MRI (fMRI). METHODS Sixteen healthy participants were randomised to receive low intensity laser acupuncture to LR8 on one side and needle acupuncture to the contralateral LR8. Stimulation was in an on-off block design and brain patterns were recorded under fMRI. RESULTS Significant activation occurred in the left precuneus during laser acupuncture compared with needle acupuncture and significant activation occurred in the left precentral gyrus during needle acupuncture compared with laser acupuncture. CONCLUSIONS Laser and needle acupuncture at LR8 in healthy participants produced different brain patterns. Laser acupuncture activated the precuneus relevant to mood in the posterior default mode network while needle acupuncture activated the parietal cortical region associated with the primary motor cortex. Further investigations are warranted to evaluate the clinical relevance of these effects.
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Affiliation(s)
- Im Quah-Smith
- School of Psychiatry, University of New South Wales and Neuropsychiatric Institute (NPI), Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Mark A Williams
- Macquarie Centre for Cognitive Sciences (MACCS), Macquarie University, North Ryde, Sydney, New South Wales, Australia
| | - Thomas Lundeberg
- Rehabilitation Medicine University Clinic, Danderyds Hospital AB, Stockholm, Sweden
| | - Chao Suo
- School of Psychiatry, University of New South Wales and Neuropsychiatric Institute (NPI), Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Perminder Sachdev
- School of Psychiatry, University of New South Wales and Neuropsychiatric Institute (NPI), Prince of Wales Hospital, Sydney, New South Wales, Australia
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Chae Y, Park HJ, Hahm DH, Lee BH, Park HK, Lee H. Spatiotemporal patterns of neural activity in response to electroacupuncture stimulation in the rodent primary somatosensory cortex. Neurol Res 2013; 32 Suppl 1:64-8. [DOI: 10.1179/016164109x12537002794084] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Li ZJ, Zeng F, Yang Y, Zhang DH, Chen Y, Sun JB, Qin W, Yang J, Liang FR. Cerebral responses to puncturing at ST36 after acupuncture treatment in patients with functional dyspepsia. Shijie Huaren Xiaohua Zazhi 2013; 21:1882-1887. [DOI: 10.11569/wcjd.v21.i19.1882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess cerebral responses to puncturing at ST36 after 4 wk of acupuncture treatment in patients with functional dyspepsia (FD) and healthy subjects (HS).
METHODS: In this study, 24 FD patients and 24 HS underwent acupuncture stimulation at ST36 and were monitored under an fMRI scan. FD patients received 4 courses of acupuncture treatment before acupuncture stimulation at ST36. The difference in fMRI data was compared between the two groups using SPM5 software.
RESULTS: After 4 wk of acupuncture treatment, Nepean dyspepsia index score(38.21 ± 9.925 vs 52.50 ± 13.53, P < 0.05), dyspepsia symptom score (0.66 ± 0.56 vs 1.41 ± 0.29, P < 0.05), self-rating anxiety scale score (35.21 ± 6.131 vs 41.72 ± 6.735, P < 0.05) and self-rating depression scale score (37.50 ± 9.178 vs 43.02 ± 8.429, P < 0.05) were significantly decreased in FD patients. Compared with HS, FD patients showed fMRI siginal decrease in the right supramaginal gyrus, bilateral postcentral gyrus, left precentral gyrus, bilateral superior occipital gyrus, bilateral middle occipital gyrus, bilateral cuneus, left superior frontal gyrus, left superior parietal gyrus, bilateral middle temporal gyrus, right lingual gyrus, right fusiform gyrus and right calcarine gyrus, but fMRI siginal increase in the left thalamus.
CONCLUSION: Acupuncture could improve the symptoms and emotion of FD patients. After 4 wk of acupuncture treatment, the central modulation pattern of acupuncture for FD symptoms-related brain regions seems to be non-specific.
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Yang J, Yang MX, Zeng F, Wu X, Chen J, Liu YQ, Feng Y, Liang FR. Visualized characterization for cerebral response of acupuncture deqi: paradox underway. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2013; 2013:894750. [PMID: 23935686 PMCID: PMC3713601 DOI: 10.1155/2013/894750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 06/05/2013] [Indexed: 12/14/2022]
Abstract
Acupuncture as an oriental natural healing therapy with prolonged history has been extensively utilized in the management of great numbers of disorders. Deqi, a renowned acupuncture needling sensation, is profoundly regarded as the predictor and also the prerequisite of a preferable acupuncture treatment efficacy. Till now, there is still no consistency being reached towards the mechanism of acupuncture Deqi as a result of the discrepancy for publicly acknowledged evidence. Recent visualized research on Deqi using modern technologies has demonstrated possible central mechanism towards it. However, there is a conspicuous paradox underway in the research of cerebral response to acupuncture Deqi. This paper provided a view of up-to-date studies using visualized tools to characterize the brain response to acupuncture Deqi, such as functional magnetic resonance imaging (fMRI) and positron emission tomography/computed tomography (PET/CT). The paradox was extruded to highlight certain reasons from a TCM view. It is hypothesized that acupoints located at different dermal sites, state of participant, and needling manipulation can all contribute to the current paradox. Hence, further studies on acupuncture Deqi should pay more attention to the strategy of experiment design with generalized measurement, valid sham control methods, and more to subjects in diseased condition.
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Affiliation(s)
- Jie Yang
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Ming-Xiao Yang
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Fang Zeng
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Xi Wu
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Jiao Chen
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Yan-Qin Liu
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Yue Feng
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Fan-Rong Liang
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
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A comparison of brain activity between healthy subjects and stroke patients on fMRI by acupuncture stimulation. Chin J Integr Med 2013; 19:269-76. [DOI: 10.1007/s11655-013-1436-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Indexed: 11/26/2022]
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Sun J, Zhu Y, Yang Y, Jin L, von Deneen KM, Qin W, Tian J. What Is the de-qi-Related Pattern of BOLD Responses? A Review of Acupuncture Studies in fMRI. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2013; 2013:297839. [PMID: 23476685 PMCID: PMC3582103 DOI: 10.1155/2013/297839] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 12/24/2012] [Accepted: 01/06/2013] [Indexed: 11/17/2022]
Abstract
de-qi, comprising mostly subjective sensations during acupuncture, is traditionally considered as a very important component for the possible therapeutic effects of acupuncture. However, the neural correlates of de-qi are still unclear. In this paper, we reviewed previous fMRI studies from the viewpoint of the neural responses of de-qi. We searched on Pubmed and identified 111 papers. Fourteen studies distinguishing de-qi and sharp pain and eight studies with the mixed sensations were included in further discussions. We found that the blood oxygenation level-dependent (BOLD) responses associated with de-qi were activation dominated, mainly around cortical areas relevant to the processing of somatosensory or pain signals. More intense and extensive activations were shown for the mixed sensations. Specific activations of sharp pain were also shown. Similar BOLD response patterns between de-qi evoked by acupuncture stimulation and de-qi-like sensations evoked by deep pain stimulation were shown. We reckon that a standardized method of qualification and quantification of de-qi, deeper understanding of grouping strategy of de-qi and sharp pain, and making deep pain stimulation as a control, as well as a series of improvements in the statistical method, are crucial factors for revealing the neural correlates of de-qi and neural mechanisms of acupuncture.
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Affiliation(s)
- Jinbo Sun
- Life Sciences Research Center, School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi 710071, China
| | - Yuanqiang Zhu
- Life Sciences Research Center, School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi 710071, China
| | - Yang Yang
- Life Sciences Research Center, School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi 710071, China
| | - Lingmin Jin
- Life Sciences Research Center, School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi 710071, China
| | - Karen M. von Deneen
- Life Sciences Research Center, School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi 710071, China
| | - Wei Qin
- Life Sciences Research Center, School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi 710071, China
| | - Jie Tian
- Life Sciences Research Center, School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi 710071, China
- Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China
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Abstract
Acupuncture is one of the most important parts of Traditional Chinese Medicine, has been used for more than 3000 years as prevention and treatment for various diseases in China as well as in adjacent regions, and is widely accepted in western countries in recent years. More and more clinical trials revealed that acupuncture shows positive effect in stroke, not only as a complementary and alternative medicine for poststroke rehabilitation but also as a preventive strategy which could induce cerebral ischemic tolerance, especially when combined with modern electrotherapy. Acupuncture has some unique characteristics, which include acupoint specificity and parameter-dependent effect. It also involves complicated mechanism to exert the beneficial effect on stroke. Series of clinical trials have shown that acupuncture primarily regulates the release of neurochemicals, hemorheology, cerebral microcirculation, metabolism, neuronal activity, and the function of specific brain region. Animal studies showed that the effects of acupuncture therapy on stroke were possibly via inhibition of postischemic inflammatory reaction, stimulation of neurogenesis and angiogenesis, and influence on neural plasticity. Mechanisms for its preconditioning effect include activity enhancement of antioxidant, regulation of the endocannabinoid system, and inhibition of apoptosis. Although being controversial, acupuncture is a promising preventive and treatment strategy for stroke, but further high-quality clinical trials would be needed to provide more confirmative evidence.
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Affiliation(s)
- Xin Li
- Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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Impact of global normalization in FMRI acupuncture studies. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:467061. [PMID: 23316257 PMCID: PMC3534243 DOI: 10.1155/2012/467061] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 09/09/2012] [Indexed: 11/23/2022]
Abstract
Global normalization is often used as a preprocessing step for dispelling the “nuisance effects.” However, it has been shown in cognitive and emotion tasks that this preprocessing step might greatly distort statistical results when the orthogonality assumption of global normalization is violated. The present study examines this issue in fMRI acupuncture studies. Thirty healthy subjects were recruited to evaluate the impacts of the global normalization on the BOLD responses evoked by acupuncture stimulation during De-qi sensation and tactile stimulation during nonpainful sensations. To this end, we compared results by conducting global normalization (PSGS) and not conducting global normalization (NO PSGS) based on a proportional scaling model. The orthogonality assumption of global normalization was violated, and significant changes between BOLD responses for NO PSGS and PSGS were shown in most subjects. Extensive deactivations of acupuncture in fMRI were the non-specifically pernicious consequences of global normalization. The central responses of acupuncture during De-qi are non-specifically activation-dominant at the somatosensory-related brain network, whose statistical power is specifically enhanced by PSGS. In conclusion, PSGS should be unjustified for acupuncture studies in fMRI. The differences including the global normalization or not may partly contribute to conflicting results and interpretations in previous fMRI acupuncture studies.
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Asghar AUR, Johnson RL, Woods W, Green GGR, Lewith G, Macpherson H. Oscillatory neuronal dynamics associated with manual acupuncture: a magnetoencephalography study using beamforming analysis. Front Hum Neurosci 2012; 6:303. [PMID: 23248594 PMCID: PMC3522113 DOI: 10.3389/fnhum.2012.00303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 10/19/2012] [Indexed: 11/13/2022] Open
Abstract
Magnetoencephalography (MEG) enables non-invasive recording of neuronal activity, with reconstruction methods providing estimates of underlying brain source locations and oscillatory dynamics from externally recorded neuromagnetic fields. The aim of our study was to use MEG to determine the effect of manual acupuncture on neuronal oscillatory dynamics. A major problem in MEG investigations of manual acupuncture is the absence of onset times for each needle manipulation. Given that beamforming (spatial filtering) analysis is not dependent upon stimulus-driven responses being phase-locked to stimulus onset, we postulated that beamforming could reveal source locations and induced changes in neuronal activity during manual acupuncture. In a beamformer analysis, a two-minute period of manual acupuncture needle manipulation delivered to the ipsilateral right LI-4 (Hegu) acupoint was contrasted with a two-minute baseline period. We considered oscillatory power changes in the theta (4-8 Hz), alpha (8-13 Hz), beta (13-30 Hz), and gamma (30-100 Hz) frequency bands. We found significant decreases in beta band power in the contralateral primary somatosensory cortex and superior frontal gyrus (SFG). In the ipsilateral cerebral hemisphere, we found significant power decreases in beta and gamma frequency bands in only the SFG. No significant power modulations were found in theta and alpha bands. Our results indicate that beamforming is a useful analytical tool to reconstruct underlying neuronal activity associated with manual acupuncture. Our main finding was of beta power decreases in primary somatosensory cortex and SFG, which opens up a line of future investigation regarding whether this contributes toward an underlying mechanism of acupuncture.
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Affiliation(s)
- Aziz U R Asghar
- Hull York Medical School, University of Hull Hull, UK ; York Neuroimaging Centre, University of York, The Biocentre, York Science Park York, UK
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Shen Y, Li M, Wei R, Lou M. Effect of acupuncture therapy for postponing Wallerian degeneration of cerebral infarction as shown by diffusion tensor imaging. J Altern Complement Med 2012; 18:1154-60. [PMID: 22950816 DOI: 10.1089/acm.2011.0493] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE One aim of this study was to investigate the effects of acupuncture on cerebral function of patients with acute cerebral infarction. Another goal was to evaluate the relationship between acupuncture treatment and motor recovery patients with stroke and to provide a foundation for using acupuncture therapy for such patients. DESIGN Twenty (20) patients with recent cerebral infarction were divided randomly to an acupuncture group and a control group. The infarction area in each patient was in the basal ganglia or included the basal ganglia with an area size of > 1 cm(2). Serial diffusion tensor imaging (DTI), fluid-attenuated inversion recovery (FLAIR), and T2-weighted imaging (T(2)WI) scans were performed on all patients and the results were evaluated using the National Institute of Health Stroke Scale and the Barthel Index each week. DTI images were postprocessed and analyzed. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values of abnormal signals on DTI in the infarction areas and cerebral peduncles were calculated for both groups and compared with one another. RESULTS (1) The ADC value of infarction lesions decreased at stroke onset; then, a significant elevation was observed after the acute stage, and a significant reduction in FA values was observed from stroke onset to the chronic stage. (2) The ADC of the bilateral cerebral peduncle was reduced on the infarction side. (3) There was a significant difference in ADC and FA values between the acupuncture and control groups. The FA value was higher in the acupuncture group than the control group. CONCLUSIONS ADC and FA values might correlate to patient recovery and reveal the progress of secondary degeneration. Acupuncture treatment is effective for protecting neurons and facilitating recovery.
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Affiliation(s)
- Yunxia Shen
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
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Quah-Smith I, Wen W, Chen X, Williams MA, Sachdev PS. The Brain Effects of Laser Acupuncture in Depressed Individuals: An fMRI Investigation. Med Acupunct 2012. [DOI: 10.1089/acu.2011.0870] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Im Quah-Smith
- School of Psychiatry, Faculty of Medicine, University of New South Wales, New South Wales, Australia
| | - Wei Wen
- School of Psychiatry, Faculty of Medicine, University of New South Wales, New South Wales, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, New South Wales, Australia
- Brain & Ageing Research Program, School of Psychiatry, Faculty of Medicine, University of New South Wales, New South Wales, Australia
| | - Xiaohua Chen
- School of Psychiatry, Faculty of Medicine, University of New South Wales, New South Wales, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, New South Wales, Australia
- Brain & Ageing Research Program, School of Psychiatry, Faculty of Medicine, University of New South Wales, New South Wales, Australia
| | - Mark A. Williams
- Macquarie Centre for Cognitive Sciences, Macquarie University, Sydney, Australia
| | - Perminder S. Sachdev
- School of Psychiatry, Faculty of Medicine, University of New South Wales, New South Wales, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, New South Wales, Australia
- Brain & Ageing Research Program, School of Psychiatry, Faculty of Medicine, University of New South Wales, New South Wales, Australia
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Huang Y, Tang C, Wang S, Lu Y, Shen W, Yang J, Chen J, Lin R, Cui S, Xiao H, Qu S, Lai X, Shan B. Acupuncture regulates the glucose metabolism in cerebral functional regions in chronic stage ischemic stroke patients--a PET-CT cerebral functional imaging study. BMC Neurosci 2012; 13:75. [PMID: 22738270 PMCID: PMC3464148 DOI: 10.1186/1471-2202-13-75] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Accepted: 05/28/2012] [Indexed: 02/07/2023] Open
Abstract
Background Acupuncture has been applied to aid in the recovery of post-stroke patients, but its mechanism is unclear. This study aims to analyze the relationship between acupuncture and glucose metabolism in cerebral functional regions in post-stroke patients using 18 FDG PET-CT techniques. Forty-three ischemic stroke patients were randomly divided into 5 groups: the Waiguan (TE5) needling group, the TE5 sham needling group, the sham point needling group, the sham point sham needling group and the non-needling group. Cerebral functional images of all patients were then acquired using PET-CT scans and processed by SPM2 software. Results Compared with the non-needling group, sham needling at TE5 and needling/sham needling at the sham point did not activate cerebral areas. However, needling at TE5 resulted in the activation of Brodmann Area (BA) 30. Needling/sham needling at TE5 and needling at the sham point did not deactivate any cerebral areas, whereas sham needling at the sham point led to deactivation in BA6. Compared with sham needling at TE5, needling at TE5 activated BA13, 19 and 47 and did not deactivate any areas. Compared with needling at the sham point, needling at TE5 had no associated activation but a deactivating effect on BA9. Conclusion Needling at TE5 had a regulating effect on cerebral functional areas shown by PET-CT, and this may relate to its impact on the recovery of post-stroke patients.
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Affiliation(s)
- Yong Huang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
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Sun F, Wang J, Wen X. Acupuncture in stroke rehabilitation: Literature retrieval based on international databases. Neural Regen Res 2012; 7:1192-9. [PMID: 25722714 PMCID: PMC4340038 DOI: 10.3969/j.issn.1673-5374.2012.15.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2011] [Accepted: 02/29/2012] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE: To identify global research trends of acupuncture in stroke rehabilitation using a bibliometric analysis of the Web of Science and the Clinical Trials registry database (ClinicalTrials.gov). DATA RETRIEVAL: We performed a bibliometric analysis of data retrievals for acupuncture in stroke rehabilitation from 1992 to 2011 using the Web of Science and ClinicalTrials.gov. SELECTION CRITERIA: Inclusion criteria: (1) Web of Science: (a) Peer-reviewed articles on acupuncture in stroke rehabilitation that were published and indexed in the Web of Science. (b) Type of articles: original research articles, reviews, meeting abstracts, proceedings papers, book chapters, editorial material and news items. (c) Year of publication: 1992–2011. (2) ClinicalTrials.gov: All clinical trials relating to acupuncture in stroke rehabilitation were searched in this database. Exclusion criteria: (1) Web of Science: (a) Articles that required manual searching or telephone access. (b) We excluded documents that were not published in the public domain. (c) We excluded a number of corrected papers from the total number of articles. (2) ClinicalTrials.gov: (a) We excluded clinical trials that were not in the ClinicalTrials.gov database. (b) We excluded clinical trials that dealt with magnetic stimulation other than acupuncture in stroke rehabilitation in the ClinicalTrials.gov database. MAIN OUTCOME MEASURES: (1) Type of literature; (2) annual publication output; (3) distribution according to journals; (4) distribution according to country; (5) distribution according to institution; (6) top cited articles over the last 20 years; and (7) clinical trials registered. RESULTS: (1) In all, 92 studies on acupuncture in stroke rehabilitation appeared in the Web of Science from 1992 to 2011, almost half of which derived from Chinese and American authors and institutes. The number of studies addressing acupuncture in stroke rehabilitation has gradually increased over the past 20 years. Most papers on acupuncture in stroke rehabilitation appeared in journals with a particular focus on rehabilitation research, such as Stroke, Archives of Physical Medicine, Cochrane Database of Systematic Reviews and Journal of Alternative and Complementary Medicine. (2) In the ClinicalTrials.gov, three studies can be searched on acupuncture and stroke, all of which were registered and sponsored by Chinese institutions since February 2009. CONCLUSION: From our analysis of the literature and research trends, we found that acupuncture in stroke rehabilitation may offer further benefits in regenerative medicine.
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Affiliation(s)
- Feng Sun
- Department of Neurology, Fifth People's Hospital of Shenyang, Shenyang 110023, Liaoning Province, China
| | - Jinchun Wang
- Department of Neurology, Fifth People's Hospital of Shenyang, Shenyang 110023, Liaoning Province, China
| | - Xia Wen
- Department of Neurology, Fifth People's Hospital of Shenyang, Shenyang 110023, Liaoning Province, China
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Huang W, Pach D, Napadow V, Park K, Long X, Neumann J, Maeda Y, Nierhaus T, Liang F, Witt CM. Characterizing acupuncture stimuli using brain imaging with FMRI--a systematic review and meta-analysis of the literature. PLoS One 2012; 7:e32960. [PMID: 22496739 PMCID: PMC3322129 DOI: 10.1371/journal.pone.0032960] [Citation(s) in RCA: 171] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Accepted: 02/08/2012] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The mechanisms of action underlying acupuncture, including acupuncture point specificity, are not well understood. In the previous decade, an increasing number of studies have applied fMRI to investigate brain response to acupuncture stimulation. Our aim was to provide a systematic overview of acupuncture fMRI research considering the following aspects: 1) differences between verum and sham acupuncture, 2) differences due to various methods of acupuncture manipulation, 3) differences between patients and healthy volunteers, 4) differences between different acupuncture points. METHODOLOGY/PRINCIPAL FINDINGS We systematically searched English, Chinese, Korean and Japanese databases for literature published from the earliest available up until September 2009, without any language restrictions. We included all studies using fMRI to investigate the effect of acupuncture on the human brain (at least one group that received needle-based acupuncture). 779 papers were identified, 149 met the inclusion criteria for the descriptive analysis, and 34 were eligible for the meta-analyses. From a descriptive perspective, multiple studies reported that acupuncture modulates activity within specific brain areas, including somatosensory cortices, limbic system, basal ganglia, brain stem, and cerebellum. Meta-analyses for verum acupuncture stimuli confirmed brain activity within many of the regions mentioned above. Differences between verum and sham acupuncture were noted in brain response in middle cingulate, while some heterogeneity was noted for other regions depending on how such meta-analyses were performed, such as sensorimotor cortices, limbic regions, and cerebellum. CONCLUSIONS Brain response to acupuncture stimuli encompasses a broad network of regions consistent with not just somatosensory, but also affective and cognitive processing. While the results were heterogeneous, from a descriptive perspective most studies suggest that acupuncture can modulate the activity within specific brain areas, and the evidence based on meta-analyses confirmed some of these results. More high quality studies with more transparent methodology are needed to improve the consistency amongst different studies.
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Affiliation(s)
- Wenjing Huang
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Daniel Pach
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany
| | - Vitaly Napadow
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts, United States of America
- Department of Radiology, Logan College of Chiropractic, Chesterfield, Missouri, United States of America
| | - Kyungmo Park
- Department of Biomedical Engineering, Kyung Hee University, Yongin, Republic of Korea
| | - Xiangyu Long
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Jane Neumann
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Leipzig University Medical Center, IFB Adiposity Diseases, Leipzig, Germany
| | - Yumi Maeda
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts, United States of America
- Department of Radiology, Logan College of Chiropractic, Chesterfield, Missouri, United States of America
| | - Till Nierhaus
- Berlin NeuroImaging Center and Department Neurology, Charité, Berlin, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Fanrong Liang
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Claudia M. Witt
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
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Neural acupuncture unit: a new concept for interpreting effects and mechanisms of acupuncture. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:429412. [PMID: 22474503 PMCID: PMC3310280 DOI: 10.1155/2012/429412] [Citation(s) in RCA: 142] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2011] [Revised: 11/30/2011] [Accepted: 12/01/2011] [Indexed: 12/12/2022]
Abstract
When an acupuncture needle is inserted into a designated point on the body and
mechanical or electrical stimulation is delivered, various neural and neuroactive
components are activated. The collection of the activated neural and neuroactive
components distributed in the skin, muscle, and connective tissues surrounding the
inserted needle is defined as a neural acupuncture unit (NAU). The traditionally defined
acupoints represent an anatomical landmark system that indicates local sites where NAUs
may contain relatively dense and concentrated neural and neuroactive components, upon
which acupuncture stimulation would elicit a more efficient therapeutic response. The
NAU-based local mechanisms of biochemical and biophysical reactions play an important
role in acupuncture-induced analgesia. Different properties of NAUs are associated with
different components of needling sensation. There exist several central pathways to
convey NAU-induced acupuncture signals, Electroacupuncture (EA) frequency-specific
neurochemical effects are related to different peripheral and central pathways transmitting
afferent signals from different frequency of NAU stimulation. More widespread and intense
neuroimaging responses of brain regions to acupuncture may be a consequence of more
efficient NAU stimulation modes. The introduction of the conception of NAU provides a
new theoretical approach to interpreting effects and mechanisms of acupuncture in
modern biomedical knowledge framework.
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Physiology and cell biology of acupuncture observed in calcium signaling activated by acoustic shear wave. Pflugers Arch 2011; 462:587-97. [PMID: 21796340 PMCID: PMC3170465 DOI: 10.1007/s00424-011-0993-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 06/28/2011] [Accepted: 06/29/2011] [Indexed: 11/03/2022]
Abstract
This article presents a novel model of acupuncture physiology based on cellular calcium activation by an acoustic shear wave (ASW) generated by the mechanical movement of the needle. An acupuncture needle was driven by a piezoelectric transducer at 100 Hz or below, and the ASW in human calf was imaged by magnetic resonance elastography. At the cell level, the ASW activated intracellular Ca2+ transients and oscillations in fibroblasts and endothelial, ventricular myocytes and neuronal PC-12 cells along with frequency–amplitude tuning and memory capabilities. Monitoring in vivo mammalian experiments with ASW, enhancement of endorphin in blood plasma and blocking by Gd3+ were observed; and increased Ca2+ fluorescence in mouse hind leg muscle was imaged by two-photon microscopy. In contrast with traditional acupuncture models, the signal source is derived from the total acoustic energy. ASW signaling makes use of the anisotropy of elasticity of tissues as its waveguides for transmission and that cell activation is not based on the nervous system.
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Witzel T, Napadow V, Kettner NW, Vangel MG, Hämäläinen MS, Dhond RP. Differences in cortical response to acupressure and electroacupuncture stimuli. BMC Neurosci 2011; 12:73. [PMID: 21794103 PMCID: PMC3162932 DOI: 10.1186/1471-2202-12-73] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Accepted: 07/27/2011] [Indexed: 11/10/2022] Open
Abstract
Background FMRI studies focus on sub-cortical effects of acupuncture stimuli. The purpose of this study was to assess changes in primary somatosensory (S1) activity over the course of different types of acupuncture stimulation. We used whole head magnetoencephalography (MEG) to map S1 brain response during 15 minutes of electroacupuncture (EA) and acupressure (AP). We further assessed how brain response changed during the course of stimulation. Results Evoked brain response to EA differed from AP in its temporal dynamics by showing clear contralateral M20/M30 peaks while the latter demonstrated temporal dispersion. Both EA and AP demonstrated significantly decreased response amplitudes following five minutes of stimulation. However, the latency of these decreases were earlier in EA (~30 ms post-stimulus) than AP (> 100 ms). Time-frequency responses demonstrated early onset, event related synchronization (ERS), within the gamma band at ~70-130 ms and the theta band at ~50-200 ms post-stimulus. A prolonged event related desynchronization (ERD) of alpha and beta power occurred at ~100-300 ms post-stimulus. There was decreased beta ERD at ~100-300 ms over the course of EA, but not AP. Conclusion Both EA and AP demonstrated conditioning of SI response. In conjunction with their subcortical effects on endogenous pain regulation, these therapies show potential for affecting S1 processing and possibly altering maladaptive neuroplasticity. Thus, further investigation in neuropathic populations is needed.
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Affiliation(s)
- Thomas Witzel
- Harvard Medical School, Martinos Center for Biomedical Imaging, Charlestown, MA 02129, USA
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Pilot scheme of health policy in stroke adjuvant acupuncture therapy for acute and subacute ischemic stroke in taiwan. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 2011:689813. [PMID: 21584251 PMCID: PMC3092629 DOI: 10.1155/2011/689813] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Revised: 12/28/2010] [Accepted: 02/07/2011] [Indexed: 11/17/2022]
Abstract
To reduce the health care burden of strokes, the Taiwan Department of Health launched the Pilot Scheme of the Health Policy in Stroke Adjuvant Acupuncture Therapy (HPSAAT) in 2006. This cross-sectional, hospital-based, match-controlled study at Chang Gung Memorial Hospital-Kaohsiung Medical Center during 2006∼2008 retrospectively evaluated the clinical characteristics of acute and subacute ischemic stroke patients who electively joined the HPSAAT. The study also evaluated the safety and clinical benefits of adjuvant acupuncture in treating acute and subacute ischemic stroke patients.
Twenty-six HPSAAT participants and 52 age-sex matched random controls were enrolled. The stroke baseline of the HPSAAT participants was more severe than the non-HPSAAT controls. Although the stroke severity closely correlates to mortality and comorbidity, this study noted no significant complications in the HPSAAT participants during the acupuncture treatment course. Adjuvant acupuncture was considered safe at the acute and subacute stages of ischemic stroke. Due to uneven baseline severity, the clinical benefits in reducing neurological deficits and functional recovery were not concluded in this study.
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Beissner F. Functional magnetic resonance imaging studies of acupuncture mechanisms: a critique. ACTA ACUST UNITED AC 2010. [DOI: 10.1111/j.2042-7166.2010.01048.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cho SY, Jahng GH, Park SU, Jung WS, Moon SK, Park JM. fMRI study of effect on brain activity according to stimulation method at LI11, ST36: painful pressure and acupuncture stimulation of same acupoints. J Altern Complement Med 2010; 16:489-95. [PMID: 20423217 DOI: 10.1089/acm.2009.0395] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The objective of this study was to assess differences in brain responses between pressure and acupuncture stimulation at the same acupoint using functional magnetic resonance imaging (fMRI). SUBJECTS A total of 10 healthy right-handed volunteers were studied. DESIGN fMRI was performed with two different paradigms; namely, pressure and acupuncture stimulation at acupuncture points LI11 and ST36 on the left. fMRI data were analyzed using SPM2. RESULTS In comparison with the left LI11 pressure stimulation, both sides of the parahippocampal gyrus, cerebellum, left side of thalamus, and right side of posterior cingulate regions were more activated by the left LI11 acupuncture stimulation. In comparison with the left ST36 pressure stimulation, the secondary motor cortex, limbic system (cingulate gyrus, posterior cingulate), primary visual cortex, pons, and medulla regions were more activated by left ST36 acupuncture stimulation. In comparison with the left ST36 pressure stimulation, both side of BA 4 and BA 6 were more activated by the LI11 pressure stimulation. In comparison with the left LI11 acupuncture stimulation, left BA 6, BA 8, and anterior cingulate cortex (ACC) were more activated by the left ST36 acupuncture stimulation. CONCLUSIONS In conclusion, brain signal activation patterns according to the stimulation methods and acupoints were observed to differ. Acupuncture stimulation activated more regions than pressure at the same acupoint. In particular, acupuncture stimulation activated the limbic system, such as the parahippocampal gyrus and ACC.
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Affiliation(s)
- Seung-Yeon Cho
- Department of Cardiovascular & Neurologic Disease (Stroke Center), East-West Neo Medical Center, College of Korean Medicine, Kyung Hee University, Seoul, Korea
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The brain effects of laser acupuncture in healthy individuals: an FMRI investigation. PLoS One 2010; 5:e12619. [PMID: 20838644 PMCID: PMC2935390 DOI: 10.1371/journal.pone.0012619] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Accepted: 08/05/2010] [Indexed: 11/28/2022] Open
Abstract
Background As laser acupuncture is being increasingly used to treat mental disorders, we sought to determine whether it has a biologically plausible effect by using functional magnetic resonance imaging (fMRI) to investigate the cerebral activation patterns from laser stimulation of relevant acupoints. Methodology/Principal Findings Ten healthy subjects were randomly stimulated with a fibreoptic infrared laser on 4 acupoints (LR14, CV14, LR8 and HT7) used for depression following the principles of Traditional Chinese Medicine (TCM), and 1 control non-acupoint (sham point) in a blocked design (alternating verum laser and placebo laser/rest blocks), while the blood oxygenation level-dependent (BOLD) fMRI response was recorded from the whole brain on a 3T scanner. Many of the acupoint laser stimulation conditions resulted in different patterns of neural activity. Regions with significantly increased activation included the limbic cortex (cingulate) and the frontal lobe (middle and superior frontal gyrus). Laser acupuncture tended to be associated with ipsilateral brain activation and contralateral deactivation that therefore cannot be simply attributed to somatosensory stimulation. Conclusions/Significance We found that laser stimulation of acupoints lead to activation of frontal-limbic-striatal brain regions, with the pattern of neural activity somewhat different for each acupuncture point. This is the first study to investigate laser acupuncture on a group of acupoints useful in the management of depression. Differing activity patterns depending on the acupoint site were demonstrated, suggesting that neurological effects vary with the site of stimulation. The mechanisms of activation and deactivation and their effects on depression warrant further investigation.
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Han JS, Ho YS. Global trends and performances of acupuncture research. Neurosci Biobehav Rev 2010; 35:680-7. [PMID: 20800613 DOI: 10.1016/j.neubiorev.2010.08.006] [Citation(s) in RCA: 117] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Revised: 08/19/2010] [Accepted: 08/20/2010] [Indexed: 02/07/2023]
Abstract
This study was designed to evaluate the global scientific output of acupuncture research in the Science Citation Index-Expanded and to assess the tendencies and research performances of leading countries/territories and institutes. Articles referring to acupuncture were assessed by distribution of document types, languages, journals, subject categories, source countries, and source institutes. Results showed that 15 languages were represented in articles from 65 countries/territories. Journal of Alternative and Complementary Medicine published the most articles, followed by American Journal of Chinese Medicine and Acupuncture & Electro-Therapeutics Research which were listed in category of integrative & complementary medicine. In the study period of 1991-2009, USA was the top producing country, followed by China (mainland) with a sharply growth trend. In 2009, publication of China (mainland) ranked top one in the world. In addition, an acupuncture research trend was found in two phases in terms of the increase of number of SCI-expanded journals' articles. Among the acupuncture research, pain control has been the most prevalent direction of study, and brain imaging is attracting the most recent attention.
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Affiliation(s)
- Ji-Sheng Han
- Neuroscience Research Institute, Peking University, Beijing 100191, People's Republic of China
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Lo YL, Cui SL, Lum SY, Chong SF, Siow HC. A study of acupuncture in Asian patients: clinical aspects and effects on cortical excitability. Acupunct Med 2010; 28:74-7. [PMID: 20615860 DOI: 10.1136/aim.2009.002055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To determine the effect of acupuncture on the phosphene threshold, by transcranial magnetic stimulation (TMS), and the clinical effect of acupuncture on headache frequency, duration and severity. METHODS Twenty-one patients (16 women; mean age 46 years; range 23-61 years, 17 Chinese, 2 Malays, 2 Indians) underwent 10 acupuncture sessions scheduled twice a week for 5 weeks. The lowest TMS intensity to elicit phosphene perception is defined as the phosphene threshold. TMS was performed before the first and last sessions, and at 2 months' follow-up. RESULTS Acupuncture resulted in reduction of headache frequency, duration and severity over the course of treatment. However, this was not accompanied by a corresponding increase in the phosphene threshold over a similar time course. The baseline threshold before acupuncture treatment had no predictive value for outcome of treatment. CONCLUSIONS Although acupuncture was effective in treating migraine, the use of occipital cortex excitability as an adjunctive parameter to evaluate treatment response was not suitable. The relief of migraine with acupuncture may be related to separate neural pathways independent of occipital or visual processes in the human brain.
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Affiliation(s)
- Y L Lo
- Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore 169608, Singapore.
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