Acupuncture stimulation at GB34 suppresses 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced oxidative stress in the striatum of mice

Management of a Patient With Premenstrual Syndrome Using Acupuncture, Supplements, and Meditation: A Case Report

Objective

The purpose of this case report was to describe a multimodal approach for the treatment of premenstrual syndrome (PMS).

Clinical Features

A 36-year-old nulliparous woman presented to a free clinic for veterans and their spouses. She received a PMS diagnosis at age 18. She was previously prescribed hormonal birth control and nonsteroidal anti-inflammatory drugs, which minimally affected her condition. She stopped using conventional medicine therapies at age 27. Laboratory results showed that her progesterone was below 0.5 ng/mL. Her symptom score was 50 out of 60 on the Treatment Strategies for PMS assessment tool. During her menses, she experienced low back pain and stiffness, bloating, swelling, weight gain, breast tenderness, swelling, and pain, and she felt overwhelmed and stressed.

Intervention and Outcome

Traditional Chinese medicine acupuncture was administered in conjunction with 100 mg of coenzyme Q10 (ubiquinol) and a B-100 complex once a day and 400 mg of magnesium citrate, 1000 mg of flaxseed oil (Linum usitatissimum), and 1000 mg of turmeric (Curcuma longa) twice a day. Five days before the onset of her menstrual period, she was to ingest a B-100 complex twice a day and 400 mg of magnesium citrate, 1000 mg of flaxseed oil, and 1000 mg of turmeric 3 times a day. Mindfulness meditation was encouraged twice a day for 10 minutes to reduce stress. After 12 treatments over 3 months, her symptom score decreased to 18 out of 60 and remained below 20 for an additional 32 weeks.

Conclusion

This patient with PMS symptoms positively responded to a multimodal approach using traditional Chinese medicine-style acupuncture, dietary supplements, and mindfulness meditation.

Electroacupuncture at GB34 modulates neurogenesis and BDNF-ERK signaling in a mouse model of Parkinson's disease

Background and aim

It has been reported that acupuncture at GB34 can enhance neurogenesis in the subventricular zone (SVZ) of mice treated with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). However, the signaling pathway that plays a critical role in neurogenesis needs to be established. Herein, we investigated the neurogenesis-promoting pathway mediated by acupuncture, focusing on extracellular signal-regulated kinase (ERK) signaling.

Experimental procedure

Male 10-week-old C57BL/6 mice were intraperitoneally injected with 30 mg/kg MPTP once daily for 5 days. Subsequently, mice were intraperitoneally injected with 50 mg/kg bromodeoxyuridine (BrdU), and electroacupuncture (EA) was performed at GB34 and BL60 for 3 weeks. The survival of dopaminergic neurons in the nigrostriatal pathway, cell proliferation in the SVZ, and expression levels of brain-derived neurotrophic factor (BDNF) and phosphorylated ERK (pERK) were evaluated.

Results and conclusion

MPTP induced dopaminergic neuronal death in the nigrostriatal pathway, and reduced the number of BrdU-positive and BrdU/doublecortin double-positive cells in the SVZ; these parameters were restored by EA. Moreover, EA prevented MPTP-induced reduction in striatal expression of BDNF and pERK. These results indicate that EA could prevent dopaminergic neuronal death in the nigrostriatal pathway and restore neurogenesis in the SVZ, which may be attributed to the activation of the BDNF-ERK pathway.

Acupuncture Regulates Symptoms of Parkinson’s Disease via Brain Neural Activity and Functional Connectivity in Mice

Parkinson’s disease (PD) is a multilayered progressive brain disease characterized by motor dysfunction and a variety of other symptoms. Although acupuncture has been used to ameliorate various symptoms of neurodegenerative disorders, including PD, the underlying mechanisms are unclear. Here, we investigated the mechanism of acupuncture by revealing the effects of acupuncture treatment on brain neural responses and its functional connectivity in an animal model of PD. We observed that destruction of neuronal network between many brain regions in PD mice were reversed by acupuncture. Using machine learning analysis, we found that the key region associated with the improvement of abnormal behaviors might be related to the neural activity of M1, suggesting that the changes of c-Fos in M1 could predict the improvement of motor function induced by acupuncture treatment. In addition, acupuncture treatment was shown to significantly normalize the brain neural activity not only in M1 but also in other brain regions related to motor behavior (striatum, substantia nigra pars compacta, and globus pallidus) and non-motor symptoms (hippocampus, lateral hypothalamus, and solitary tract) of PD. Taken together, our results demonstrate that acupuncture treatment might improve the PD symptoms by normalizing the brain functional connectivity in PD mice model and provide new insights that enhance our current understanding of acupuncture mechanisms for non-motor symptoms.

The potential applications of traditional Chinese medicine in Parkinson's disease: A new opportunity

Parkinson's disease (PD) presents a common challenge for people all over the world and has become a major research hotspot due to the large population affected by the illness and the difficulty of clinical treatment. The prevalence of PD is increasing every year, the pathogenesis is complex, and the current treatment is ineffective. Therefore, it has become imperative to find effective drugs for PD. With the advantages of low cost, high safety and high biological activity, Chinese medicine has great advantages in the prevention and treatment of PD. This review systematically summarizes the potential of Chinese medicine for the treatment of PD, showing that Chinese medicine can exert anti-PD effects through various pathways, such as anti-inflammatory and antioxidant pathways, reducing mitochondrial dysfunction, inhibiting endoplasmic reticulum stress and iron death, and regulating intestinal flora. These mainly involve HMGB1/TLR4, PI3K/Akt, NLRP3/ caspase-1/IL-1β, Nrf2/HO-1, SIRT1/Akt1, PINK1/parkin, Bcl-2/Bax, BDNF-TrkB and other signaling pathways. In sum, based on modern phytochemistry, pharmacology and genomic proteomics, Chinese medicine is likely to be a potential candidate for PD treatment, which requires more clinical trials to further elucidate its importance in the treatment of PD.

Acupuncture for Parkinson's Disease: Efficacy Evaluation and Mechanisms in the Dopaminergic Neural Circuit

Parkinson's disease (PD) is a chronic and progressive neurodegenerative disease caused by degeneration of dopaminergic neurons in the substantia nigra. Existing pharmaceutical treatments offer alleviation of symptoms but cannot delay disease progression and are often associated with significant side effects. Clinical studies have demonstrated that acupuncture may be beneficial for PD treatment, particularly in terms of ameliorating PD symptoms when combined with anti-PD medication, reducing the required dose of medication and associated side effects. During early stages of PD, acupuncture may even be used to replace medication. It has also been found that acupuncture can protect dopaminergic neurons from degeneration via antioxidative stress, anti-inflammatory, and antiapoptotic pathways as well as modulating the neurotransmitter balance in the basal ganglia circuit. Here, we review current studies and reflect on the potential of acupuncture as a novel and effective treatment strategy for PD. We found that particularly during the early stages, acupuncture may reduce neurodegeneration of dopaminergic neurons and regulate the balance of the dopaminergic circuit, thus delaying the progression of the disease. The benefits of acupuncture will need to be further verified through basic and clinical studies.

Effects of Acupuncture on Oxidative Stress Amelioration via Nrf2/ARE-Related Pathways in Alzheimer and Parkinson Diseases

Oxidative stress is responsible for the pathogeneses of various diseases. Mitochondrial dysfunction, impaired DNA repair, and cellular damage followed by oxidative stress contribute to neurodegenerative diseases, such as Alzheimer disease (AD) and Parkinson disease (PD). Acupuncture is a traditional therapy that has been practiced for >3000 years in Asia. Many studies have demonstrated that acupuncture has notable antioxidative, anti-inflammatory, and antiapoptotic effects. However, the exact mechanism remains unclear. Nuclear factor erythroid 2-related factor (Nrf2) is crucial in regulating the redox equilibrium. Activated Nfr2 translocates into the nucleus, binds to the antioxidant response element (ARE), and initiates antioxidative enzyme transcription. In this review, we demonstrated the effects of acupuncture on oxidative stress amelioration in AD and PD animal models through Nrf2/ARE pathway activation and Nrf2/ARE-related pathway regulation. Thus, acupuncture could be a therapeutic option for AD and PD.

Jiaji (EX-B2)-Based Electroacupuncture Preconditioning Attenuates Early Ischaemia Reperfusion Injury in the Rat Myocardium

Background

Acupuncture preconditioning was able to reduce the extent of ischaemia reperfusion (I/R) injury. Previous studies have shown that electroacupuncture (EA) pretreatment at T4-T5 Jiaji (EX-B2) acupoints had cardioprotective effects against myocardial I/R injury. However, the molecular mechanism remains inconclusive.

Methods

Wistar rats were pretreated with electroacupuncture for 7 days at the Neiguan (PC6), T4-T5 Jiaji (EX-B2), Yanglingquan (GB34), and Quchi (LI11) acupoints, which belong to different meridians. Then, we investigated the genome-wide gene expression profiles of rats prestimulated at these acupoints after I/R injury.

Results

Our study revealed previously unknown cardioprotective roles of T4-T5 Jiaji (EX-B2) acupoints in the I/R progression. The extent of myocardial injury was significantly decreased in the Jiaji group compared with the I/R group. In addition, our data are among the first to link the EA preconditioning at Neiguan (PC6) acupoints and circadian rhythm in the I/R model. Also, for the first time, we explored the meridian and acupoint specificity involved in EA pretreatment at the heart meridian, in which Yanglingquan and Quchi acupoints were selected as the control group for heart-divergent-meridian and nonheart-meridian acupoints.

Conclusions

The present study suggested that EA pretreatment at Jiaji alters genome-wide gene expression and protects the rat myocardium against I/R injury, which are most likely through neurohumoral regulation.

Decreased Risk of Dementia Among Patients With Traumatic Brain Injury Receiving Acupuncture Treatment: A Population-Based Retrospective Cohort Study

OBJECTIVE

We conducted a longitudinal cohort study comparing the effect of acupuncture on the risk of dementia in Taiwanese individuals with traumatic brain injury (TBI).

DESIGN AND PARTICIPANTS

A national health insurance database was used to identify 15 440 newly diagnosed TBI patients 20 to 70 years old between 1998 and 2007. Of the identified patients, 6308 received acupuncture following the onset of TBI (acupuncture users) and 9132 patients did not receive acupuncture (nonacupuncture users).

MEASURES

All enrollees were followed until the end of 2012 to record incident cases of dementia. A Cox proportional hazards regression model was used to compute adjusted hazard ratios for the relationship of acupuncture use with dementia.

RESULTS

During the follow-up period, 249 acupuncture users and 810 nonacupuncture users developed dementia, corresponding to incidence rates of 6.11 and 9.64 per 1000 person-years, respectively. Use of acupuncture was significantly associated with a lower risk of dementia. Those who received more than 5 sessions of acupuncture benefited most from it.

CONCLUSIONS

Adding acupuncture to the clinical management of patients with TBI may benefit these patients by decreasing their risk of developing dementia.

Complementary Therapies in Parkinson Disease: a Review of Acupuncture, Tai Chi, Qi Gong, Yoga, and Cannabis

Parkinson disease (PD) is a progressive neurodegenerative condition characterized by bradykinesia, rigidity, resting tremor, and postural instability. Non-motor symptoms, including pain, fatigue, insomnia, anxiety, and depression to name a few, are increasingly recognized and often just as disabling at motor symptoms. The mainstay of treatment is dopamine replacement; however, the beneficial effects tend to wane over time with disease progression, and patients often experience motor fluctuations and medication side effects. The lack of a disease-modifying intervention and the shortcomings of traditional symptomatic medications have led many patients to pursue complementary therapies to alleviate motor and non-motor symptoms associated with PD. The term complementary implies that the therapy is used along with conventional medicine and may include supplements, manipulative treatments (chiropractic, massage), exercise-based programs, and mind-body practices. As these practices become more widespread in Western medicine, there is a growing interest in evaluating their effects on a number of medical conditions, PD included. In this review, we provide an update on clinical trials that have evaluated the effectiveness of complementary treatments for patients with PD, specifically focusing on acupuncture, Tai Chi, Qi Gong, yoga, and cannabis.

Effects of Combined Treatment with Acupuncture and Chunggan Formula in a Mouse Model of Parkinson's Disease

Parkinson's disease is the second most common neurodegenerative disease. Patients with Parkinson's disease can be treated with a combination of acupuncture and herbal medicine, but studies on the synergistic effects of the combined treatment have not yet been conducted. Thus, we subjected an MPTP-induced Parkinson's disease mouse model to the combined treatment. We used acupoint GB34 for acupuncture and modified Chunggantang (KD5040) as the herbal medicine, as they have been reported to be effective in Parkinson's disease. We investigated the suboptimal dose of KD5040 and then used this dose in the combined treatment. The results showed that the combined treatment had a synergistic effect on improvements in abnormal motor function and neurodegeneration compared with the use of acupuncture or herbal medicine alone. The combined treatment also had a neuroprotective effect via the PI3K/AKT and MAPK/ERK signaling pathways. These findings suggest that the combined treatment with acupuncture and KD5040 can help improve the symptoms of Parkinson's disease.

Effects of Acupuncture on Neurological Disease in Clinical- and Animal-Based Research

Neurological disease, including Alzheimer’s disease (AD), Parkinson’s disease (PD), which were caused by abnormalities in the nervous system involves the accumulation of false proteins, neurotransmitter abnormalities, neuronal apoptosis, etc. As an alternative supplementary medicine (ASM), acupuncture plays an important role in the treatment of neurological diseases. In this review article, we summarized the current evidence for the treatment efficacy of acupuncture in AD and PD from the perspective of clinical trials and animal model. Acupuncture can inhibit the accumulation of toxic proteins in neurological diseases, modulate energy supply based on glucose metabolism, depress neuronal apoptosis, etc., and exert a wide range of neuroprotective effects.

Inhibition of GABAergic Neurons and Excitation of Glutamatergic Neurons in the Ventrolateral Periaqueductal Gray Participate in Electroacupuncture Analgesia Mediated by Cannabinoid Receptor

Although electroacupuncture (EA) has become a worldwide practice, little is understood about its precise target in the central nervous system (CNS) and the cell type-specific analgesia mechanism. In the present study, we found that EA has significant antinociceptive effects both in inflammatory and neuropathic pain models. Chemogenetic inhibition of GABAergic neurons in the ventrolateral periaqueductal gray (vlPAG) replicated the effects of EA, whereas the combination of chemogenetic activation of GABAergic neurons and chemogenetic inhibition of glutamatergic neurons in the vlPAG was needed to reverse the effects of EA. Specifically knocking out CB1 receptors on GABAergic neurons in the vlPAG abolished the EA effect on pain hypersensitivity, while specifically knocking out CB1 receptors on glutamatergic neurons attenuated only a small portion of the EA effect. EA synchronously inhibits GABAergic neurons and activates glutamatergic neurons in the vlPAG through CB1 receptors to produce EA-induced analgesia. The CB1 receptors on GABAergic neurons localized in the vlPAG was the basis of the EA effect on pain hypersensitivity. This study provides new experimental evidence that EA can bidirectionally regulate GABAergic neurons and glutamatergic neurons via the CB1 receptors of the vlPAG to produce analgesia effects.

Does Acupuncture Protect Dopamine Neurons in Parkinson's Disease Rodent Model?: A Systematic Review and Meta-Analysis

Background: Acupuncture has been reported to have significant effects, not only in alleviating impaired motor function, but also rescuing dopaminergic neuron deficits in rodent models of Parkinson's disease (PD). However, a systemic analysis of these beneficial effects has yet to be performed. Objective: To evaluate the neuroprotective effect of acupuncture in animal models of PD. Methods: A literature search of the PubMed, MEDLINE, EMBASE, China National Knowledge Infrastructure, Research Information Service System, and Japan Society of Acupuncture and Moxibustion databases was performed to retrieve studies that investigated the effects of acupuncture on PD. The quality of each included study was evaluated using the 10-item checklist modified from the Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies. RevMan version 5.3 (Foundation for Statistical Computing, Vienna, Austria) was used for meta-analysis. Results: The 42 studies included scored between 2 and 7 points, with a mean score of 4.6. Outcome measures included tyrosine hydroxylase (TH) level and dopamine content. Meta-analysis results revealed statistically significant effects of acupuncture for increasing both TH levels (33.97 [95% CI 33.15-34.79]; p < 0.00001) and dopamine content (4.23 [95% CI 3.53-4.92]; p < 0.00001) compared with that observed in PD control groups. In addition, motor dysfunctions exhibited by model PD animals were also mitigated by acupuncture treatment. Conclusions: Although there were limitations in the number and quality of the included studies, results of this analysis suggest that acupuncture exerts a protective effect on dopaminergic neurons in rodent models of PD.