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Wu R, Ma H, Hu J, Wang D, Wang F, Yu X, Li Y, Fu W, Lai M, Hu Z, Feng W, Shan C, Wang C. Electroacupuncture stimulation to modulate neural oscillations in promoting neurological rehabilitation. Brain Res 2024; 1822:148642. [PMID: 37884179 DOI: 10.1016/j.brainres.2023.148642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 10/28/2023]
Abstract
Electroacupuncture (EA) stimulation is a modern neuromodulation technique that integrates traditional Chinese acupuncture therapy with contemporary electrical stimulation. It involves the application of electrical currents to specific acupoints on the body following acupuncture. EA has been widely used in the treatment of various neurological disorders, including epilepsy, stroke, Parkinson's disease, and Alzheimer's disease. Recent research suggests that EA stimulation may modulate neural oscillations, correcting abnormal brain electrical activity, therefore promoting brain function and aiding in neurological rehabilitation. This paper conducted a comprehensive search in databases such as PubMed, Web of Science, and CNKI using keywords like "electroacupuncture," "neural oscillations," and "neurorehabilitation", covering the period from year 1980 to 2023. We provide a detailed overview of how electroacupuncture stimulation modulates neural oscillations, including maintaining neural activity homeostasis, influencing neurotransmitter release, improving cerebral hemodynamics, and enhancing specific neural functional networks. The paper also discusses the current state of research, limitations of electroacupuncture-induced neural oscillation techniques, and explores prospects for their combined application, aiming to offer broader insights for both basic and clinical research.
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Affiliation(s)
- Ruiren Wu
- The Second Rehabilitation Hospital of Shanghai, Shanghai, China; School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China; Institute of Rehabilitation Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Hongli Ma
- The Second Rehabilitation Hospital of Shanghai, Shanghai, China; School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China; Institute of Rehabilitation Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Jun Hu
- The Second Rehabilitation Hospital of Shanghai, Shanghai, China; School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Institute of Rehabilitation Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Deheng Wang
- School of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Feng Wang
- Department of Neurology, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaoming Yu
- Department of Rehabilitation, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuanli Li
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Department of Rehabilitation, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China; Institute of Rehabilitation Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Wang Fu
- Department of Neurology, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Minghui Lai
- Department of Rehabilitation, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zekai Hu
- The Second Rehabilitation Hospital of Shanghai, Shanghai, China; School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Institute of Rehabilitation Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Wei Feng
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Institute of Rehabilitation Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Chunlei Shan
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Department of Rehabilitation, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China; Institute of Rehabilitation Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Cong Wang
- The Second Rehabilitation Hospital of Shanghai, Shanghai, China; School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Department of Neurology, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Department of Rehabilitation, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China; Institute of Rehabilitation Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China; Queensland Brain Institute, The University of Queensland, Brisbane, Australia.
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Medvediev VV, Oleksenko NP, Pichkur LD, Verbovska SA, Savosko SI, Draguntsova NG, Lontkovskyi YA, Vaslovych VV, Tsymbalyuk VI. Implantation Effect of a Fibrin Matrix Associated with Mesenchymal Wharton’s Jelly Stromal Cells on the Course of an Experimental Spinal Cord Injury. CYTOL GENET+ 2023. [DOI: 10.3103/s0095452723010073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
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Kawakami K, Tanaka S, Sugiyama Y, Mochizuki N, Kawamata M. Intrathecal morphine exacerbates paresis with increasing muscle tone of hindlimbs in rats with mild thoracic spinal cord injury but without damage of lumbar α-motoneurons. PLoS One 2022; 17:e0273095. [PMID: 35969631 PMCID: PMC9377624 DOI: 10.1371/journal.pone.0273095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 08/02/2022] [Indexed: 11/25/2022] Open
Abstract
Adverse effects of morphine on locomotor function after moderate to severe spinal cord injury (SCI) have been reported; however, the effects after mild SCI without damage of lumbar α-motoneurons have not been investigated. We investigated the effects of lumbar intrathecal morphine on locomotor function after mild thoracic SCI and the involvement of classic opioid receptor activation. A mild thoracic contusive SCI was induced in adult rats at the T9-T10 spine level under sevoflurane anesthesia. We evaluated the effects of single doses of intrathecal morphine and selective μ-, δ-, and κ-opioid receptor agonists, continuous infusion of intrathecal morphine for 72 hours, and administration of physiological saline on locomotor function and muscle tone in the hindlimbs. The numbers of damaged and total α-motoneurons in the lumbar spinal cord were also investigated. Single doses of morphine aggravated residual locomotor function after SCI but did not affect functional recovery. Single doses of morphine and μ- and δ-opioid receptor agonists significantly aggravated residual locomotor function with increases in muscle tone after SCI, and the effects of the drugs were reversed by naloxone. In contrast, continuous infusion of morphine led to persistent decline in locomotor function with increased muscle tone, which was not reversed by naloxone, but did not increase the number of damaged lumbar α-motoneurons. These results indicate that a single dose of morphine at an analgesic dose transiently increases muscle tone of the hindlimbs via activation of spinal μ- and δ- opioid receptors, resulting in further deterioration of locomotor function in the acute phase of mild SCI. Our results also suggest that an increased dose of morphine with prolonged administration leads to persistent decline in locomotor function with increased muscle tone via mechanisms other than direct activation of classical opioid receptors. Morphine should be used cautiously even after mild SCI.
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Affiliation(s)
- Katsuhiro Kawakami
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Nagano, Japan
| | - Satoshi Tanaka
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Nagano, Japan
- * E-mail:
| | - Yuki Sugiyama
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Nagano, Japan
| | - Noriaki Mochizuki
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Nagano, Japan
| | - Mikito Kawamata
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Nagano, Japan
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Phenotypes of Motor Deficit and Pain after Experimental Spinal Cord Injury. BIOENGINEERING (BASEL, SWITZERLAND) 2022; 9:bioengineering9060262. [PMID: 35735505 PMCID: PMC9220047 DOI: 10.3390/bioengineering9060262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/31/2022] [Accepted: 06/14/2022] [Indexed: 11/21/2022]
Abstract
Motor disability is a common outcome of spinal cord injury (SCI). The recovery of motor function after injury depends on the severity of neurotrauma; motor deficit can be reversible, at least partially, due to the innate tissue capability to recover, which, however, deteriorates with age. Pain is often a comorbidity of injury, although its prediction remains poor. It is largely unknown whether pain can attend motor dysfunction. Here, we implemented SCI for modelling severe and moderate neurotrauma and monitored SCI rats for up to 5 months post-injury to determine the profiles of both motor deficit and nociceptive sensitivity. Our data showed that motor dysfunction remained persistent after a moderate SCI in older animals (5-month-old); however, there were two populations among young SCI rats (1 month-old) whose motor deficit either declined or exacerbated even more over 4–5 weeks after identical injury. All young SCI rats displayed changed nociceptive sensitivity in thermal and mechanical modalities. The regression analysis of the changes revealed a population trend with respect to hyper- or hyposensitivity/motor deficit. Together, our data describe the phenotypes of motor deficit and pain, the two severe complications of neurotrauma. Our findings also suggest the predictability of motor dysfunction and pain syndromes following SCI that can be a hallmark for long-term rehabilitation and recovery after injury.
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Medvediev VV, Oleksenko NP, Pichkur LD, Verbovska SA, Savosko SI, Draguntsova NG, Lontkovskiy YA, Vaslovych VV, Tsymbalyuk VI. Effect of Implantation of a Fibrin Matrix Associated with Neonatal Brain Cells on the Course of an Experimental Spinal Cord Injury. CYTOL GENET+ 2022. [DOI: 10.3103/s0095452722020086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chen Y, Gong Y, Huai X, Gu X, Su D, Yu W, Xie H. Effects of transcutaneous electrical acupuncture point stimulation on peripheral capillary oxygen saturation in elderly patients undergoing colonoscopy with sedation: a prospective randomized controlled trial. Acupunct Med 2020; 39:292-298. [PMID: 33256456 DOI: 10.1177/0964528420960479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION This study investigated whether transcutaneous electrical acupuncture point stimulation (TEAS) at PC6 can reduce the proportion of elderly patients experiencing a drop of ⩾4% in peripheral capillary oxygen saturation (SpO2) while undergoing colonoscopy under sedation. METHODS A total of 32 elderly patients (aged ⩾ 65 years) scheduled for colonoscopy were randomly assigned in a 1:1 ratio to receive either real or sham TEAS (treatment or control groups, respectively). Each patient received oxygen (2 L/min) delivered routinely via nasal cannula. The treatment group was given TEAS at PC6 for 20 min at 2 Hz frequency and 6 mA intensity; the control group underwent the same procedures but with zero frequency/intensity. SpO2 and other physiological parameters were measured prior to sedation and colonoscopy (baseline) and at seven other timepoints through departure from recovery. Depth of anesthesia was measured using a Narcotrend monitor. RESULTS Significantly fewer patients in the treatment group experienced a ⩾4% decrease from baseline SpO2 (2/16) than patients in the control group (10/16; p = 0.004). The two groups were comparable with regard to respiratory rate, systolic and diastolic blood pressures, mean arterial pressure, and heart rate. CONCLUSION TEAS applied at PC6 with 2 Hz frequency was feasible and may be helpful in reducing the rate of hypoxia in elderly patients during colonoscopy.Trial registration number: NCT03775122 (ClinicalTrials.gov).
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Affiliation(s)
- Yongming Chen
- Department of Anesthesiology, The Second Affiliated Hospital of Soochow University, Suzhou, China.,Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yin Gong
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xiaorong Huai
- Department of Anesthesiology, The Second Affiliated Hospital of Soochow University, Suzhou, China.,Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xiyao Gu
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Diansan Su
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Weifeng Yu
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Hong Xie
- Department of Anesthesiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
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Yoshizaki S, Yokota K, Kubota K, Saito T, Tanaka M, Konno DJ, Maeda T, Matsumoto Y, Nakashima Y, Okada S. The beneficial aspects of spasticity in relation to ambulatory ability in mice with spinal cord injury. Spinal Cord 2019; 58:537-543. [PMID: 31822806 DOI: 10.1038/s41393-019-0395-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/21/2019] [Accepted: 11/22/2019] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Experimental study with mice. OBJECTIVES Spasticity is a common complication after spinal cord injury (SCI) and has detrimental aspects, such as persistent pain and involuntary muscle spasms. This study aimed to assess the influence of antispastic therapy on locomotor function after SCI. SETTING University-based laboratory in Fukuoka, Japan. METHODS A mouse model of spasticity was developed by producing incomplete SCI at the 9th thoracic level. At 8 weeks after SCI, an antispastic drug, baclofen, was intraperitoneally administered to six injured and two sham-operated mice. The severity of spasticity was evaluated by the modified Ashworth scoring (MAS) system, and locomotor function was evaluated by the Basso-Beattie-Bresnahan (BBB) scale/Basso mouse score (BMS). RESULTS The administration of baclofen significantly improved spasticity in the SCI mice and the mean MAS decreased to from 6.2 to 2.8. However, at the same time, it significantly exacerbated the locomotor dysfunction of the SCI mice and the mean BMS decreased from 4.7 to 2.3. The time-course of the changes in locomotor function coincided with the time-course of the spasticity score. We also confirmed that the administration of baclofen was not associated with any changes in either locomotor function or spasticity of the sham-operated control mice. CONCLUSIONS Our results suggest that spasticity has a certain beneficial effect on ambulation ability. It is important to note that antispastic treatments may be associated with a risk of impairing the preserved function of chronic SCI patients.
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Affiliation(s)
- Shingo Yoshizaki
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Immunology and Neuroscience, Medical Institute of Bioregulation, Kyushu University, Fukuoka, Japan
| | - Kazuya Yokota
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kensuke Kubota
- Department of Orthopaedic Surgery, Japan Labor Health and Welfare Organization, Spinal Injuries Center, Fukuoka, Japan
| | - Takeyuki Saito
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masatake Tanaka
- Department of Immunology and Neuroscience, Medical Institute of Bioregulation, Kyushu University, Fukuoka, Japan
| | - Dai-Jiro Konno
- Department of Immunology and Neuroscience, Medical Institute of Bioregulation, Kyushu University, Fukuoka, Japan
| | - Takeshi Maeda
- Department of Orthopaedic Surgery, Japan Labor Health and Welfare Organization, Spinal Injuries Center, Fukuoka, Japan
| | - Yoshihiro Matsumoto
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuharu Nakashima
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Seiji Okada
- Department of Immunology and Neuroscience, Medical Institute of Bioregulation, Kyushu University, Fukuoka, Japan.
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Yu Y, Sha SB, Zhang B, Guan Q, Liang M, Zhao LG, Zhang QY, Wen J, Sun W. Effects and mechanism of action of transcutaneous electrical acupuncture point stimulation in patients with abnormal semen parameters. Acupunct Med 2019; 37:25-32. [PMID: 30942613 DOI: 10.1136/acupmed-2017-011365] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Objective: To evaluate the effect of transcutaneous electrical acupuncture point stimulation (TEAS) on sperm parameters and the underlying molecular mechanisms. Methods: A total of 121 patients diagnosed with oligozoospermia, asthenozoospermia or oligoasthenozoospermia were randomised into four groups (three treatment groups, one control): the TEAS groups were treated with 2 Hz (n=31), 100 Hz (n=31), or mock stimulation (n=29) at acupuncture points BL23, ST36, CV1 and CV4 for 2 months. The control group (n=30) was provided with lifestyle advice only. Results The changes in total sperm count and motility in the 2 Hz TEAS group were significantly greater than those in the mock group and the control group. The change in neutral α-glucosidase (NAG) and zinc levels in the 2 Hz group were significantly greater than those in the mock group and control group, and the changes in fructose levels of the 2 Hz group were significantly greater than those in the control group. Significant increases in calcium and integrin-binding protein 1 (CIB1) and reduction of cyclin-dependent kinase 1 b (CDK1) were also found after 2 Hz TEAS treatment. Conclusions The present findings suggest that 2 Hz TEAS can improve sperm count and motility in patients with abnormal semen parameters, and is associated with increases in seminal plasma zinc, NAG and fructose. The upregulation of CIB1 and downregulation of CDK1 by TEAS may be associated with its positive effects on sperm motility and count. Trial registration: http://www.chictr.org ; registration no. ChiCTR-TRC-11001775.
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Affiliation(s)
- Yan Yu
- Reproductive Medical Center, The Second Hospital affiliated to Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Shu-Bin Sha
- Reproductive Medical Center, The Second Hospital affiliated to Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Bin Zhang
- Reproductive Medical Center, The Second Hospital affiliated to Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Qun Guan
- Reproductive Medical Center, The Second Hospital affiliated to Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Ming Liang
- Reproductive Medical Center, The Second Hospital affiliated to Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Lu-Gang Zhao
- Reproductive Medicine Research Centre, 6th Affiliated Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Qi-Yao Zhang
- Reproductive Medical Center, The Second Hospital affiliated to Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Ji Wen
- Reproductive Medical Center, The Second Hospital affiliated to Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Wei Sun
- Reproductive Medical Center, The Second Hospital affiliated to Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
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Electroacupuncture Treatment Alleviates the Remifentanil-Induced Hyperalgesia by Regulating the Activities of the Ventral Posterior Lateral Nucleus of the Thalamus Neurons in Rats. Neural Plast 2018; 2018:6109723. [PMID: 30534151 PMCID: PMC6252233 DOI: 10.1155/2018/6109723] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 09/04/2018] [Indexed: 11/17/2022] Open
Abstract
Mechanisms underlying remifentanil- (RF-) induced hyperalgesia, a phenomenon that is generally named as opioid-induced hyperalgesia (OIH), still remain elusive. The ventral posterior lateral nucleus (VPL) of the thalamus, a key relay station for the transmission of nociceptive information to the cerebral cortex, is activated by RF infusion. Electroacupuncture (EA) is an effective method for the treatment of pain. This study aimed to explore the role of VPL in the development of OIH and the effect of EA treatment on OIH in rats. RF was administered to rats via the tail vein for OIH induction. Paw withdrawal threshold (PWT) in response to mechanical stimuli and paw withdrawal latency (PWL) to thermal stimulation were tested in rats for the assessment of mechanical allodynia and thermal hyperalgesia, respectively. Spontaneous neuronal activity and local field potential (LFP) in VPL were recorded in freely moving rats using the in vivo multichannel recording technique. EA at 2 Hz frequency (pulse width 0.6 ms, 1-3 mA) was applied to the bilateral acupoints "Zusanli" (ST.36) and "Sanyinjiao" (SP.6) in rats. The results showed that both the PWT and PWL were significantly decreased after RF infusion to rats. Meanwhile, both the spontaneous neuronal firing rate and the theta band oscillation in VPL LFP were increased on day 3 post-RF infusion, indicating that the VPL may promote the development of RF-induced hyperalgesia by regulating the pain-related cortical activity. Moreover, 2 Hz-EA reversed the RF-induced decrease both in PWT and PWL of rats and also abrogated the RF-induced augmentation of the spontaneous neuronal activity and the power spectral density (PSD) of the theta band oscillation in VPL LFP. These results suggested that 2 Hz-EA attenuates the remifentanil-induced hyperalgesia via reducing the excitability of VPL neurons and the low-frequency (theta band) oscillation in VPL LFP.
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Zhao W, Wang C, Li Z, Chen L, Li J, Cui W, Ding S, Xi Q, Wang F, Jia F, Xiao S, Guo Y, Zhao Y. Efficacy and safety of transcutaneous electrical acupoint stimulation to treat muscle spasticity following brain injury: a double-blinded, multicenter, randomized controlled trial. PLoS One 2015; 10:e0116976. [PMID: 25643051 PMCID: PMC4314074 DOI: 10.1371/journal.pone.0116976] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 12/07/2014] [Indexed: 11/18/2022] Open
Abstract
Objective This study was aimed at evaluating the clinical efficacy and safety of transcutaneous electrical acupoint stimulation (TEAS) to treat muscle spasticity after brain injury (Chinese Clinical Trial Registry: ChiCTR-TRC-11001310). Methods A total of 60 patients with muscle spasticity after brain injury were randomized to the following 3 groups: 100, 2, and 0 Hz (sham) TEAS. The acupoints Hegu (LI4)—Yuji (LU10) and Zusanli (ST36)—Chengshan (BL57) on the injured side were stimulated at 0, 2, or 100 Hz, 5 times per week for 4 weeks. The patients were followed up for 1 and 2 months after the treatments. The effects of the treatments on muscle spasticity at the wrist, thumb, the other 4 fingers, elbow, shoulder, knee, and ankle were evaluated by the Modified Ashworth Scale, and the effects on disability were assessed by the Disability Assessment Scale. The walking capability was evaluated by the Holden functional ambulation classification score. The overall performance was assessed by the Global Assessment Scale score and the improved Barthel Index. The safety of the treatments administered was also monitored. Results The wrist spasticity was significantly reduced from baseline at weeks 2, 3, and 4 of treatment and at the 1- and 2-month follow-up visits in the 100 Hz group (P < 0.01). Compared with 2 Hz or sham TEAS, 100 Hz TEAS decreased wrist spasticity at weeks 2, 3, and 4 of treatment and 1 month after treatment (P < 0.001). The other endpoints were not affected by the treatments. No treatment-emergent adverse events were reported during treatments and follow-up visits. Conclusions TEAS appears to be a safe and effective therapy to relieve muscle spasticity after brain injury, although large-scale studies are required to further verify the findings. Trial Registration Chinese Clinical Trial Registry ChiCTR-TRC-11001310 http://www.chictr.org
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Affiliation(s)
- Wenli Zhao
- Department of Neurology, Tianjin Nankai Hospital, Tianjin, 300100, China
| | - Chao Wang
- Department of Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Zhongzheng Li
- Department of Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Lei Chen
- Department of Acupuncture and Moxibustion, Tianjin Ninghe Hospital, Tianjin, 301500, China
| | - Jianbo Li
- Department of Acupuncture and Moxibustion, Tianjin Ninghe Hospital, Tianjin, 301500, China
| | - Weidong Cui
- Department of Acupuncture and Moxibustion, Tianjin Ninghe Hospital, Tianjin, 301500, China
| | - Shasha Ding
- Department of Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Qiang Xi
- Department of Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Fan Wang
- Department of Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Fei Jia
- Department of Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Shuhua Xiao
- Department of Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Yi Guo
- Department of Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Ye Zhao
- Department of Clinical Research, Tianjin Nankai Hospital and Tianjin Academy of Integrative Medicine, Tianjin, 300100, China
- * E-mail:
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11
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Park J, Seo D, Choi W, Lee S. The effects of exercise with TENS on spasticity, balance, and gait in patients with chronic stroke: a randomized controlled trial. Med Sci Monit 2014; 20:1890-6. [PMID: 25300431 PMCID: PMC4206395 DOI: 10.12659/msm.890926] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Transcutaneous electrical nerve stimulation (TENS) is a useful modality for pain control. TENS has recently been applied to decrease spasticity. The purpose of this study is to determine whether the addition of TENS to an exercise program reduces spasticity and improves balance and gait in chronic stroke patients. Material/Methods This was a single-blinded, multicenter, randomized controlled trial. Thirty-four ambulatory individuals with chronic stroke participated and were randomly allocated to the TENS or Placebo group. The TENS group performed therapeutic exercise with TENS while the placebo (non-stimulation) TENS group performed therapeutic exercise with placebo TENS. Participants in both groups followed the same 30-min exercise regimen 5 times per week for a period of 6 weeks. Spasticity (modified Ashworth scale), static (balance system), and dynamic balance (timed up and go test), and gait ability (gait analyzer) were measured at 1 week before and 1 week after the intervention. Results Significant differences were observed between the 2 groups. Spasticity improved by 0.80 points in the TENS group. Anterior-posterior and medial-lateral sway velocity among static balance parameters and dynamic balance showed significant differences between the TENS and Placebo TENS groups (p=.000). Gait speed and cadence were enhanced significantly in the TENS group (p=.000). Step and stride length on the paretic side showed a significant difference in the TENS group (p=.000), while only velocity showed a significant difference in the Placebo TENS group (p=.004). Conclusions A combination of therapeutic exercise and TENS may reduce spasticity and improve balance, gait, and functional activity in chronic stroke patients.
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Affiliation(s)
- Junhyuck Park
- Department of Physical Therapy, Graduate School of Sahmyook University, Seoul, Korea
| | - Dongkwon Seo
- Department of Physical Therapy, Konyang University, Daejeon, Korea
| | - Wonjae Choi
- Department of Physical Therapy, Graduate School of Sahmyook University, Seoul, Korea
| | - Seungwon Lee
- Department of Physical Therapy, Sahmyook University, Seoul, Korea
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Hahm SC, Yoon YW, Kim J. High-Frequency Transcutaneous Electrical Nerve Stimulation Alleviates Spasticity After Spinal Contusion by Inhibiting Activated Microglia in Rats. Neurorehabil Neural Repair 2014; 29:370-81. [DOI: 10.1177/1545968314545172] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Transcutaneous electrical nerve stimulation (TENS) can be used as a physical therapy for spasticity, but the effects of TENS on spasticity and its underlying mechanisms remain unclear. Objective. The purpose of this study was to test the effects of TENS on spasticity and the role of activated microglia as underlying mechanisms of TENS treatment for spasticity in rats with a 50-mm contusive spinal cord injury (SCI). Methods. A spinal contusion was made at the T12 spinal segment in adult male Sprague-Dawley rats using the NYU impactor. Behavioral tests for motor function were conducted before and after SCI and before and after TENS application. To assess spasticity, the modified Ashworth scale (MAS) was used before and after SCI, high-frequency (HF)/low-frequency (LF) TENS application at 3 different intensities (motor threshold [MT], 50% and 90% MT) or minocycline administration. Immunohistochemistry for microglia was performed at the lumbar spinal segments. Results. Motor recovery reached a plateau approximately 28 days after SCI. Spasticity was well developed and was sustained above the MAS grade of 3, beginning at 28 days after SCI. HF-TENS at 90% MT significantly alleviated spasticity. Motor function did not show any significant changes with LF- or HF-TENS treatment. HF-TENS significantly reduced the proportion of activated microglia observed after SCI. Minocycline, the microglia inhibitor, also significantly alleviated spasticity with the reduction of activated microglia expression. Conclusions. These results suggest that HF-TENS at 90% MT alleviates spasticity in rats with SCI by inhibiting activated microglia.
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Affiliation(s)
- Suk-Chan Hahm
- Department of Physical Therapy, Korea University College of Health Science, Seoul, Korea
- Rehabilitation Science Program, Department of Health Science, Graduate School, Korea University, Seoul, Korea
- BK21+ Program in Embodiment, Health-Society Interaction, Department of Public Health Science, Graduate School, Korea University, Seoul, Korea
| | - Young Wook Yoon
- Neuroscience Research Institute and Department of Physiology, Korea University College of Medicine, Seoul, Korea
| | - Junesun Kim
- Department of Physical Therapy, Korea University College of Health Science, Seoul, Korea
- Rehabilitation Science Program, Department of Health Science, Graduate School, Korea University, Seoul, Korea
- BK21+ Program in Embodiment, Health-Society Interaction, Department of Public Health Science, Graduate School, Korea University, Seoul, Korea
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Cho HY, In TS, Cho KH, Song CH. A single trial of transcutaneous electrical nerve stimulation (TENS) improves spasticity and balance in patients with chronic stroke. TOHOKU J EXP MED 2013; 229:187-93. [PMID: 23419328 DOI: 10.1620/tjem.229.187] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Spasticity management is pivotal for achieving functional recovery of stroke patients. The purpose of this study was to investigate the effects of a single trial of transcutaneous electrical nerve stimulation (TENS) on spasticity and balance in chronic stroke patients. Forty-two chronic stroke patients were randomly allocated into the TENS (n = 22) or the placebo-TENS (n = 20) group. TENS stimulation was applied to the gastrocnemius for 60 min at 100 Hz, 200 µs with 2 to 3 times the sensory threshold (the minimal threshold in detecting electrical stimulation for subjects) after received physical therapy for 30 min. In the placebo-TENS group, electrodes were placed but no electrical stimulation was administered. For measuring spasticity, the resistance encountered during passive muscle stretching of ankle joint was assessed using the Modified Ashworth Scale, and the Hand held dynamometer was used to assess the resistive force caused by spasticity. Balance ability was measured using a force platform that measures postural sway generated by postural imbalance. The TENS group showed a significantly greater reduction in spasticity of the gastrocnemius, compared to the placebo-TENS group (p < 0.05). TENS resulted in greater balance ability improvements, especially during the eyes closed condition (p < 0.05). However, these effects returned to baseline values within one day. This study shows that TENS provides an immediately effective means of reducing spasticity and of improving balance in chronic stroke patients. The present data may be useful to establish the standard parameters for TENS application in the clinical setting of stroke.
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Affiliation(s)
- Hwi-young Cho
- Department of Physical Therapy, Gachon University, Incheon, Republic of Korea
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14
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Cho HY, Kim EH, Kim B, Lee GE, Hahm SC, Lee GC, Yoon YW, Kim J. Effects of Repetitive High Frequency Transcutaneous Electrical Nerve Stimulation (HF-TENS) on Spasticity and Motor Function following Spinal Cord Injury in Rats. J Phys Ther Sci 2012. [DOI: 10.1589/jpts.24.133] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Hwi-young Cho
- Department of Physiology, Korea University College of Medicine
| | - Eun-hye Kim
- Department of Physical Therapy, Korea University College of Health Science
| | - Bokkyu Kim
- Department of Physical Therapy, Korea University College of Health Science
| | - Go-eun Lee
- Department of Physical Therapy, Korea University College of Health Science
| | - Seok-chan Hahm
- Department of Physical Therapy, Korea University College of Health Science
| | - Gyu-chang Lee
- Department of Physical Therapy, Korea University College of Health Science
- Department of Physical Therapy, Kyungnam University College of Natural Science
| | - Young Wook Yoon
- Department of Physiology, Korea University College of Medicine
| | - Junesun Kim
- Department of Physical Therapy, Korea University College of Health Science
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15
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Han JS. Acupuncture analgesia: areas of consensus and controversy. Pain 2011; 152:S41-S48. [PMID: 21078546 DOI: 10.1016/j.pain.2010.10.012] [Citation(s) in RCA: 206] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Revised: 10/08/2010] [Accepted: 10/12/2010] [Indexed: 11/25/2022]
Affiliation(s)
- Ji-Sheng Han
- Neuroscience Research Institute and Department of Neurobiology, Peking University Health Science Center, Key Laboratory of Neuroscience, The Ministry of Education and Ministry of Public Health, Beijing 100191, China
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16
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Bianco J, Gueye Y, Marqueste T, Alluin O, Risso JJ, Garcia S, Lavault MN, Khrestchatisky M, Feron F, Decherchi P. Vitamin D₃ improves respiratory adjustment to fatigue and H-reflex responses in paraplegic adult rats. Neuroscience 2011; 188:182-92. [PMID: 21571043 DOI: 10.1016/j.neuroscience.2011.04.066] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Revised: 04/11/2011] [Accepted: 04/29/2011] [Indexed: 11/29/2022]
Abstract
We previously demonstrated that vitamin D₂ (ergocalciferol) triggers axon regeneration in a rat model of peripheral nerve transection. In order to confirm the regenerative potential of this neuroactive steroid, we performed a study in which vitamin D₃ (cholecalciferol) was delivered at various doses to paralytic rats. After spinal cord compression at the T10 level, rats were given orally either vehicle or vitamin D₃ at the dose of 50 IU/kg/day or 200 IU/kg/day. Three months later, M and H-waves were recorded from rat Tibialis anterior muscle in order to quantify the maximal H-reflex (H(max)) amplitude. We also monitored the ventilatory frequency during an electrically induced muscle fatigue known to elicit the muscle metaboreflex and an increase in respiratory rate. Spinal cords were then collected, fixed and immunostained with an anti-neurofilament antibody. We show here that vitamin D-treated animals display an increased number of axons within the lesion site. In addition, rats supplemented with vitamin D₃ at the dose of 200 IU/kg/day exhibit (i) an improved breathing when hindlimb was electrically stimulated; (ii) an H-reflex depression similar to control animals and (iii) an increased number of axons within the lesion and in the distal area. Our data confirm that vitamin D is a potent molecule that can be used for improving neuromuscular adaptive mechanisms and H-reflex responses.
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Affiliation(s)
- J Bianco
- Institut des Sciences du Mouvement, Etienne-Jules MAREY, UMR CNRS 6233, Université de la Méditerranée (Aix-Marseille II,Aix-Marseille Université), Parc Scientifique et Technologique de Luminy, Faculté des Sciences du Sport de Marseille, 13288 Marseille Cedex 09, France
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Dorsher PT, McIntosh PM. Acupuncture's Effects in Treating the Sequelae of Acute and Chronic Spinal Cord Injuries: A Review of Allopathic and Traditional Chinese Medicine Literature. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2010; 2011:428108. [PMID: 19244295 PMCID: PMC3135628 DOI: 10.1093/ecam/nep010] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2008] [Accepted: 01/12/2009] [Indexed: 11/13/2022]
Abstract
Each year, there are an estimated 12 000 individuals who sustain a spinal cord injury (SCI) in the United States. Improved understanding of the pathophysiology of SCI and its sequelae has over the past 50 years led to the development of medical treatments (especially urologic) that have enhanced short- and long-term survival from these injuries. The prevalence of individuals with SCI in this country is ~250 000 individuals; and beyond the incalculable personal consequences of these devastating neurologic injuries, substantial direct and indirect societal costs result from the sequelae of SCI including paralysis, sensory loss, chronic pain, decubiti and bladder and/or bowel incontinence. The purpose of this treatise is to review the allopathic and traditional Chinese medicine (TCM) literature available through MEDLINE, PubMed and eCAM search engines that discuss the potential uses of acupuncture to treat acute and chronic spinal cord injuries and their sequelae, and present the neurophysiologic mechanisms for acupuncture's beneficial effects. There is evidence that use of electroacupuncture in acute SCI may significantly improve long-term neurologic recovery from these injuries both in terms of motor, sensory and bowel/bladder function with essentially no risk. Acupuncture may even improve neurourologic function in individuals with chronic SCI, and help with management with chronic pain associated with these injuries.
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Affiliation(s)
- Peter T Dorsher
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, 4500 San Pablo Road, Jacksonville, Florida 32224, USA
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Abstract
This paper is the 28th consecutive installment of the annual review of research concerning the endogenous opioid system, now spanning over a quarter-century of research. It summarizes papers published during 2005 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior (Section 2), and the roles of these opioid peptides and receptors in pain and analgesia (Section 3); stress and social status (Section 4); tolerance and dependence (Section 5); learning and memory (Section 6); eating and drinking (Section 7); alcohol and drugs of abuse (Section 8); sexual activity and hormones, pregnancy, development and endocrinology (Section 9); mental illness and mood (Section 10); seizures and neurologic disorders (Section 11); electrical-related activity, neurophysiology and transmitter release (Section 12); general activity and locomotion (Section 13); gastrointestinal, renal and hepatic functions (Section 14); cardiovascular responses (Section 15); respiration and thermoregulation (Section 16); immunological responses (Section 17).
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, 65-30 Kissena Blvd., Flushing, NY 11367, USA.
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