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Yoon DE, Lee S, Kim J, Kim K, Park HJ, Napadow V, Lee IS, Chae Y. Graded brain fMRI response to somatic and visual acupuncture stimulation. Cereb Cortex 2023; 33:11269-11278. [PMID: 37804240 DOI: 10.1093/cercor/bhad364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 10/09/2023] Open
Abstract
Increased stimulation can enhance acupuncture clinical response; however, the impact of acupuncture stimulation as "dosage" has rarely been studied. Furthermore, acupuncture can include both somatic and visual components. We assessed both somatic and visual acupuncture dosage effects on sensory ratings and brain response. Twenty-four healthy participants received somatic (needle inserted, manually stimulated) and visual (needle video, no manual stimulation) acupuncture over the leg at three different dosage levels (control, low-dose, and high-dose) during functional magnetic resonance imaging (fMRI). Participants reported the perceived deqi sensation for each acupuncture dose level. Blood-oxygen-level dependent imaging data were analyzed by general linear model and multivariate pattern analysis. For both somatic and visual acupuncture, reported deqi sensation increased with increased dosage of acupuncture stimulation. Brain fMRI analysis demonstrated that higher dosage of somatic acupuncture produced greater brain responses in sensorimotor processing areas, including anterior and posterior insula and secondary somatosensory cortex. For visual acupuncture, higher dosage of stimulation produced greater brain responses in visual-processing areas, including the middle temporal visual areas (V5/MT+) and occipital cortex. Psychophysical and psychophysiological responses to both somatic and visual acupuncture were graded in response to higher doses. Our findings suggest that acupuncture response may be enhanced by the dosage of needling-specific and nonspecific components, represented by different neural mechanisms.
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Affiliation(s)
- Da-Eun Yoon
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, Seoul, Korea
| | - Seoyoung Lee
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, Seoul, Korea
| | - Jundong Kim
- Department of Ophthalmology, Otorhinolaryngology and Dermatology of Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02247, Korea
| | - Kyuseok Kim
- Department of Ophthalmology, Otorhinolaryngology and Dermatology of Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02247, Korea
| | - Hi-Joon Park
- Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul 02247, Korea
| | - Vitaly Napadow
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Charlestown, MA 02129, United States
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, United States
| | - In-Seon Lee
- Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul 02247, Korea
| | - Younbyoung Chae
- Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul 02247, Korea
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Charlestown, MA 02129, United States
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Kwon CY. Gap between the Scientificization and Utilization of Korean Medicine for Depressive Disorder in South Korea with the Highest Suicide Rate among OECD Countries. J Clin Med 2022; 11:7022. [PMID: 36498597 PMCID: PMC9737407 DOI: 10.3390/jcm11237022] [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: 10/30/2022] [Revised: 11/25/2022] [Accepted: 11/26/2022] [Indexed: 11/29/2022] Open
Abstract
In South Korea, with the highest suicide rate among Organization for Economic Co-operation and Development countries, doctors of both Korean medicine (KM) and Western medicine (WM) are licensed in the national healthcare system. The beneficial effects of complementary and integrative medicine, including KM, for depressive disorders, a major cause of suicide, have been reported in some clinical studies. Longitudinal change (2012-2021) of KM and WM use for depressive disorders and the attempts to scientificize KM in the context of depressive disorders were investigated. Specifically, clinical practice guidelines (CPGs) and national R&D projects of KM in the treatment of depressive disorders were investigated. The use of KM treatment for patients with a depressive disorder appears to be gradually decreasing in South Korea (annual number of patients in 2012 and 2021: 3607 and 2151 (-40.37%)), while the use of WM treatment is increasing (662,947 and 989,909 (+49.32%)). With the support of the government, KM CPG for depressive disorders and some R&D projects on KM for depressive disorders are being implemented. Our findings highlight the gap between the accumulation of clinical evidence, or the government's efforts to promote the evidence-based use of KM for depressive disorders, and its practical use in South Korea.
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Affiliation(s)
- Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-Eui University College of Korean Medicine, 52-57 Yangjeong-ro, Busanjin-gu, Busan 47227, Republic of Korea
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Kim JT, Kim K, Ang L, Lee HW, Choi JY, Lee MS. Acupuncture for treating attention deficit hyperactivity disorder in children: A protocol for systematic review and meta-analysis. PLoS One 2022; 17:e0275504. [PMID: 36215241 PMCID: PMC9550064 DOI: 10.1371/journal.pone.0275504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/16/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) patients often use complementary and alternative medicine to treat symptoms, and acupuncture is one option. This systematic review aims to assess whether acupuncture is an effective treatment for attention deficit hyperactivity disorder (ADHD). METHODS We will search nine databases from their inception: PubMed, AMED, CINAHL, EMBASE, the Cochrane Central Register of Controlled Trials, RISS, KoreaMed, KISS, and the China National Knowledge Infrastructure database. Two investigators will independently review the selected studies, extract the data, and analyze them. The Cochrane Risk of Bias Assessment Tool will be used to assess the risk of bias. DISCUSSION Because this is a systematic review, no ethical approval is needed. The systematic review will be published in a peer-reviewed journal and disseminated both electronically and in print. The review will be updated to support health policy and practice. TRIAL REGISTRATION NUMBER Reviewregistry1345.
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Affiliation(s)
- Jung Tae Kim
- Department of Korean Pediatrics, School of Korean Medicine, Pusan National University, Yangsan, Republic of Korea
- IMOM Korean Medicine Clinic, Jeju, Republic of Korea
| | - Kibong Kim
- Department of Korean Pediatrics, School of Korean Medicine, Pusan National University, Yangsan, Republic of Korea
- Department of Korean Pediatrics, School of Korean Medicine & Korean Medicine Hospital, Pusan National University, Yangsan, Republic of Korea
| | - Lin Ang
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Hye Won Lee
- KM Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Jun-Yong Choi
- Department of Korean Internal Medicine, School of Korean Medicine & Korean Medicine Hospital, Pusan National University, Yangsan, Republic of Korea
| | - Myeong Soo Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Acupuncture for Managing Cancer-Related Fatigue in Breast Cancer Patients: A Systematic Review and Meta-Analysis. Cancers (Basel) 2022; 14:cancers14184419. [PMID: 36139579 PMCID: PMC9496910 DOI: 10.3390/cancers14184419] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/02/2022] [Accepted: 09/08/2022] [Indexed: 11/17/2022] Open
Abstract
Breast cancer (BC) is the most common cancer in women and is a serious threat to women's health. Cancer-related fatigue (CRF) is a distressing symptom in BC patients during and after chemotherapy or radiation therapy that severely affects quality of life (QoL). AT is widely used for fatigue management. However, the effect of AT on CRF is still uncertain. This study aimed to evaluate the efficacy and safety of AT in the management of CRF in patients with BC. Eleven databases were searched through June 2022. Two researchers independently performed the database search, study selection, data extraction, and risk of bias assessment. Study selection was performed based on predefined Participants, Intervention, Comparators, Outcomes, Study design (PICOS) criteria, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed when reporting the results. A meta-analysis was performed according to the Cochrane systematic review method using RevMan 5.3. A total of 12 studies including a total of 1084 participants were included. The results showed that AT had a beneficial effect compared with sham AT (n = 256, SMD = -0.26, 95% CI [-0.51, -0.01], p = 0.04, I2 = 0%) and a long-term effect on fatigue score (n = 209, MD = -0.32, 95% CI [-0.59, -0.04], p = 0.02, I2 = 0%). Meta-analysis showed that AT had a beneficial effect compared with usual care (UC) on fatigue scores (n = 238, SMD = -0.39, 95% CI [-0.66 to -0.12], p = 0.005, I2 = 0%). Of the 12 articles, 3 articles were judged as having a low risk of bias in all domains and hence were of high quality. No serious adverse effects were identified. AT is an effective and safe treatment for CRF, and AT is more effective than sham AT or UC or wait-list control (WLC). Nevertheless, the methodological quality of most of these studies was low, and the included studies/sample sizes were small, so the ability to derive decisive implications was limited. Further research is needed to confirm these findings.
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Heo JW, Jo JH, Lee JJ, Kang H, Choi TY, Lee MS, Kim JI. Electroacupuncture for the treatment of frozen shoulder: A systematic review and meta-analysis. Front Med (Lausanne) 2022; 9:928823. [PMID: 36059821 PMCID: PMC9433806 DOI: 10.3389/fmed.2022.928823] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundElectroacupuncture (EA) has reportedly been successful in controlling pain, but there have been no systematic reviews examining the impact of EA on patients with frozen shoulder (FS). The purpose of this review is to provide evidence on the safety and efficacy of EA for pain management in patients with FS.MethodsWe searched 11 databases from their inception: EMBASE, the Cochrane Library, PubMed, AMED, one Chinese medical database, and six Korean medical databases. Two researchers independently performed the study selection, data extraction, and assessment. Bias-related risk was evaluated using the Cochrane risk-of-bias assessment tool.ResultsThis review included thirteen studies involving 936 patients. The EA group exhibited improvements in FS pain (MD −1.11, 95% CI −1.61 to −0.61, p < 0.0001, I2 = 97%), function (SMD 2.02, 95% CI 0.36–3.69, p < 0.00001, I2 = 97%), and response rates (RR 1.16, 95% CI 1.07–1.25; p = 0.0002; I2 = 0%) over the manual acupuncture (MA) group. As an adjunct treatment, EA improved FS pain (SMD −1.12, 95% CI −1.52 to −0.71, P < 0.00001, I2 = 0) compared to the control treatments. No adverse effects were reported.ConclusionEA is reported to improve FS pain and function compared with control treatments. Additionally, EA can be used as an adjunct therapy for FS pain. EA could emerge as a potent intervention against FS.Systematic review registration[http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42021247090], identifier [CRD42021247090]
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Affiliation(s)
- Jeong-Weon Heo
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Jeong-Hun Jo
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Jung-Ju Lee
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Hee Kang
- Humanitas College, Kyung Hee University, Yongin, South Korea
| | - Tae-Young Choi
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Myeong Soo Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
- *Correspondence: Myeong Soo Lee,
| | - Jong-In Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
- Jong-In Kim,
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Lee IS, Chae Y. Exploring Acupuncture Actions in the Body and Brain. J Acupunct Meridian Stud 2022; 15:157-162. [PMID: 35770545 DOI: 10.51507/j.jams.2022.15.3.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 11/03/2022] Open
Abstract
Acupuncture's actions have been explained by biomedical research. However, the meridian system used in acupuncture needs further clarification. This review describes how acupuncture affects the body and brain. From the perspective of traditional East Asian medicine, the meridian system is closely connected with acupuncture's treatment effects. In the body, the indications of acupoints, primarily established based on the meridian system, have spatial symptom patterns. Spatial patterns of acupoint indications are distant from the stimulated sites and strongly associated with the corresponding meridian's route. Understanding how acupuncture works based on the original meridian system is important. From a neuroscience perspective, an acupuncture-induced sensation originates from the bottom-up action of simple needling in the peripheral receptor and the reciprocal interaction with top-down brain modulation. In the brain, enhanced bodily attention triggered by acupuncture stimulation can activate the salience network and deactivate the default mode network regardless of the actual stimulation. The application of data science technology to acupuncture research may provide new tools to uncover the principles of acupoint selection and enhance the clinical efficacy of acupuncture treatment in various diseases.
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Affiliation(s)
- In-Seon Lee
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - Younbyoung Chae
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Korea
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Li K, Wang J, Hu Z, Deng B, Yu H. Gating attractor dynamics of frontal cortex under acupuncture via recurrent neural network. IEEE J Biomed Health Inform 2022; 26:3836-3847. [PMID: 35290193 DOI: 10.1109/jbhi.2022.3158963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Acupuncture can regulate the functions of human body and improve the cognition of brain. However, the mechanism of acupuncture manipulations remains unclear. Here, we hypothesis that the frontal cortex plays a gating role in information routing of brain network under acupuncture. To that end, the gating effect of frontal cortex under acupuncture is analyzed in combination with EEG data of acupuncture at Zusanli acupoints. In addition, recurrent neural network (RNN) is used to reproduce the dynamics of frontal cortex under normal state and acupuncture state. From low-dimensional view, it is shown that the brain networks under acupuncture state can show stable attractor cycle dynamics, which may explain the regulation effect of acupuncture. Comparing with different manipulations, we find that the attractor of low-dimensional trajectory varies under different frequencies of acupuncture. Besides, a strip gated band of neural dynamics is found by changing the frequency of stimulation and excitatory-inhibitory balance of network. The attractor state is found to transport in the gating area under different stimulation frequencies, and the probability of attractor migration is different across acupuncture manipulations. This reverse engineering of brain network indicates that the differences among acupuncture manipulations are caused by interaction and separation in the neural activity space between attractors that encode acupuncture function. Consequently, our results may provide help for quantitative analysis of acupuncture, and benefit for the clinical guidance of acupuncture clinicians.
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