1
|
Al-Zamil M, Kulikova NG, Minenko IA, Shurygina IP, Petrova MM, Mansur N, Kuliev RR, Blinova VV, Khripunova OV, Shnayder NA. Comparative Analysis of High-Frequency and Low-Frequency Transcutaneous Electrical Stimulation of the Right Median Nerve in the Regression of Clinical and Neurophysiological Manifestations of Generalized Anxiety Disorder. J Clin Med 2024; 13:3026. [PMID: 38892737 PMCID: PMC11172620 DOI: 10.3390/jcm13113026] [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: 04/10/2024] [Revised: 05/15/2024] [Accepted: 05/19/2024] [Indexed: 06/21/2024] Open
Abstract
Background/Objectives: The anxiolytic effect of transcutaneous electrical nerve stimulation (TENS) is associated with the activation of endogenous inhibitory mechanisms in the central nervous system. Both low-frequency, high-amplitude TENS (LF-TENS) and high-frequency, low-amplitude TENS (HF-TENS) are capable of activating opioid, GABA, serotonin, muscarinic, and cannabinoid receptors. However, there has been no comparative analysis of the effectiveness of HF-TENS and LF-TENS in the treatment of GAD. The purpose of our research was to study the effectiveness of direct HF-TENS and LF-TENS of the right median nerve in the treatment of patients with GAD compared with sham TENS. Methods: The effectiveness of direct HF-TENS and LF-TENS of the right median nerve in the treatment of GAD was studied using Generalized Anxiety Disorder 7-item scale (GAD-7) and the Hamilton Anxiety Rating Scale (HAM-A). 40 patients underwent sham TENS, 40 patients passed HF-TENS (50 Hz-50 μs-sensory response) and 41 patients completed LF -TENS (1 Hz-200 μs-motor response) for 30 days daily. After completion of treatment, half of the patients received weekly maintenance therapy for 6 months. Electroencephalography was performed before and after treatment. Results: Our study showed that a significant reduction in the clinical symptoms of GAD as assessed by GAD-7 and HAM-A was observed after HF-TENS and LF-TENS by an average of 42.4%, and after sham stimulation only by 13.5% for at least 2 months after the end of treatment. However, LF-TENS turned out to be superior in effectiveness to HF-TENS by 51% and only on electroencephalography leads to an increase in PSD for the alpha rhythm in the occipital regions by 24% and a decrease in PSD for the beta I rhythm in the temporal and frontal regions by 28%. The prolonged effect of HF-TENS and LF-TENS was maintained without negative dynamics when TENS treatment was continued weekly throughout the entire six-month observation period. Conclusions: A prolonged anxiolytic effect of direct TENS of the right median nerve has been proven with greater regression of clinical and neurophysiological manifestations of GAD after LF-TENS compared to HF-TENS. Minimal side effects, low cost, safety, and simplicity of TENS procedures are appropriate as a home treatment modality.
Collapse
Affiliation(s)
- Mustafa Al-Zamil
- Department of Physiotherapy, Faculty of Continuing Medical Education, Peoples’ Friendship University of Russia, 117198 Moscow, Russia; (N.G.K.); (N.M.); (V.V.B.)
| | - Natalia G. Kulikova
- Department of Physiotherapy, Faculty of Continuing Medical Education, Peoples’ Friendship University of Russia, 117198 Moscow, Russia; (N.G.K.); (N.M.); (V.V.B.)
- Department of Sports Medicine and Medical Rehabilitation, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (I.A.M.); (O.V.K.)
| | - Inessa A. Minenko
- Department of Sports Medicine and Medical Rehabilitation, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (I.A.M.); (O.V.K.)
- Department of Restorative Medicine and Neurorehabilitation, Medical Dental Institute, 127253 Moscow, Russia;
| | - Irina P. Shurygina
- Department of Ophthalmology, Rostov State Medical University, 344022 Rostov, Russia;
| | - Marina M. Petrova
- Shared Core Facilities “Molecular and Cell Technologies”, Professor V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia;
| | - Numman Mansur
- Department of Physiotherapy, Faculty of Continuing Medical Education, Peoples’ Friendship University of Russia, 117198 Moscow, Russia; (N.G.K.); (N.M.); (V.V.B.)
- Department of Restorative Medicine and Neurorehabilitation, Medical Dental Institute, 127253 Moscow, Russia;
- City Clinical Hospital Named after V. V. Vinogradov, 117292 Moscow, Russia
| | - Rufat R. Kuliev
- Department of Restorative Medicine and Neurorehabilitation, Medical Dental Institute, 127253 Moscow, Russia;
| | - Vasilissa V. Blinova
- Department of Physiotherapy, Faculty of Continuing Medical Education, Peoples’ Friendship University of Russia, 117198 Moscow, Russia; (N.G.K.); (N.M.); (V.V.B.)
- Department of Restorative Medicine and Neurorehabilitation, Medical Dental Institute, 127253 Moscow, Russia;
| | - Olga V. Khripunova
- Department of Sports Medicine and Medical Rehabilitation, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (I.A.M.); (O.V.K.)
| | - Natalia A. Shnayder
- Shared Core Facilities “Molecular and Cell Technologies”, Professor V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia;
- Institute of Personalized Psychiatry and Neurology, V.M. Bekhterev National Medical Research Centre for Psychiatry and Neurology, 192019 Saint Petersburg, Russia
| |
Collapse
|
2
|
Wang J, Zhang Q, Yao L, He T, Chen X, Su Y, Sun S, Fan M, Yan J, Wang T, Zhang M, Guo F, Mo S, Lu M, Zou M, Li L, Yuan Q, Pan H, Chen Y. Modulating activity of PVN neurons prevents atrial fibrillation induced circulation dysfunction by electroacupuncture at BL15. Chin Med 2023; 18:135. [PMID: 37848944 PMCID: PMC10580609 DOI: 10.1186/s13020-023-00841-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 09/20/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Circulation dysfunction is a major contributing factor to thrombosis in patients with atrial fibrillation (AF) for which effective interventions are lacking. Growing evidence indicates that regulating the paraventricular nucleus (PVN), an autonomic control center, could offer a novel strategy for treating cardiovascular and circulatory diseases. Concurrently, electroacupuncture (EA) at Xinshu (BL15), a form of peripheral nerve stimulation, has shown efficacy in treating several cardiovascular conditions, although its specific mechanism remains unclear. This study aimed to assess the impact of EA at BL15 on circulatory dysfunction in a rat AF model and investigate the pivotal role of PVN neuronal activity. METHODS To mimic the onset of AF, male SD rats received tail intravenous injection of ACh-CaCl2 and were then subjected to EA at BL15, sham EA, or EA at Shenshu (BL23). Macro- and micro-circulation function were evaluated using in vivo ultrasound imaging and laser doppler testing, respectively. Vasomotricity was assessed by measuring dimension changes during vascular relaxation and contraction. Vascular endothelial function was measured using myograph, and the activation of the autonomic nerve system was evaluated through nerve activity signals. Additionally, chemogenetic manipulation was used to block PVN neuronal activation to further elucidate the role of PVN activation in the prevention of AF-induced blood circulation dysfunction through EA treatment. RESULTS Our data demonstrate that EA at BL15, but not BL23 or sham EA, effectively prevented AF-induced macro- and micro-circulation dysfunction. Furthermore, EA at BL15 restored AF-induced vasomotricity impairment. Additionally, EA treatment prevented abnormal activation of the autonomic nerve system induced by AF, although it did not address vascular endothelial dysfunction. Importantly, excessive activation of PVN neurons negated the protective effects of EA treatment on AF-induced circulation dysfunction in rats. CONCLUSION These results indicate that EA treatment at BL15 modulates PVN neuronal activity and provides protection against AF-induced circulatory dysfunction.
Collapse
Affiliation(s)
- Jingya Wang
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, 250355, People's Republic of China
- South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, 510006, People's Republic of China
| | - Qiumei Zhang
- South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, 510006, People's Republic of China
- Institute of Physical and Health, Guangzhou University of Chinese Medicine, Guangzhou, 510006, People's Republic of China
- Guangdong Chaozhou Health Vocational College, Chaozhou, 521000, People's Republic of China
| | - Lin Yao
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, 250355, People's Republic of China
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, People's Republic of China
| | - Teng He
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, 250355, People's Republic of China
| | - Xinyi Chen
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, People's Republic of China
| | - Yang Su
- South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, 510006, People's Republic of China
| | - Shengxuan Sun
- South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, 510006, People's Republic of China
| | - Mengyue Fan
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, 250355, People's Republic of China
| | - Jinglan Yan
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, 250355, People's Republic of China
| | - Taiyi Wang
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, 250355, People's Republic of China
| | - Meng Zhang
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, 250355, People's Republic of China
| | - Feng Guo
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, 250355, People's Republic of China
| | - Shiqing Mo
- South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, 510006, People's Republic of China
| | - Manqi Lu
- South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, 510006, People's Republic of China
| | - Meixia Zou
- South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, 510006, People's Republic of China
| | - Liangjie Li
- South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, 510006, People's Republic of China
| | - Qing Yuan
- South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, 510006, People's Republic of China
| | - Huashan Pan
- Institute of Physical and Health, Guangzhou University of Chinese Medicine, Guangzhou, 510006, People's Republic of China.
- Guangdong Chaozhou Health Vocational College, Chaozhou, 521000, People's Republic of China.
| | - Yongjun Chen
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, 250355, People's Republic of China.
- South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, 510006, People's Republic of China.
| |
Collapse
|
3
|
Sanchez-Perez JA, Gazi AH, Rahman FN, Seith A, Saks G, Sundararaj S, Erbrick R, Harrison AB, Nichols CJ, Modak M, Chalumuri YR, Snow TK, Hahn JO, Inan OT. Transcutaneous auricular Vagus Nerve Stimulation and Median Nerve Stimulation reduce acute stress in young healthy adults: a single-blind sham-controlled crossover study. Front Neurosci 2023; 17:1213982. [PMID: 37746156 PMCID: PMC10512834 DOI: 10.3389/fnins.2023.1213982] [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: 04/28/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
Stress is a major determinant of health and wellbeing. Conventional stress management approaches do not account for the daily-living acute changes in stress that affect quality of life. The combination of physiological monitoring and non-invasive Peripheral Nerve Stimulation (PNS) represents a promising technological approach to quantify stress-induced physiological manifestations and reduce stress during everyday life. This study aimed to evaluate the effectiveness of three well-established transcutaneous PNS modalities in reducing physiological manifestations of stress compared to a sham: auricular and cervical Vagus Nerve Stimulation (taVNS and tcVNS), and Median Nerve Stimulation (tMNS). Using a single-blind sham-controlled crossover study with four visits, we compared the stress mitigation effectiveness of taVNS, tcVNS, and tMNS, quantified through physiological markers derived from five physiological signals peripherally measured on 19 young healthy volunteers. Participants underwent three acute mental and physiological stressors while receiving stimulation. Blinding effectiveness was assessed via subjective survey. taVNS and tMNS relative to sham resulted in significant changes that suggest a reduction in sympathetic outflow following the acute stressors: Left Ventricular Ejection Time Index (LVETI) shortening (tMNS: p = 0.007, taVNS: p = 0.015) and Pre-Ejection Period (PEP)-to-LVET ratio (PEP/LVET) increase (tMNS: p = 0.044, taVNS: p = 0.029). tMNS relative to sham also reduced Pulse Pressure (PP; p = 0.032) and tonic EDA activity (tonicMean; p = 0.025). The nonsignificant blinding survey results suggest these effects were not influenced by placebo. taVNS and tMNS effectively reduced stress-induced sympathetic arousal in wearable-compatible physiological signals, motivating their future use in novel personalized stress therapies to improve quality of life.
Collapse
Affiliation(s)
| | - Asim H. Gazi
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Farhan N. Rahman
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Alexis Seith
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Georgia Saks
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | | | - Rachel Erbrick
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Anna B. Harrison
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Christopher J. Nichols
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Mihir Modak
- Department of Bioengineering, University of Maryland, College Park, MD, United States
| | - Yekanth R. Chalumuri
- Department of Mechanical Engineering, University of Maryland, College Park, MD, United States
| | - Teresa K. Snow
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States
| | - Jin-Oh Hahn
- Department of Mechanical Engineering, University of Maryland, College Park, MD, United States
| | - Omer T. Inan
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| |
Collapse
|
4
|
Ma LH, Zhang Z, Ma LX, Mu JD, Qian X, Zhang QY, Sun TY. Biofeedback physical regulation of hypertension based on acupoints: A clinical trial. Medicine (Baltimore) 2023; 102:e33946. [PMID: 37352053 PMCID: PMC10289684 DOI: 10.1097/md.0000000000033946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/16/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Hypertension is a predominant risk factor for cardiovascular disease and has imposed a global disease burden. Poor medication compliance is the major obstacle to antihypertensive drug therapy, and negative mood status is also detrimental to blood pressure (BP) management. While transcutaneous electrical acupoint stimulation (TEAS), as an electrical stimulation modality for biofeedback physical regulation based on acupoints, offers a such nondrug alternative option that is noninvasive, safe, and effective with high adherence. However, the optimal stimulation parameters of TEAS for hypertension remain unclear, especially the frequency, which needs further exploration. OBJECTIVE The study aims to investigate the efficacy of TEAS for hypertension, and to screen the optimal electrical stimulation frequency. METHODS This is an 8-week, randomized, controlled pilot trial with 3 parallel groups. In a ratio of 1:1:1, 120 patients with stage 1 hypertension will be divided into the TEAS-2Hz group, TEAS-10Hz group, or usual care group. All patients will receive the usual care for hypertension including lifestyle education, etc. Additionally, the 2 TEAS groups will receive 12 sessions of TEAS interventions at 2 Hz or 10 Hz, 3 times weekly for 30 minutes each, with 4 weeks of follow-up. The main outcome will be the change from baseline to week 4 in systolic BP among the groups. Secondary outcomes consist of changes in diastolic BP, mean arterial pressure, heart rate, heart rate variability, medication adherence, and quality of life. The safety outcomes will be any adverse event during the treatment. DISCUSSION As a pre-study for the next large clinical trial of TEAS for hypertension, this study will offer references for optimized frequency of biofeedback electrical devices and promote more consciousness of the benefits of body-mind holistic regulation of BP, thereby achieving proactive and overall process management of BP.
Collapse
Affiliation(s)
- Ling-Hui Ma
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Zhou Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Liang-Xiao Ma
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
- The Key Unit of State Administration of Traditional Chinese Medicine, Evaluation of Characteristic Acupuncture Therapy, Beijing, China
| | - Jie-Dan Mu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xu Qian
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Qin-Yong Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Tian-Yi Sun
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| |
Collapse
|
5
|
Bang SK, Chang S, Seo SY, Kang SY, Cho SJ, Choi KH, Juping X, Kim HY, Ryu Y. Attenuation of immobilization stress-induced hypertension by temperature-controllable warm needle acupuncture in rats and the peripheral neural mechanisms. Front Neurol 2023; 14:1168012. [PMID: 37384285 PMCID: PMC10294230 DOI: 10.3389/fneur.2023.1168012] [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: 02/17/2023] [Accepted: 05/26/2023] [Indexed: 06/30/2023] Open
Abstract
Introduction We and others have shown that electrical stimulation of the PC-6 acupoint over the wrist relieves hypertension by stimulating afferent sensory nerve fibers and activating the central endogenous opioid system. Warm needle acupuncture has long been utilized to treat various diseases in clinics. Methods Here, we developed a temperature-controllable warm needle acupuncture instrument (WAI) and investigated the peripheral mechanism underlying the effect of warm needle acupuncture at PC-6 on hypertension in a rat model of immobilization stress-induced hypertension. Results Stimulation with our newly developed WAI and traditional warm needle acupuncture attenuated hypertension development. Such effects were reproduced by capsaicin (a TRPV1 agonist) injection into PC-6 or WAI stimulation at 48°C. In contrast, PC-6 pretreatment with the TRPV1 antagonist capsazepine blocked the antihypertensive effect of WAI stimulation at PC-6. WAI stimulation at PC-6 increased the number of dorsal root ganglia double-stained with TRPV1 and CGRP. QX-314 and capsaicin perineural injection into the median nerve for chemical ablation of small afferent nerve fibers (C-fibers) prevented the antihypertensive effect of WAI stimulation at PC-6. Additionally, PC-6 pretreatment with RTX ablated the antihypertensive effect of WAI stimulation. Conclusion These findings suggest that warm needle acupuncture at PC-6 activates C-fiber of median nerve and the peripheral TRPV1 receptors to attenuate the development of immobilization stress-induced hypertension in rats.
Collapse
Affiliation(s)
- Se Kyun Bang
- Department of Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- Department of Korean convergence Medical Science, University of Science and Technology, Daejeon, Republic of Korea
| | - Suchan Chang
- Department of Physiology, College of Korean Medicine, Daegu Haany University, Daegu, Republic of Korea
| | - Su Yeon Seo
- Department of Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Suk-Yun Kang
- Department of Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Seong Jin Cho
- Department of Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Kwang-Ho Choi
- Department of Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Xing Juping
- Department of Physiology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hee Young Kim
- Department of Physiology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yeonhee Ryu
- Department of Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- Department of Korean convergence Medical Science, University of Science and Technology, Daejeon, Republic of Korea
| |
Collapse
|
6
|
Giollo-Junior LT, Cosenso-Martin LN, da Silva Lopes V, Paz Landim M, Barufi Fernandes LA, Aparecido de Oliveira K, Spaziani AO, Santos AP, Silva MA, Yugar-Toledo JC, Vilela-Martin JF. The Effect of Transcutaneous Electrical Nerve Stimulation in Peripheral and Central Hemodynamic Parameters on Resistant Hypertension: A Case Report. Vasc Health Risk Manag 2023; 19:317-323. [PMID: 37215282 PMCID: PMC10199678 DOI: 10.2147/vhrm.s408082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/04/2023] [Indexed: 05/24/2023] Open
Abstract
Resistant hypertension (RH) is characterized by being difficult to control, even with the use of various antihypertensive drugs and is associated with target organ lesions and other comorbidities. Thus, new treatment alternatives such as transcutaneous electrical nerve stimulation (TENS) can offer benefits to resistant hypertensive patients by reducing blood pressure (BP) in a non-invasive way and without the need for the association of more antihypertensive drugs. In this case, a patient with RH was submitted to three weekly applications of TENS on the stellate ganglion lasting 40 min each for 1 month. Peripheral and central hemodynamic assessments were performed by 24-h ambulatory BP monitoring (ABPM) before and after TENS applications. After completion of the TENS applications, significant reductions in office systolic (SBP) and diastolic BP (DBP) were observed. There was also a decrease in peripheral SBP and DBP in the 24-h ABPM and sleep and SBP during wakefulness. Additionally, central parameters including central SBP and pulse wave velocity presented a significant reduction in the 24-h ABPM, during the wakefulness and sleep. TENS is able to attenuate the sympathetic hyperactivity present in RH cases and decrease the peripheral and central hemodynamic parameters of a resistant hypertensive patient.
Collapse
Affiliation(s)
- Luiz Tadeu Giollo-Junior
- General Hospital at Brazilian Army, Curitiba, Parana, Brazil
- Hypertension Clinic - Internal Medicine Department, State Medical School in Sao Jose do Rio Preto (FAMERP), Sao Jose do Rio Preto, São Paulo, Brazil
| | - Luciana Neves Cosenso-Martin
- Hypertension Clinic - Internal Medicine Department, State Medical School in Sao Jose do Rio Preto (FAMERP), Sao Jose do Rio Preto, São Paulo, Brazil
| | - Valquiria da Silva Lopes
- Hypertension Clinic - Internal Medicine Department, State Medical School in Sao Jose do Rio Preto (FAMERP), Sao Jose do Rio Preto, São Paulo, Brazil
| | - Manoel Paz Landim
- Hypertension Clinic - Internal Medicine Department, State Medical School in Sao Jose do Rio Preto (FAMERP), Sao Jose do Rio Preto, São Paulo, Brazil
| | - Leticia Aparecida Barufi Fernandes
- Hypertension Clinic - Internal Medicine Department, State Medical School in Sao Jose do Rio Preto (FAMERP), Sao Jose do Rio Preto, São Paulo, Brazil
| | - Kleber Aparecido de Oliveira
- Hypertension Clinic - Internal Medicine Department, State Medical School in Sao Jose do Rio Preto (FAMERP), Sao Jose do Rio Preto, São Paulo, Brazil
| | - Amanda Oliva Spaziani
- Hypertension Clinic - Internal Medicine Department, State Medical School in Sao Jose do Rio Preto (FAMERP), Sao Jose do Rio Preto, São Paulo, Brazil
| | - Aleandra Polegati Santos
- Hypertension Clinic - Internal Medicine Department, State Medical School in Sao Jose do Rio Preto (FAMERP), Sao Jose do Rio Preto, São Paulo, Brazil
| | - Marco Antonio Silva
- Hypertension Clinic - Internal Medicine Department, State Medical School in Sao Jose do Rio Preto (FAMERP), Sao Jose do Rio Preto, São Paulo, Brazil
| | - Juan Carlos Yugar-Toledo
- Hypertension Clinic - Internal Medicine Department, State Medical School in Sao Jose do Rio Preto (FAMERP), Sao Jose do Rio Preto, São Paulo, Brazil
| | - Jose Fernando Vilela-Martin
- Hypertension Clinic - Internal Medicine Department, State Medical School in Sao Jose do Rio Preto (FAMERP), Sao Jose do Rio Preto, São Paulo, Brazil
| |
Collapse
|
7
|
Cho SJ, Choi KH, Kim MJ, Kwon OS, Kang SY, Seo SY, Ryu Y. Biopotential changes of acupuncture points by acupuncture stimulation. Integr Med Res 2022; 11:100871. [PMID: 35865757 PMCID: PMC9294553 DOI: 10.1016/j.imr.2022.100871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 11/24/2022] Open
Abstract
Background The energy flow at acupuncture point is important for understanding the mechanism of acupuncture treatment. However, there are few studies on energy at acupuncture point, and related studies have limitation in explaining the energy flow in all meridians. Thus, we aimed to understand the properties of electrical energy at acupuncture point in twelve meridians by measuring the biopotential at acupuncture and non-acupuncture points. Methods For each meridian, twenty subjects were participated, and biopotential was measured at five transport points and their adjacent non-acupuncture points. In each subject, both ‘non-stimulation’ and ‘stimulation’ experiments were conducted in random order. The data were analyzed in two parts: biopotential variability and biopotential difference between acupuncture and non-acupuncture points. Results The biopotential variability at acupuncture point was increased by acupuncture stimulation, and it was related to the activation of Qi flow by acupuncture stimulation. The biopotential difference between acupuncture and non-acupuncture points was formed in the direction related to the Qi flow theory, and this biopotential difference tended to decrease by acupuncture stimulation. Conclusion The study on biopotential can provide a foundation for research on energy flow mechanism of acupuncture stimulation, and it is expected to overcome limitation of qualitative explanation in traditional medicine.
Collapse
|
8
|
Chen L, Shen Y, Liu S, Cao Y. Transcutaneous Electrical Acupoint Stimulation Improved Preoperative Blood Pressure in Gynecological Malignant Tumor Patients With Hypertension: A Randomized, Controlled Trial. Front Oncol 2022; 12:906528. [PMID: 35720011 PMCID: PMC9198572 DOI: 10.3389/fonc.2022.906528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Gynecological malignant tumor patients with hypertension, even if blood pressure is well controlled, are prone to hypertension before surgery. We plan to verify the effect of transcutaneous electrical acupoint stimulation (TEAS) on stabilizing blood pressure before operation. Methods We enrolled 91 patients and randomly divided them into TEAS group (n=46) and control group (n=45). Patients in TEAS group received TEAS at acupoints Hegu and Neiguan. Patients in control group received transcutaneous electrical stimulation at the nonacupoint position of the upper limbs. After entering the operating room, the blood pressure before and after induction was measured. The main results were the occurrence of preinduction hypertension and postinduction hypotension. Results There was no difference in the general information of the two groups. There were four cases (9%) of preinduction hypertension in TEAS group and 13 cases (29%) in control group. The incidence in TEAS group was significantly lower (P=0.013). There were five cases (11%) of postinduction hypotension in TEAS group and eight cases (18%) in control group. There was no significant difference between the two groups (P=0.346). The systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean blood pressure (MBP) of the highest blood pressure before induction in TEAS group were lower than those in control group (P=0.002, 0.002, and 0.001). There was no difference in SBP, DBP, or MBP between the two groups on the day before the operation. There was no difference in the lowest blood pressure before operation between the two groups after induction Conclusion TEAS can prevent preinduction hypertension in patients with gynecological malignant tumors. Clinical Trial Registration http://www.chictr.org.cn/showproj.aspx?proj=143276, identifier ChiCTR2100054336.
Collapse
Affiliation(s)
- Liang Chen
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Shen
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shuangmei Liu
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yanyan Cao
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China
| |
Collapse
|
9
|
Shin JH, Fan Y, Kim DH, Jang HB, Chang S, Ryu Y, Bae JH, Lee S, Lee BH, Steffensen SC, Yang CH, Kim HY. Paired mechanical and electrical acupuncture of neurogenic spots induces opioid-mediated suppression of hypertension in rats. J Physiol Sci 2020; 70:14. [PMID: 32039692 PMCID: PMC7005077 DOI: 10.1186/s12576-020-00735-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 11/10/2019] [Indexed: 12/12/2022]
Abstract
While our recent studies have suggested that effective acupoints display neurogenic inflammation and can be identified as neurogenic spots (Neuro-Sps), the optimal stimulation conditions and the underlying mechanisms remain uncharacterized. We developed a combined mechano-electrical acupuncture device (MEA) and examined the effects of acupuncture at Neuro-Sps on systolic blood pressure (BP) in a rat model of immobilization-induced hypertension (IMH) and the mediation of endogenous opioid systems in its effect. Cutaneous neurogenic spots were found mostly in the forelimb. Electrical and mechanical acupuncture of Neuro-Sps increased 22-kHz ultrasonic vocalizations (USVs), c-Fos expression and cell excitability in the midbrain and synergistically alleviated the development of hypertension following immobilization stress, which was prevented by administration of the opioid antagonist naloxone into the rostral ventrolateral medulla (rVLM). These findings suggest that mechanical and electrical stimulation at Neuro-Sps suppresses the development of hypertension via mediation of the endogenous opioid system.
Collapse
Affiliation(s)
- Joo Hyun Shin
- Department of Physiology, College of Korean Medicine, Daegu Haany University, Daegu, 42158, South Korea
| | - Yu Fan
- Department of Physiology, College of Korean Medicine, Daegu Haany University, Daegu, 42158, South Korea
| | - Do-Hee Kim
- Department of Physiology, College of Korean Medicine, Daegu Haany University, Daegu, 42158, South Korea
| | - Han Byeol Jang
- Department of Physiology, College of Korean Medicine, Daegu Haany University, Daegu, 42158, South Korea
| | - Suchan Chang
- Department of Physiology, College of Korean Medicine, Daegu Haany University, Daegu, 42158, South Korea
| | - Yeonhee Ryu
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, 34054, South Korea
| | - Jong Han Bae
- Department of Physics, Yeungnam University, Gyeongsan, Gyeongbukdo, 38541, South Korea
| | - Sanghag Lee
- TriBell Lab, Yeungnam University, Gyeongsan, Gyeongbukdo, 38541, South Korea
| | - Bong Hyo Lee
- Department of Physiology, College of Korean Medicine, Daegu Haany University, Daegu, 42158, South Korea
| | - Scott C Steffensen
- Department of Psychology and Neuroscience, Brigham Young University, Provo, UT, 84602, USA
| | - Chae Ha Yang
- Department of Physiology, College of Korean Medicine, Daegu Haany University, Daegu, 42158, South Korea
| | - Hee Young Kim
- Department of Physiology, College of Korean Medicine, Daegu Haany University, Daegu, 42158, South Korea.
| |
Collapse
|
10
|
Kanashiro A, Hiroki CH, da Fonseca DM, Birbrair A, Ferreira RG, Bassi GS, Fonseca MD, Kusuda R, Cebinelli GCM, da Silva KP, Wanderley CW, Menezes GB, Alves-Fiho JC, Oliveira AG, Cunha TM, Pupo AS, Ulloa L, Cunha FQ. The role of neutrophils in neuro-immune modulation. Pharmacol Res 2019; 151:104580. [PMID: 31786317 DOI: 10.1016/j.phrs.2019.104580] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/07/2019] [Accepted: 11/27/2019] [Indexed: 01/10/2023]
Abstract
Neutrophils are peripheral immune cells that represent the first recruited innate immune defense against infections and tissue injury. However, these cells can also induce overzealous responses and cause tissue damage. Although the role of neutrophils activating the immune system is well established, only recently their critical implications in neuro-immune interactions are becoming more relevant. Here, we review several aspects of neutrophils in the bidirectional regulation between the nervous and immune systems. First, the role of neutrophils as a diffuse source of acetylcholine and catecholamines is controversial as well as the effects of these neurotransmitters in neutrophil's functions. Second, neutrophils contribute for the activation and sensitization of sensory neurons, and thereby, in events of nociception and pain. In addition, nociceptor activation promotes an axon reflex triggering a local release of neural mediators and provoking neutrophil activation. Third, the recruitment of neutrophils in inflammatory responses in the nervous system suggests these immune cells as innovative targets in the treatment of central infectious, neurological and neurodegenerative disorders. Multidisciplinary studies involving immunologists and neuroscientists are required to define the role of the neurons-neutrophils communication in the pathophysiology of infectious, inflammatory, and neurological disorders.
Collapse
Affiliation(s)
- Alexandre Kanashiro
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil; Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | - Carlos Hiroji Hiroki
- Department of Immunology and Biochemistry, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Denise Morais da Fonseca
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Alexander Birbrair
- Department of Pathology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Raphael Gomes Ferreira
- Araguaína Medical School, Federal University of Tocantins, Avenida Paraguai s/n, 77824-838, Araguaína, TO, Brazil
| | - Gabriel Shimizu Bassi
- Center for Perioperative Organ Protection, Department of Anesthesiology, Duke University, Durham, NC, 27710, USA
| | - Mirian D Fonseca
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ricardo Kusuda
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Katiussia Pinho da Silva
- Department of Pharmacology, Instituto de Biociências, Universidade Estadual Paulista, Botucatu, SP, Brazil
| | - Carlos Wagner Wanderley
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - José Carlos Alves-Fiho
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - André Gustavo Oliveira
- Department of Physiology and Biophysics, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Thiago M Cunha
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - André Sampaio Pupo
- Department of Pharmacology, Instituto de Biociências, Universidade Estadual Paulista, Botucatu, SP, Brazil
| | - Luis Ulloa
- Center for Perioperative Organ Protection, Department of Anesthesiology, Duke University, Durham, NC, 27710, USA.
| | - Fernando Queiroz Cunha
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
| |
Collapse
|
11
|
Guo ZL, Malik S. Acupuncture activates a direct pathway from the nucleus tractus solitarii to the rostral ventrolateral medulla. Brain Res 2019; 1708:69-77. [PMID: 30529283 PMCID: PMC6378112 DOI: 10.1016/j.brainres.2018.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 11/05/2018] [Accepted: 12/05/2018] [Indexed: 12/12/2022]
Abstract
Our previous studies have shown that electroacupuncture (EA) at the Jianshi-Neiguan acupoints (P5-6, overlying the median nerve) attenuates sympathoexcitatory responses through its influence on neuronal activity in the rostral ventrolateral medulla (rVLM). The nucleus tractus solitarii (NTS) receives input from somatic nerve stimulation. Connections between the NTS and the rVLM during EA stimulation have not been investigated and thus were the focus of the present study. Seven to ten days after unilateral microinjection of a rhodamine-conjugated microsphere retrograde tracer (100 nl) into the rVLM, rats were subjected to EA or sham-EA without electrical stimulation. EA was performed for 30 min at the P5-6 acupoints bilaterally. Perikarya containing the microsphere tracer were found in the NTS of both groups. Compared to controls (needle placement without electrical stimulation, n = 7), c-Fos immunoreactivity and neurons double-labeled with c-Fos, an immediate early gene, and the tracer were significantly increased in the NTS of EA-treated rats (all P < 0.05; n = 8), particularly, in the medial and lateral subdivisions of NTS at subpostremal and obex levels. These results suggest that EA at the P5-6 acupoints activates NTS neurons. Furthermore, EA-activated NTS neurons directly project to the rVLM and likely influence the rVLM activity.
Collapse
Affiliation(s)
- Zhi-Ling Guo
- Department of Medicine and Susan Samueli Integrative Health Institute, School of Medicine, University of California, Irvine, Irvine, CA 92697, USA.
| | - Shaista Malik
- Department of Medicine and Susan Samueli Integrative Health Institute, School of Medicine, University of California, Irvine, Irvine, CA 92697, USA
| |
Collapse
|