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Wang PZ, Pressman A, Sanchez G, Aparicio C, Nielsen A, Avins A. Prior acupuncture experience among elderly participants enrolled in a clinical trial of acupuncture for chronic low back pain: Implications for future trials. Integr Med Res 2024; 13:101042. [PMID: 38765784 PMCID: PMC11101849 DOI: 10.1016/j.imr.2024.101042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 04/13/2024] [Accepted: 04/16/2024] [Indexed: 05/22/2024] Open
Abstract
Background The effectiveness of acupuncture for chronic low back pain (cLBP) has not been studied specifically in the 65-and-older population. To inform the validity and generalizability of future acupuncture studies among older adults, we characterized elderly participants' prior experience with and views toward acupuncture and tested for clinical and sociodemographic differences between acupuncture-naïve and non-naïve participants. Methods Data for this study were collected during the baseline telephone interview from the participants enrolled in the Kaiser Permanente Northern California site of an NIH-funded, multicenter clinical trial of acupuncture for cLBP in older adults. Results Nearly two-thirds (65.6 %) of participants surveyed reported they had previously received acupuncture treatment with the vast majority seeking acupuncture treatment for pain-related issues (84.8 %). The majority of these participants reported relatively modest levels of exposure to acupuncture with most participants (63.1 %) reporting fewer than 10 treatment sessions over their lifetimes. There were no significant differences in age, sex, race, ethnicity, disability scores, income levels, or pain levels between the acupuncture-naïve and non-naïve groups. Conclusion Contextual consideration for prior acupuncture utilization rates is warranted and may be higher than expected or previously reported. We found few differences in baseline characteristics between participants who were acupuncture-naïve and those with prior acupuncture experience; thus, future pragmatic clinical trials might relax previous acupuncture-use considerations in their recruitment criteria. For trials focused on acupuncture-naive patients, it may be more feasible to expand the definition of "acupuncture-naive" based on lifetime acupuncture visits or time since last treatment. Trial registration The protocol was registered at clinicaltrials.gov (#NCT04982315).
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Affiliation(s)
- Prince Ziyi Wang
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Alice Pressman
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Gabriela Sanchez
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Crystal Aparicio
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Arya Nielsen
- Icahn School of Medicine at Mount Sinai, Department of Family Medicine & Community Health. New York, New York, USA
| | - Andrew Avins
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
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Zhou F, Wang Z, Xiong K, Zhang M, Wang Q, Wang Y, Li X. Olfactory three needle regulates the proliferation of olfactory bulb neural stem cells and ameliorates brain injury after subarachnoid hemorrhage by regulating Wnt/β-catenin signaling. Heliyon 2024; 10:e28551. [PMID: 38596082 PMCID: PMC11002047 DOI: 10.1016/j.heliyon.2024.e28551] [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: 08/25/2023] [Revised: 03/14/2024] [Accepted: 03/20/2024] [Indexed: 04/11/2024] Open
Abstract
Background Subarachnoid hemorrhage (SAH) is a serious cerebrovascular emergency. The incidence of SAH and hazard ratio of death increase with age. Objective In this study, we aimed to observe the effects and potential mechanisms of olfactory three needle (OTN) on cognitive impairment, neuronal activity, and neural stem cell differentiation in SAH rats. Methods Sprague-Dawley (SD) rats were randomly divided into five groups: Sham, SAH group, SAH + Nimodipine (NMP) group, and SAH + OTN group. The rats in the SAH + OTN group received the OTN electroacupuncture treatment. For treatment with recombinant DKK1 (a Wnt/β-catenin inhibitor), mice were injected with DKK1. Results Our results found that OTN improved cognitive impairment and hippocampal neuron damage in SAH rats. Furthermore, OTN promoted the proliferation of neural stem cells in SAH rats. Mechanistically, OTN activated Wnt/β-catenin signaling in SAH rats, as indicated by the increased expression levels of Wnt1, β-Catenin, LMNB1, and p-GSK-3β. DKK1 reversed the improvement effect of OTN on cognitive impairment and neuronal damage in SAH rats. Meanwhile, DKK1 blocked the promoting effect of OTN on the proliferation of NSCs in SAH rats. Conclusions OTN electroacupuncture may be an effective therapeutic strategy for SAH.
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Affiliation(s)
- Feng Zhou
- Department of Neurosurgery, The Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712020, China
| | - Zhenzhi Wang
- Department of Chinese and Western Medicine, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712046, China
| | - Kang Xiong
- Department of Chinese and Western Medicine, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712046, China
| | - Meiling Zhang
- Department of Chinese and Western Medicine, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712046, China
| | - Qiang Wang
- Combination of Acupuncture and Medicine Innovation Research Center, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712046, China
| | - Yuan Wang
- Combination of Acupuncture and Medicine Innovation Research Center, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712046, China
| | - Xiong Li
- Department of Chinese and Western Medicine, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712046, China
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Wang Y, Yang X, Cao Y, Li X, Xu R, Yan J, Guo Z, Sun S, Sun X, Wu Y. Electroacupuncture promotes remyelination and alleviates cognitive deficit via promoting OPC differentiation in a rat model of subarachnoid hemorrhage. Metab Brain Dis 2023; 38:687-698. [PMID: 36383326 DOI: 10.1007/s11011-022-01102-5] [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: 02/07/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022]
Abstract
Subarachnoid hemorrhage (SAH) is a devastating cerebral vascular disease which causes neurological deficits including long-term cognitive deficit. Demyelination of white matter is correlated with cognitive deficit in SAH. Electroacupuncture (EA) is a traditional Chinese medical treatment which protects against cognitive deficit in varies of neurological diseases. However, whether EA exerts protective effect on cognitive function in SAH has not been investigated. The underlying mechanism of remyelination regulated by EA remains unclear. This study aimed to investigate the protective effects of EA on cognitive deficit in a rat model of SAH. SAH was induced in SD rats (n = 72) by endovascular perforation. Rats in EA group received EA treatment (10 min per day) under isoflurane anesthesia after SAH. Rats in SAH and sham groups received the same isoflurane anesthesia with no treatment. The mortality rate, neurological score, cognitive function, cerebral blood flow (CBF), and remyelination in sham, SAH and EA groups were assessed at 21 d after SAH.EA treatment alleviated cognitive deficits and myelin injury of rats compared with that in SAH group. Moreover, EA treatment enhanced remyelination in white matter and promoted the differentiation of OPCs after SAH. EA treatment inhibited the expression of Id2 and promoted the expression of SOX10 in oligodendrocyte cells. Additionally, the cerebral blood flow (CBF) of rats was increased by EA compared with that in SAH group. EA treatment exerts protective effect against cognitive deficit in the late phase of SAH. The underlying mechanisms involve promoting oligodendrocyte progenitor cell (OPC) differentiation and remyelination in white matter via regulating the expression of Id2 and SOX10. The improvement of CBF may also account for the protective effect of EA on cognitive function. EA treatment is a potential therapy for the treatment of cognitive deficit after SAH.
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Affiliation(s)
- Yingwen Wang
- Departement of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, NO.1 of Youyi Road, Yuzhong District, Chongqing, China
| | - Xiaomin Yang
- Departement of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, NO.1 of Youyi Road, Yuzhong District, Chongqing, China
| | - Yunchuan Cao
- Departement of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, NO.1 of Youyi Road, Yuzhong District, Chongqing, China
| | - Xiaoguo Li
- Departement of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, NO.1 of Youyi Road, Yuzhong District, Chongqing, China
| | - Rui Xu
- Departement of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, NO.1 of Youyi Road, Yuzhong District, Chongqing, China
| | - Jin Yan
- Departement of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, NO.1 of Youyi Road, Yuzhong District, Chongqing, China
| | - Zongduo Guo
- Departement of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, NO.1 of Youyi Road, Yuzhong District, Chongqing, China
| | - Shanquan Sun
- Institute of Neuroscience, Chongqing Medical University, Chongqing, China
| | - Xiaochuan Sun
- Departement of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, NO.1 of Youyi Road, Yuzhong District, Chongqing, China.
| | - Yue Wu
- Departement of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, NO.1 of Youyi Road, Yuzhong District, Chongqing, China.
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Slavin KV, Vannemreddy P. Cervical spinal cord stimulation for prevention and treatment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage: clinical and radiographic outcomes of a prospective single-center clinical pilot study. Acta Neurochir (Wien) 2022; 164:2927-2937. [PMID: 35920945 DOI: 10.1007/s00701-022-05325-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 07/21/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Cerebral vasospasm induced by aneurysmal subarachnoid hemorrhage (aSAH) is a major cause of high morbidity and mortality, for which there is no consistently effective treatment. Cervical spinal cord stimulation (cSCS) has been shown to induce vasodilatation and improve peripheral and cerebral blood flow in both animal and human studies. This pilot study was performed to assess the clinical effect and long-term results of cSCS treatment in aSAH patients. METHODS This was the first IRB- and US FDA-approved prospective non-randomized non-controlled study comprising of 12 aSAH patients (8 women, 4 men, age range 34-62 years) treated between May and November 2008. All patients underwent up to 2 weeks of cSCS with a single percutaneously implanted 8-contact electrode. Neurological outcomes at discharge and follow-up of up to 13 years and mortality/complications rates were analyzed. RESULTS All 12 aSAH patients underwent cSCS electrode implantation immediately after securing the aneurysm. Patients were stimulated for 10-14 consecutive days starting within 3 days of aneurysm rupture. Angiographic vasospasm occurred in six patients; two patients developed new vasospasm-related neurological symptoms; both recovered completely by discharge time. One patient died from unrelated multi-system failure; the rest were followed up clinically (average, 7.5 years; range, 12-151 months) and angiographically (average, 6.5 years; range, 36-125 months). No delayed ischemic neurological deficits/strokes and no cSCS-related adverse effects were observed. CONCLUSIONS Our short- and long-term data suggest that cSCS is feasible and safe for patients in the acute aSAH settings. Small size of the patient cohort and lack of control do not allow us to conclude whether cSCS is able to prevent cerebral vasospasm, decrease its severity, and improve clinical outcomes in aSAH patients. However, our findings support further clinical trials and development of cSCS as a new concept to prevent and treat cerebral vasospasm. TRIAL REGISTRATION CLINICALTRIALS gov NCT00766844, posted on 10/06/2008.
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Affiliation(s)
- Konstantin V Slavin
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA. .,Neurology Service, Jesse Brown Veterans Administration Hospital, Chicago, IL, USA.
| | - Prasad Vannemreddy
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA
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Wang LX, Li WH, He F. Efficacy and Safety of Electroacupuncture in the Treatment of Cerebral Infarction: Systematic Review and Meta-Analysis. Appl Bionics Biomech 2022; 2022:1350501. [PMID: 35800118 PMCID: PMC9256421 DOI: 10.1155/2022/1350501] [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: 05/01/2022] [Revised: 06/02/2022] [Accepted: 06/04/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose The goal of this study was to see if electroacupuncture was effective and safe in the management of cerebral infarction. PubMed, Embase, Cochrane Library, and Web of Science were used to conduct a comprehensive literature survey. Methods Basic features of 7 studies were identified using the searching strategy. The investigation was found in PubMed, Embase, and Web of Science, with the most recent search being in March 2022. "Electroacupuncture," "cerebral infarction," and their permutations were among the MeSH terms and free words used. As literature, two reviewers independently used a standardized form to gather pertinent data from qualifying research. Results 157 literatures were identified and evaluated. Electroacupuncture improved the BI score in individuals with cerebral infarction (mean difference = 0.10, 95 percent CI: 0.00-0.20, p = 0.04). Electroacupuncture enhanced BI score in individuals with cerebral infarction (mean difference = 0.10, 95 percent CI: 0.00-0.20, p = 0.04). The effects of electroacupuncture increased Fugl-Meyer index in patients with cerebral infarction (mean difference = 25.92, 95% CI: 25.28-26.56, p < 0.00001). Electroacupuncture effects decreased CSS in patients with cerebral infarction in the experiment group (mean difference = -2.10, 95% CI: -2.53--1.67, p < 0.0001). Electroacupuncture also reduced CSS individuals with cerebral infarction in the control group; however, there was no statistically significant (risk difference = 0.06, 95 percent CI: 0.02-0.13, p = 0.12). Conclusion This study demonstrated that electroacupuncture helped decreased CSS in patients with cerebral infarction.
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Affiliation(s)
- Lan Xiang Wang
- Department of Rehabilitation Medicine, The 8th Medical Center of Chinese PLA General Hospital, China
| | - Wei Hong Li
- Beijing University of Chinese Medicine, China
| | - Fang He
- Department of Outpatient, The 8th Medical Center of Chinese PLA General Hospital, China
- Jia NO2 Niangniang Mansion, Xiangshan Road, Haidian District, Beijing 100093, China
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Qin L, Wang Y, Xie Z, Ma Y. The Role of ET-1 in Early Cerebral Microcirculation Changes after Subarachnoid Hemorrhage. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:4592986. [PMID: 35444782 PMCID: PMC9015879 DOI: 10.1155/2022/4592986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/04/2022] [Accepted: 02/15/2022] [Indexed: 11/17/2022]
Abstract
Subarachnoid hemorrhage (SAH), especially aneurysmal subarachnoid hemorrhage, is a serious cerebrovascular disease with high mortality and morbidity. However, there is no effective treatment in clinics. In recent years, more and more studies have shown that early brain injury (EBI) may be an important reason for poor prognosis of SAH. Explore the mechanism of early brain injury after subarachnoid hemorrhage (SAH). In this study, 20 male New Zealand white rabbits were selected and divided into the experimental group and sham operation group, with 10 rabbits in each group. The neurobehavioral scores, food intake, and cerebral perfusion parameters, cerebral blood volume (CBV), cerebral blood flow velocity (CBF), ET-1, IL-1, and IL-6, in rabbit plasma were compared. The food intake scores and neurological dysfunction scores of the experimental group at 1 h, 6 h, 24 h, and 72 h after modeling were higher than those of the sham operation group, which had a statistical significance (P < 0.05). The dysfunction scores all showed a gradual decrease; the CBV and CBF values of the experimental group at 1 h, 6 h, 24 h, and 72 h after modeling were all lower than those of the sham operation group, which had a statistical significance (P < 0.05), and the MTT values were all higher than that of the sham operation group, which had a statistical significance (P < 0.05). The TTP values of rats in the experimental group were higher than those in the sham operation group at 6 h, 24 h, and 72 h after modeling (P < 0.05), the experimental group was in the modeling. The levels of serum ET-1, IL-1, and IL-6 at 1 h, 6 h, 24 h, and 72 h were higher than those in the sham operation group, which had a statistical significance (P < 0.05). New Zealand white rabbits can have brain perfusion volume disorder, inflammatory reaction, and cerebral vasospasm in the early stage after SAH, and brain injury can appear in the early stage.
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Affiliation(s)
- Lei Qin
- Department of Radiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China
- Department of Medical Imaging Diagnostics, College of Medical Imaging, Bengbu Medical College, Bengbu 233000, China
| | - Yanan Wang
- Department of Function, The Second Affiliated Hospital of Bengbu Medical College, Bengbu 233040, China
| | - Zongyu Xie
- Department of Radiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China
- Department of Medical Imaging Diagnostics, College of Medical Imaging, Bengbu Medical College, Bengbu 233000, China
| | - Yichuan Ma
- Department of Radiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China
- Department of Medical Imaging Diagnostics, College of Medical Imaging, Bengbu Medical College, Bengbu 233000, China
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