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Guo K, Lu Y. Acupuncture modulates the AMPK/PGC-1 signaling pathway to facilitate mitochondrial biogenesis and neural recovery in ischemic stroke rats. Front Mol Neurosci 2024; 17:1388759. [PMID: 38813438 PMCID: PMC11133568 DOI: 10.3389/fnmol.2024.1388759] [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: 02/20/2024] [Accepted: 04/30/2024] [Indexed: 05/31/2024] Open
Abstract
Aims The main objective of this study was to investigate the role and mechanism of acupuncture on anti-nerve injury in the acute phase by regulating mitochondrial energy metabolism via monophosphate-activated protein kinase (AMPK)/peroxisome proliferator-activated receptor-γ coactivator 1α (PGC-1α) axis in rat ischemic stroke. Main methods Middle cerebral artery occlusion (MCAO) was established by middle cerebral artery occlusion/reperfusion. One-week of acupuncture was performed during the acute phase of ischemic stroke. The neurological function and brain tissue integrity were evaluated. Mitochondrial function (intracellular ATP level and the activity of mitochondrial respiratory chain complex I) and the level of NADH oxidase (NOX) were detected by enzymatic chemistry. Next, the potential molecular mechanisms were explored by western blotting, fluorescence quantitative PCR and immunohistochemistry method. Key findings (1) Acupuncture treatment for MCAO/R rats showed a significant improvement in the infarcted tissue accompanied by functional recovery in Zea-Longa score and balance beam score outcomes, motor function performances. (2) Acupuncture increased the levels of ATP and mitochondrial respiratory chain complex I, decreased the NOX levels in cerebral ischemia established by suture-occluded method. (3) Acupuncture reduced the necrosis dissolution of neuronal cells and meningeal edema, while promoting angiogenesis. (4) Quantitative immunohistochemical staining results showed acupuncture can increase the expression of AMPK, p-AMPK and the mitochondrial transcription factor PGC-1α, NRF2, TFAM and uncoupling protein 2 (UCP2). Meanwhile, acupuncture treatment up-regulated the expression of the corresponding protein. (5) Subsequently, acupuncture enhanced AMPK phosphorylation as well as the expression of PGC-1α, NRF2, TFAM and UCP2, implicated in mitochondrial synthesis and cellular apoptosis. (6) Finally, injections of AMPK antagonists and activators confirmed AMPK as a therapeutic target for the anti-nerve damage effects of acupuncture. Significance Acupuncture intervention relieved ischemic stroke progression in MCAO rats by promoting energy metabolism and mitochondrial biogenesis in the brain and alleviating neuronal apoptosis, which was mediated by eliciting AMPK/PGC-1α axis, among them AMPK is a therapeutic target.
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Affiliation(s)
| | - Yan Lu
- Department of Acupuncture, Shandong University of Traditional Chinese Medicine, Jinan, China
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Tian H, Tian F, Ma D, Xiao B, Ding Z, Zhai X, Song L, Ma C. Priming and Combined Strategies for the Application of Mesenchymal Stem Cells in Ischemic Stroke: A Promising Approach. Mol Neurobiol 2024:10.1007/s12035-024-04012-y. [PMID: 38366307 DOI: 10.1007/s12035-024-04012-y] [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: 09/20/2023] [Accepted: 01/31/2024] [Indexed: 02/18/2024]
Abstract
Ischemic stroke (IS) is a leading cause of death and disability worldwide. Tissue plasminogen activator (tPA) administration and mechanical thrombectomy are the main treatments but have a narrow time window. Mesenchymal stem cells (MSCs), which are easily scalable in vitro and lack ethical concerns, possess the potential to differentiate into various types of cells and secrete a great number of growth factors for neuroprotection and regeneration. Moreover, MSCs have low immunogenicity and tumorigenic properties, showing safety and preliminary efficacy both in preclinical studies and clinical trials of IS. However, it is unlikely that MSC treatment alone will be sufficient to maximize recovery due to the low survival rate of transplanted cells and various mechanisms of ischemic brain damage in the different stages of IS. Preconditioning was used to facilitate the homing, survival, and secretion ability of the grafted MSCs in the ischemic region, while combination therapies are alternatives that can maximize the treatment effects, focusing on multiple therapeutic targets to promote stroke recovery. In this case, the combination therapy can yield a synergistic effect. In this review, we summarize the type of MSCs, preconditioning methods, and combined strategies as well as their therapeutic mechanism in the treatment of IS to accelerate the transformation from basic research to clinical application.
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Affiliation(s)
- Hao Tian
- Experimental Management Center, The Key Research Laboratory of Benefiting Qi for Acting Blood Circulation Method to Treat Multiple Sclerosis of State Administration of Traditional Chinese Medicine/Research Center of Neurobiology, Shanxi University of Chinese Medicine, No. 121, University Street, Higher Education Park, Jinzhong, 030619, China
| | - Feng Tian
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China
| | - Dong Ma
- Department of Neurosurgery, The Key Laboratory of Prevention and Treatment of Neurological Disease of Shanxi Provincial Health Commission, Sinopharm Tongmei General Hospital, Datong, 037003, China
| | - Baoguo Xiao
- Institute of Neurology, Huashan Hospital, Institutes of Brain Science and State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Zhibin Ding
- Department of Neurology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030000, China
| | - Xiaoyan Zhai
- Experimental Management Center, The Key Research Laboratory of Benefiting Qi for Acting Blood Circulation Method to Treat Multiple Sclerosis of State Administration of Traditional Chinese Medicine/Research Center of Neurobiology, Shanxi University of Chinese Medicine, No. 121, University Street, Higher Education Park, Jinzhong, 030619, China
- School of Basic Medicine of Shanxi University of Chinese Medicine, Jinzhong, 030619, China
| | - Lijuan Song
- Experimental Management Center, The Key Research Laboratory of Benefiting Qi for Acting Blood Circulation Method to Treat Multiple Sclerosis of State Administration of Traditional Chinese Medicine/Research Center of Neurobiology, Shanxi University of Chinese Medicine, No. 121, University Street, Higher Education Park, Jinzhong, 030619, China.
| | - Cungen Ma
- Experimental Management Center, The Key Research Laboratory of Benefiting Qi for Acting Blood Circulation Method to Treat Multiple Sclerosis of State Administration of Traditional Chinese Medicine/Research Center of Neurobiology, Shanxi University of Chinese Medicine, No. 121, University Street, Higher Education Park, Jinzhong, 030619, China.
- Institute of Brain Science, Shanxi Key Laboratory of Inflammatory Neurodegenerative Diseases, Medical School of Shanxi Datong University, Datong, China.
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Lee Y, Lee H, Kim EJ, Lee SD, Jung CY. Potential use of polydimethylsiloxane phantom in acupuncture manipulation practice. Heliyon 2024; 10:e25428. [PMID: 38322835 PMCID: PMC10845916 DOI: 10.1016/j.heliyon.2024.e25428] [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: 08/14/2022] [Revised: 01/14/2024] [Accepted: 01/26/2024] [Indexed: 02/08/2024] Open
Abstract
Objectives Sufficient trials of acupuncture manipulations should be practiced to obtain proficiency. However, there is not an adequate quantitative methodology for selecting a tissue-mimicking phantom that effectively reproduces the mechanical behavior that occurs during acupuncture. The objective of this study was to determine the proper mixing ratio of polydimethylsiloxane (PDMS) to obtain tissue phantom that is the most similar to porcine phantoms. Design An automatic needle manipulator equipped with a six-degrees-of-freedom force/torque sensor was installed to monitor the interaction force that occurred when the acupuncture needle performed lifting-thrusting and twirling manipulations. Four types of PDMS phantoms, composed of two silicone elastomers with different hardener ratios, were studied alongside four control groups consisting of different porcine sites. A Visual Analog Scale was used to quantify the similarity of the PDMS phantoms to the controls by 11 Korean medical doctors. Results Using the lifting-thrusting method, PDMS D (mixing ratio of 1:4.5) and control 2 (porcine blade shoulder) revealed no significant difference in the dynamic friction coefficients or maximum and minimum friction force values (P < 0.001). Using the twirling method, PDMS D showed no significant difference from all controls in the viscosity coefficient or maximum and minimum torque values (P ≤ 0.001). By practitioners, PDMS D showed the greatest score. Conclusion PDMS D delivered a haptic sensation that is most similar to that of biological tissues in the case of acu-needle lifting-thrusting and twirling methods. This finding guides the preparation of tissue phantoms for acu-needle studies and acupuncture training.
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Affiliation(s)
- Yeonsun Lee
- Department of Acupuncture & Moxibustion, Bucheon Jaseng Hospital of Oriental Medicine, Bucheon, 14598, Republic of Korea
| | - Hyosang Lee
- Haptic intelligence Department, Max Planck Institute for Intelligent Systems, Stuttgart 70569, Germany
| | - Eun Jung Kim
- Department of Acupuncture & Moxibustion, Dongguk University Bundang Oriental Hospital, Seongnam, 13601, Republic of Korea
| | - Seung Deok Lee
- Dongguk University Los Angeles, 440 Shatto PI, Los Angeles, CA 90020, USA
| | - Chan Yung Jung
- Department of Acupuncture & Moxibustion, Dongguk University Ilsan Oriental Hospital, Goyang, 10326, Republic of Korea
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Wen Q, Zha F, Shan L, Zhang S, Xiao P, Zhang C, Yu H, Wang Y. Electroacupuncture attenuates middle cerebral artery occlusion-induced learning and memory impairment by regulating microglial polarization in hippocampus. Int J Neurosci 2024:1-13. [PMID: 38315119 DOI: 10.1080/00207454.2024.2313664] [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: 12/06/2023] [Accepted: 01/29/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND As a traditional medical therapy, electroacupuncture (EA) has been demonstrated to have beneficial effects on ischemic stroke-induced cognitive impairment. However, the underlying mechanism is largely unclear. METHODS Adult rats received occlusion of the middle cerebral artery and reperfusion (MCAO/R) to establish the ischemic stroke model. Morris water maze test was performed following EA stimulation at the GV20, PC6, and KI1 acupoints in rats to test the learning and memory ability. Western blot, immunofluorescent staining, and enzyme-linked immunosorbent assay were conducted to assess the cellular and molecular mechanisms. RESULTS EA stimulation attenuated neurological deficits. In the Morris water maze test, EA treatment ameliorated the MCAO/R-induced learning and memory impairment. Moreover, we observed that MCAO/R induced microglial activation and polarization in the ischemic hippocampus, whereas, EA treatment dampened microglial activation and inhibited M1 microglial polarization but enhanced M2 microglial polarization. EA treatment inhibited the increased expression of proinflammatory cytokines and enhanced the increased expression of anti-inflammatory cytokines. Finally, we found that EA treatment dampened microglial p38 mitogen-activated protein kinase (MAPK) phosphorylation. CONCLUSION Collectively, our data suggested that EA treatment ameliorated cognitive impairment induced by MCAO/R and the underlying mechanism may be p38-mediated microglia polarization and neuroinflammation.
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Affiliation(s)
- Qiong Wen
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
- Department of Rehabilitation, Shenzhen Dapeng New District Nanao People's Hospital, Shenzhen, China
| | - Fubing Zha
- Department of Rehabilitation, The First Affiliated Hospital, Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Linlin Shan
- Department of Rehabilitation, The First Affiliated Hospital, Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Shaohua Zhang
- Department of Rehabilitation, Shenzhen Dapeng New District Nanao People's Hospital, Shenzhen, China
| | - Peng Xiao
- Department of Rehabilitation, Shenzhen Dapeng New District Nanao People's Hospital, Shenzhen, China
| | - Chunxia Zhang
- Department of Rehabilitation, Shenzhen Dapeng New District Nanao People's Hospital, Shenzhen, China
| | - Haibo Yu
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Yulong Wang
- Department of Rehabilitation, The First Affiliated Hospital, Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
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Li SS, Xing XX, Hua XY, Zhang YW, Wu JJ, Shan CL, Zheng MX, Wang H, Xu JG. Alteration of brain functional networks induced by electroacupuncture stimulation in rats with ischemia–reperfusion: An independent component analysis. Front Neurosci 2022; 16:958804. [PMID: 35992929 PMCID: PMC9382119 DOI: 10.3389/fnins.2022.958804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/11/2022] [Indexed: 11/24/2022] Open
Abstract
Motor dysfunction is the major sequela of ischemic stroke. Motor recovery after stroke has been shown to be associated with remodeling of large-scale brain networks, both functionally and structurally. Electroacupuncture (EA) is a traditional Chinese medicine application that has frequently been recommended as an alternative therapy for ischemic stroke and is reportedly effective for alleviating motor symptoms in patients. In the present study, the effect of EA on the alterations of functional resting state networks (RSNs) was explored after middle cerebral artery occlusion/reperfusion (MCAO/R) injury using resting-state functional MRI. Rats were randomly assigned to three groups, including the sham group, MCAO/R group and MCAO/R+EA group. The ladder rung walking test was conducted prior to and after modeling to assess behavioral changes. RSNs were identified based on the independent component analysis (ICA) performed on the fMRI data from groups. EA treatment effectively reduced the occurrence of contralateral forelimb foot faults. Furthermore, our results suggested the disrupted function of the whole-brain network following ischemic stroke and the modulatory effect of acupuncture. The sensorimotor network (SMN), interoceptive network (IN), default mode network (DMN) and salience network (SN) were related to the therapeutic effect of EA on stroke recovery. Collectively, our findings confirmed the effect of EA on motor function recovery after cerebral ischemia reperfusion and shed light on the assessment of EA intervention-induced effects on brain networks. This study provides neuroimaging evidence to explain the therapeutic effects of EA in ischemic stroke and will lay the groundwork for further studies.
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Affiliation(s)
- Si-Si Li
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiang-Xin Xing
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xu-Yun Hua
- Department of Traumatology and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yu-Wen Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Jia-Jia Wu
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chun-Lei Shan
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China
| | - Mou-Xiong Zheng
- Department of Traumatology and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Mou-Xiong Zheng,
| | - He Wang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- He Wang,
| | - Jian-Guang Xu
- 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
- *Correspondence: Jian-Guang Xu,
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Combination of stem cell therapy and acupuncture to treat ischemic stroke: a prospective review. Stem Cell Res Ther 2022; 13:87. [PMID: 35241146 PMCID: PMC8896103 DOI: 10.1186/s13287-022-02761-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 01/17/2022] [Indexed: 12/03/2022] Open
Abstract
Stroke is the second leading cause globally that leads to severe disability and death. Stem cell therapy has been developed over the recent years to treat stroke and diminish the mortality and disability rate of brain injuries. Acupuncture, which can activate endogenous recovery via physical stimuli, has been applied to enhance the recovery and rehabilitation of stroke patients. Attempts have been made to combine stem cell therapy and acupuncture to treat stroke patients and have shown the promising results. This prospective review will look into the possible mechanisms of stem cell therapy and acupuncture and intend to undercover the potential benefit of the combined therapy. It intends to bridge the modern emerging stem cell therapy and traditional acupuncture at cellular and molecular levels and to demonstrate the potential benefit to improve clinical outcomes.
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Effectiveness of Acupuncture for Scoliosis: A Systematic Review. JOURNAL OF ACUPUNCTURE RESEARCH 2022. [DOI: 10.13045/jar.2021.00325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Scoliosis is a 3-dimensional change of the spine, presenting 10° above Cobb angle. Various acupuncture methods are being increasingly performed to correct scoliosis. However, no systematic review has been published. Therefore, we report on the effectiveness of acupuncture on mild scoliosis in this systematic review. We searched various databases for acupuncture treatment for scoliosis published before June 2021. The primary outcome was Cobb angle, and the secondary outcomes were patient-centered scores. Six studies were identified. RCTs that compared combination therapy with acupuncture, and other treatment methods and showed significant improvement in the Cobb angle, and effective rate, but, with low quality evidence. Acupuncture monotherapy resulted in significant improvement in the Cobb angle and had high heterogeneity compared with other treatment methods, but no significant improvement in the effective rate was observed, and the quality of evidence was low. Regardless of the type of scoliosis, acupuncture monotherapy or combination therapy with acupuncture showed significant improvement in the Cobb angle, and the quality of evidence was moderate. No serious adverse events were observed in the 6 studies reviewed. Acupuncture is considered safe, and it is more effective when performed with other conventional treatments.
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Choi TY, Ang L, Jun JH, Lee HW, Yun JM, Kim J, Moon BS, Joo MC, Lee MS. Acupuncture and electroacupuncture for stroke: A protocol for overview of systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e28496. [PMID: 35029904 PMCID: PMC8735753 DOI: 10.1097/md.0000000000028496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 12/16/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The aim of this study was to undertake a systematic overview of meta-analyses and published systematic reviews to identify whether and when acupunctureand electroacupuncture are deemed efficacious treatment options for stroke and stroke-related disorders. METHODS Four databases, namely, PubMed, AMED, EMBASE, and the Cochrane Library will be searched from their inception. Two reviewers will independently perform study selection, data extraction, and assessment. This will be followed by an assessment of the methodological and report quality using the Assessment of Multiple Systematic Reviews-2 tool. Finally, the study will entail the assessment of evidence quality by employing the Grading of Recommendations Assessment, Development, and Evaluation system. RESULTS This overview is expected to provide data on using acupuncture for stroke and stroke-related disorders on the basis of the included systematic reviews' qualitative and quantitative syntheses. CONCLUSION This overview will assess the benefits as well as hazards of acupuncture for stroke, subsequently providing patients and practitioners with useful information and have implications for future studies on the topic. TRIAL REGISTRATION NUMBER Reviewregistry1263.
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Affiliation(s)
- Tae-Young Choi
- Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Lin Ang
- Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
- Korean Convergence Medicine, University of Science and Technology, Daejeon, South Korea
| | - Ji Hee Jun
- Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Hye Won Lee
- Korean Medicine Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Jong-Min Yun
- Department of Korean Internal Medicine, College of Korean Medicine, Wonkwang University, Iksan, South Korea
| | - JiHee Kim
- Department of Rehabilitation Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, South Korea
| | - Byung Soon Moon
- Department of Korean Internal Medicine, College of Korean Medicine, Wonkwang University, Iksan, South Korea
| | - Min Cheol Joo
- Department of Rehabilitation Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, South Korea
| | - Myeong Soo Lee
- Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
- Korean Convergence Medicine, University of Science and Technology, Daejeon, South Korea
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Immediate Effects of Acupuncture on Explosive Force Production and Stiffness in Male Knee Joint. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189518. [PMID: 34574441 PMCID: PMC8470529 DOI: 10.3390/ijerph18189518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/27/2021] [Accepted: 09/05/2021] [Indexed: 01/01/2023]
Abstract
Acupuncture can improve explosive force production and affect joint stiffness by affecting muscle activation levels. This study aims to explore the effects of true acupuncture (TA) compared with sham acupuncture (SA) on the explosive force production and stiffness of the knee joint in healthy male subjects. Twenty subjects were randomly divided into the TA group (n = 10) and SA group (n = 10) to complete isokinetic movement of the right knee joint at a speed of 240°/s before and after acupuncture. Futu (ST32), Liangqiu (ST34), Zusanli (ST36), Xuehai (SP10), and Chengshan (BL57) were selected for acupuncture. The intervention of SA is that needles with a blunt tip were pushed against the skin, giving an illusion of insertion. The results showed that acupuncture and the intervention time had a significant interaction effect on knee joint explosive force and joint stiffness (p < 0.05). The average maximum (max) torque, average work, average power, average peak power and total work of the TA group increased significantly after acupuncture (p < 0.05), while the SA group did not (p > 0.05). Therefore, true acupuncture can immediately improve the explosive force and joint stiffness of the male knee joint by inducing post-activation potentiation (PAP) and/or De-Qi.
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Zhang J, Li Z, Li Z, Li J, Hu Q, Xu J, Yu H. Progress of Acupuncture Therapy in Diseases Based on Magnetic Resonance Image Studies: A Literature Review. Front Hum Neurosci 2021; 15:694919. [PMID: 34489662 PMCID: PMC8417610 DOI: 10.3389/fnhum.2021.694919] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/21/2021] [Indexed: 01/18/2023] Open
Abstract
The neural mechanisms of acupuncture are not well-understood. Over the past decades, an increasing number of studies have used MRI to investigate the response of the brain to acupuncture. The current review aims to provide an update on acupuncture therapy in disease. The PubMed, Embase, Web of Science, and Cochrane Library databases were searched from inception to January 31, 2021. Article selection and data extraction were conducted by two review authors. A total of 107 publications about MRI in acupuncture were included, the collective findings of which were as follows: (1) stroke and GB34 (Yanglingquan) are the most studied disease and acupoint. Related studies suggested that the mechanism of acupuncture treatment for stroke may associate with structural and functional plasticity, left and right hemispheres balance, and activation of brain areas related to movement and cognition. GB34 is mainly used in stroke and Parkinson's disease, which mainly activates brain response in the premotor cortex, the supplementary motor area, and the supramarginal gyrus; (2) resting-state functional MRI (rs-fMRI) and functional connectivity (FC) analysis are the most frequently used approaches; (3) estimates of efficacy and brain response to acupuncture depend on the type of sham acupuncture (SA) used for comparison. Brain processing after acupuncture differs between patients and health controls (HC) and occurs mainly in disorder-related areas. Factors that influence the effect of acupuncture include depth of needling, number and locations of acupoints, and deqi and expectation effect, each contributing to the brain response. While studies using MRI have increased understanding of the mechanism underlying the effects of acupuncture, there is scope for development in this field. Due to the small sample sizes, heterogeneous study designs, and analytical methods, the results were inconsistent. Further studies with larger sample sizes, careful experimental design, multimodal neuroimaging techniques, and standardized methods should be conducted to better explain the efficacy and specificity of acupuncture, and to prepare for accurate efficacy prediction in the future.
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Affiliation(s)
- Jinhuan Zhang
- Department of Acupuncture, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Zihan Li
- Department of Acupuncture, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Zhixian Li
- Department of Acupuncture, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Jiaying Li
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Qingmao Hu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Chinese Academy of Sciences (CAS) Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Jinping Xu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Haibo Yu
- Department of Acupuncture, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
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Zhou Y, Shi J, Zhang Y, Zhang X, Dai A, Feng S, Luo C, Huang Z, Huang G. Study for cerebral central network mechanism of acupuncture stimulation quantity based on changes of cerebral functional connection of fMRI. Medicine (Baltimore) 2021; 100:e25480. [PMID: 33832167 PMCID: PMC8036113 DOI: 10.1097/md.0000000000025480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 03/18/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Ischemic stroke is a major chronic noninfectious disease that seriously endangers health. Acupuncture is effective for ischemic stroke and less adverse reactions. However, there is not enough clinical trial data and solid evidence could confirm how acupuncture work to cerebral functional connectivity changes, and whether the changes is related to the different stimulation quantity. DESIGN This is a multicenter, central-randomized, controlled, double-blind, noninferiority, 2 factors and 3 levels orthogonal clinical trial. A total of 100 participants with ischemic stroke aged from 40 to 80 were randomized into experimental group and control group, the experimental group was divided into 9 groups (A1-A9) according to different factors or levels, and each group have 10 participants. The whole study period is 17 days, including 1 week for baseline observation, 3 days treatment and observation, and 1 week follow-up. Primary outcome is the fMRI based on blood oxygenation level dependent. Secondary outcomes included National Institute of Health Stroke Scale, Modified Barthel Index, Brunnstrom stroke recovery, stroke Chinese medicine symptom. Clinical assessments will be evaluated at before and the 0 hour, 24 hours, 36 hours after treatment, and 1 week follow-up. The primary outcome of the postacupuncture effect were investigated by paired T-test, and the continuous outcome variables will be analyzed with univariate repetitive measurement deviation analysis. Adverse events will be noted and recorded for the safety evaluation. CONCLUSION The purpose of this study was to evaluate the central mechanism of acupuncture stimulation quantity using time and frequency as control conditions. This study will provide reasonable stimulation parameters and strong mechanism evidence of cerebral central network for the use of acupuncture for ischemic stroke. CHICTR REGISTRATION NUMBER ChiCTR1900023169. Registered 15 May 2019.
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Affiliation(s)
- Yihao Zhou
- Yunnan University of Traditional Chinese Medicine
| | - Jing Shi
- The First Clinical Medical College of Yunnan University of Traditional Chinese Medicine, Kunming
| | - Yi Zhang
- Qingdao Central Hospital, Qingdao, China
| | | | - Anhong Dai
- Yunnan University of Traditional Chinese Medicine
| | - Sifeng Feng
- The First Clinical Medical College of Yunnan University of Traditional Chinese Medicine, Kunming
| | - Chunhong Luo
- Yunnan University of Traditional Chinese Medicine
| | - Zhilin Huang
- Yunnan University of Traditional Chinese Medicine
| | - Gan Huang
- Yunnan University of Traditional Chinese Medicine
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Effects of Acupuncture on Explosive Force Production by the Healthy Female Shoulder Joint. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:8835672. [PMID: 33343681 PMCID: PMC7725556 DOI: 10.1155/2020/8835672] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 11/11/2020] [Accepted: 11/20/2020] [Indexed: 11/18/2022]
Abstract
Background Acupuncture is often used to treat chronic conditions, such as pain. In recent years, given the importance of the explosive forces generated by shoulder muscles for the completion of motor tasks, studies in which nerves were stimulated through acupuncture to increase the explosive forces were conducted. This study explored the effect of acupuncture on explosive force production by the muscles of the female shoulder joint. Methods Eighteen healthy women underwent shoulder adduction (Add), abduction (Abd), flexion (Flex), and extension (Ext) tests with an isokinetic measurement system. Acupuncture was used to stimulate the Zhongfu (LU1), Tianfu (LI3), Xiabai (LU4), Binao (LI14), Naohui (SJ13), Jianliao (SJ14), and Xiaoluo (SJ12) points, and electromyography (EMG) signals were recorded before and after acupuncture. Results After acupuncture, there was a significant difference in the average maximum work, the average maximum power, the average maximum speed, the total work in Add/Abd and Flex/Ext, the EMG signals, and the stiffness of the muscles in Abd and Ext (P < 0.05). There were no significant differences in the average maximum torque in Abd or Flex. Conclusion Based on the results, there may be a significant correlation between the manipulation of different acupoints by acupuncture and the average maximum torque and stiffness. Acupuncture may stimulate nerves to activate muscles and induce a postactivation potentiation effect that improves explosive force production. Therefore, acupuncture as an auxiliary tool may increase the explosive forces generated by acupoint-related muscles by stimulating nerves.
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Garrido-Ardila EM. Reply to 'Comments on Effectiveness of acupuncture vs. core stability training in balance and functional capacity of women with fibromyalgia: A randomized controlled trial'. Clin Rehabil 2020; 34:1417-1419. [PMID: 32757626 DOI: 10.1177/0269215520945656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Elisa María Garrido-Ardila
- ADOLOR Research group, Department of Medical-Surgical Therapy, Medicine Faculty, Physiotherapy Field, Extremadura University, Badajoz, Spain
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Lu KY, Yuen KF, Luo JY, Hong CZ, Chou LW. Therapeutic effects of acupuncture on sensory ataxia after a cerebral hemorrhage: A case report. Medicine (Baltimore) 2020; 99:e21124. [PMID: 32702864 PMCID: PMC7373561 DOI: 10.1097/md.0000000000021124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Sensory ataxia is a dysfunction of dynamic balance due to impairment of sensory input into the control of movement. The sequelae of stroke, such as hemiplegia, somatosensory impairment, and impaired balance may cause significant disability and may affect patients' quality of life. In addition to rehabilitation programs, acupuncture therapy has been applied to stroke patients and is recommended as a complementary therapy in stroke rehabilitation. PATIENT CONCERNS A 70-year-old male had a sudden onset of conscious loss. The brain computed tomography showed intracerebral hemorrhage with subdural hemorrhage and subarachnoid hemorrhage. DIAGNOSIS Intracerebral hemorrhagic stroke was diagnosed. INTERVENTIONS He received craniotomy with hematoma evacuation immediately and waked up 3 weeks with bilateral hemiparesis (right side weaker than left), impaired position sensation and tactile perception in the right lower limb. He then began to receive rehabilitation therapy and had significant improvement in muscle strength and static balance, but no improvement in tactile perception of position sense in the right lower limbs and reached plateau. Then he received acupuncture therapies to Yongquan (KI1), Tongtien (BL7) and Houxi (SI3). OUTCOMES The patient's walking ability recovered after receiving rehabilitation programs for 3 years, but the impairment in proprioception and dynamic balance persisted. The perception and dynamic balance had significantly improved after patient received acupuncture therapy, especially the acupuncture point of Yongquan (KI1). CONCLUSION The clinical effect of acupuncture in combination with conventional rehabilitation therapy for neurological impairment recovery, improving activity of daily living performance and improving post-stroke imbalance was explored. We hope that this report can facilitate further well controlled quantitative objective studies on a big size of samples.
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Affiliation(s)
- Kuan-Yu Lu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chiayi
| | - Ka-Fai Yuen
- Department of Rehabilitation, Ton-Yen General Hospital, Tsinchu County
| | - Jia-Yuan Luo
- Department of Physical Medicine and Rehabilitation, Puzi Hospital, Ministry of Health and Welfare, Chiayi, Taiwan
| | - Chang-Zern Hong
- Retired professor, Department of Physical Medicine and Rehabilitation, University of California Irvine, CA, USA
| | - Li-Wei Chou
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital
- Department of Physical Therapy and Graduate Institute of Rehabilitation Science, China Medical University
- Department of Rehabilitation, Asia University Hospital, Taichung, Taiwan
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15
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Garrido-Ardila EM, González-López-Arza MV, Jiménez-Palomares M, García-Nogales A, Rodríguez-Mansilla J. Effectiveness of acupuncture vs. core stability training in balance and functional capacity of women with fibromyalgia: a randomized controlled trial. Clin Rehabil 2020; 34:630-645. [DOI: 10.1177/0269215520911992] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: This study investigated the effectiveness of a core stability training physiotherapy programme vs. acupuncture for the management of balance and functional capacity impairments of women with Fibromyalgia. Design: Single-blind randomized controlled trial. Setting: Outpatients setting. Subjects: Women with Fibromyalgia and balance impairment. Interventions: Participants were randomized to a core stability physiotherapy programme group ( n = 45), acupuncture treatment group ( n = 45) and control group ( n = 45) for 13 weeks. Main Measures: Measures were taken at baseline (week 0), postintervention (week 6) and follow-up (week 13). The primary outcome measures were static balance (posturography) and dynamic balance and functional mobility (Berg Balance Scale, timed up and go test and 10-m walk). The secondary outcome measure was functional capacity (Fibromyalgia Health Assessment Questionnaire and the physical function item from the Spanish Fibromyalgia Impact Questionnaire). Results: In all, 103 participants completed the study. The results showed statistically significant improvements in the acupuncture and physiotherapy groups vs. the control group at week 6 regarding Berg Balance Scale ( P = 0.00, both groups), timed up and go test ( P = 0.00 and P = 0.01, respectively) and 10-m walk test at comfortable speed ( P = 0.02 and P = 0.03, respectively). The 10-m walk test at maximum speed showed significance when comparing the physiotherapy and control group ( P = 0.03). However, no significant differences were found between the physiotherapy and the acupuncture groups. In relation to functional capacity, the improvements achieved after the treatments were not statistically significant. Conclusion: Core stability-based physiotherapy and acupuncture improve dynamic balance and postural control in women with Fibromyalgia.
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Yang JL, Chen TL, Yeh CC, Hu CJ, Liao CC, Lane HL, Shih CC. Acupuncture treatment and the risk of urinary tract infection in stroke patients: a nationwide matched cohort study. Acupunct Med 2019; 37:175-183. [PMID: 31032620 DOI: 10.1177/0964528419834017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The association between acupuncture treatment and post-stroke urinary tract infection (UTI) remains incompletely understood. OBJECTIVE To compare the long-term risks of UTI among stroke patients treated with or without acupuncture treatment. METHODS This retrospective cohort study was based on data from the National Health Insurance Research Database in Taiwan that included hospitalized stroke patients. We identified 19,286 patients aged 30 years and older who were hospitalized for newly diagnosed stroke between 1 January 2000 and 31 December 2004. Considering immortal time bias, we compared the incidence of UTI during the follow-up period until the end of 2009 in patients with stroke who did and did not receive acupuncture. The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of UTI associated with acupuncture were calculated using multivariate Cox proportional hazard regression analysis. RESULTS Stroke patients who received acupuncture treatment experienced a lower incidence of UTI than those who were not treated with acupuncture (95.4 vs 110.0 per 1000 person-years) with an HR of 0.76 (95% CI: 0.73-0.80). The association between acupuncture treatment and UTI was significant for both sexes and for patients older than 40 years of age, particularly for patients who had no history of medical conditions. CONCLUSIONS In this nationwide retrospective cohort study, we raised the possibility that acupuncture treatment may be associated with a reduced risk of UTI among stroke patients. However, the protective effect associated with acupuncture treatment requires further validation using randomized clinical trials.
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Affiliation(s)
- Jen-Lin Yang
- 1 Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,2 Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Ta-Liang Chen
- 3 Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,4 Department of Anesthesiology, School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chun-Chieh Yeh
- 5 Department of Surgery, China Medical University Hospital, Taichung, Taiwan.,6 Department of Surgery, University of Illinois, Chicago, IL, USA
| | - Chaur-Jong Hu
- 7 Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chien-Chang Liao
- 4 Department of Anesthesiology, School of Medicine, Taipei Medical University, Taipei, Taiwan.,8 Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan.,9 Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan.,10 School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.,11 Department of Anesthesiology, Shuan Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hsin-Long Lane
- 12 School of Chinese Medicine for Post-Baccalaureate, I-Shou University, Kaohsiung, Taiwan
| | - Chun-Chuan Shih
- 12 School of Chinese Medicine for Post-Baccalaureate, I-Shou University, Kaohsiung, Taiwan.,13 Ph.D. Program in Clinical Drug Development of Herbal Medicine, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
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17
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Liu CH, Hsieh YT, Tseng HP, Lin HC, Lin CL, Wu TY, Lin SH, Tsao SH, Zhang H. Acupuncture for a First Episode of Acute Ischaemic Stroke: An Observer-Blinded Randomised Controlled Pilot Study. Acupunct Med 2018; 34:349-355. [DOI: 10.1136/acupmed-2015-010825] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 03/25/2016] [Indexed: 01/16/2023]
Abstract
Objective To determine the required sample size for, and feasibility of, a RCT examining the effectiveness of early acupuncture for acute ischaemic stroke. Methods Thirty-eight patients aged 40–85 years with a first episode of acute ischaemic stroke presenting within 72 h of stroke onset were randomly assigned to receive manual acupuncture (MA group; n=20) plus standard care or standard care only (control group, n=18). The acupuncture treatment was provided daily for 2 weeks. The primary outcome was the change in the National Institutes of Health Stroke Scale (NIHSS) score between baseline and 4 weeks. Secondary outcomes included changes in the Fugl–Meyer assessment (FMA) and the functional independence measure scores between baseline and 4 weeks, and changes in NIHSS, Barthel Index and modified Rankin Scale scores at 12 weeks. Results Thirty-one patients completed the study (dropout rate=18%) and adverse effects were minimal. No significant differences were seen between groups in the improvements in NIHSS scores, although there tended to be a greater reduction in NIHSS score after 1 week in the MA group relative to the control group (p=0.066). The post-stroke motor activity at 4 weeks was associated with a significantly increased FMA score in the acupuncture group compared with the control group (p<0.05), but not supported by intergroup analysis. Conclusions This pilot study indicates that acupuncture appears to be safe for patients in the acute stage of ischaemic stroke. A subsequent trial with a larger sample size (estimated at n=122) is required to confirm whether early acupuncture intervention contributes to earlier functional improvement and to assess the longer-term clinical efficacy of acupuncture. Trial Registration Number NCT02210988; Results.
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Affiliation(s)
- Ching-Hsiung Liu
- Department of Neurology, Lotung Poh-Ai Hospital, Ilan, Taiwan
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Ting Hsieh
- Department of Physical Medicine and Rehabilitation, Lotung Poh-Ai Hospital, Ilan, Taiwan
| | - Hung-Pin Tseng
- Department of Neurology, Lotung Poh-Ai Hospital, Ilan, Taiwan
| | - Hung-Chih Lin
- Department of Neurology, Lotung Poh-Ai Hospital, Ilan, Taiwan
| | - Chun-Liang Lin
- Department of Neurology, Lotung Poh-Ai Hospital, Ilan, Taiwan
| | - Tai-Yi Wu
- Department of Physical Medicine and Rehabilitation, Lotung Poh-Ai Hospital, Ilan, Taiwan
| | - Shu-Hua Lin
- Department of Physical Medicine and Rehabilitation, Lotung Poh-Ai Hospital, Ilan, Taiwan
| | - Szu-Hung Tsao
- Department of Physical Medicine and Rehabilitation, Lotung Poh-Ai Hospital, Ilan, Taiwan
| | - Hong Zhang
- College of Acupuncture and Tuina, Guangzhou University of Chinese Medicine, Guangdong, China
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18
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Quantitative Comparison of Acupuncture Needle Force Generation According to Diameter. JOURNAL OF ACUPUNCTURE RESEARCH 2018. [DOI: 10.13045/jar.2018.00283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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19
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Abstract
Acupuncture is potentially beneficial for post-stroke rehabilitation and is considered a promising preventive strategy for stroke. Electroacupuncture pretreatment or treatment after ischemic stroke by using appropriate electroacupuncture parameters generates neuroprotective and neuroregenerative effects that increase cerebral blood flow, regulate oxidative stress, attenuate glutamate excitotoxicity, maintain blood-brain barrier integrity, inhibit apoptosis, increase growth factor production, and induce cerebral ischemic tolerance.
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Affiliation(s)
- Qwang-Yuen Chang
- Department of Family Medicine, Lin Shin Hospital, Taichung, Taiwan, China
| | - Yi-Wen Lin
- Research Center for Chinese Medicine and Acupuncture; Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung, Taiwan, China
| | - Ching-Liang Hsieh
- Research Center for Chinese Medicine and Acupuncture; Graduate Institute of Acupuncture Science, College of Chinese Medicine; Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University; Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan, China
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20
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Li X, Liu M, Zhang Y, Li Z, Wang D, Yan X. Acupuncture for vertebrobasilar insufficiency vertigo: Protocol for a systematic review and meta-analysis. Medicine (Baltimore) 2017; 96:e9261. [PMID: 29390369 PMCID: PMC5815781 DOI: 10.1097/md.0000000000009261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Vertebrobasilar insufficiency vertebrobasilar (VBIV) is a serious nerve disease and many old people suffer from it. Acupuncture has been widely applied in the treatment of VBIV. However, to our knowledge, there has been no systematic review or meta-analysis of randomized controlled trails regarding the effectiveness of this treatment. Here, we provide a protocol to evaluate the effectiveness and safety of acupuncture for VBIV. METHODS Relevant randomized controlled trials in 5 databases (EMBASE, PubMed, the Cochrane Central Register of Controlled Trials [Cochrane Library], Chinese Biomedical Literature Database [CBM], China National Knowledge Infrastructure [CNKI]) will be comprehensively searched by 2 researchers in December 2017. The clinical efficacy will be accepted as the primary outcomes. We will also use RevMan V.5.3 software to compute the data synthesis carefully when a meta-analysis is allowed. RESULTS This study will provide a high-quality synthesis of current evidence of acupuncture for VBIV from several aspects including clinical efficacy, the blood flow velocity of the left vertebral artery (LVA), the right vertebral artery (RVA), the basilar artery (BA)and adverse events. CONCLUSION The conclusion of our systematic review will provide evidence to judge whether acupuncture is an effective and safety intervention for patient with VBIV.
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Affiliation(s)
- Xiaohui Li
- Guangzhou University of Chinese Medicine
| | - Menghui Liu
- The First Affiliated Hospital, Sun Yet-sen University
| | - Yu Zhang
- Guangzhou University of Chinese Medicine
| | - Ziqing Li
- Guangzhou University of Chinese Medicine
| | - Dawei Wang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Xia Yan
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
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21
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Mechanisms of Acupuncture Therapy in Ischemic Stroke Rehabilitation: A Literature Review of Basic Studies. Int J Mol Sci 2017; 18:ijms18112270. [PMID: 29143805 PMCID: PMC5713240 DOI: 10.3390/ijms18112270] [Citation(s) in RCA: 172] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 10/08/2017] [Accepted: 10/24/2017] [Indexed: 12/20/2022] Open
Abstract
Acupuncture is recommended by the World Health Organization (WHO) as an alternative and complementary strategy for stroke treatment and for improving stroke care. Clinical trial and meta-analysis findings have demonstrated the efficacy of acupuncture in improving balance function, reducing spasticity, and increasing muscle strength and general well-being post-stroke. The mechanisms underlying the beneficial effects of acupuncture in stroke rehabilitation remain unclear. The aim of this study was to conduct a literature review, summarize the current known mechanisms in ischemic stroke rehabilitation through acupuncture and electroacupuncture (EA) therapy, and to detail the frequently used acupoints implicated in these effects. The evidence in this review indicates that five major different mechanisms are involved in the beneficial effects of acupuncture/EA on ischemic stroke rehabilitation: (1) Promotion of neurogenesis and cell proliferation in the central nervous system (CNS); (2) Regulation of cerebral blood flow in the ischemic area; (3) Anti-apoptosis in the ischemic area; (4) Regulation of neurochemicals; and, (5) Improvement of impaired long-term potentiation (LTP) and memory after stroke. The most frequently used acupoints in basic studies include Baihui (GV20), Zusanli (ST36), Quchi (LI11), Shuigou (GV26), Dazhui (GV14), and Hegu (LI4). Our findings show that acupuncture exerts a beneficial effect on ischemic stroke through modulation of different mechanisms originating in the CNS.
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22
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Neuronal Regeneration after Electroacupuncture Treatment in Ischemia-Reperfusion-Injured Cerebral Infarction Rats. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3178014. [PMID: 28913350 PMCID: PMC5587926 DOI: 10.1155/2017/3178014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 06/27/2017] [Accepted: 07/20/2017] [Indexed: 01/30/2023]
Abstract
Adult neuronal cells which can regenerate have been reported. The present study investigated whether acupuncture enhances neuronal regeneration in ischemic stroke rats. We established an ischemic stroke rat model by occluding the cerebral blood flow of the right middle cerebral artery for 15 minutes and then allowing reperfusion in Sprague–Dawley rats. The results indicated that, in these rats, 2 Hz electroacupuncture (EA) at both Zusanli (ST36) and Shangjuxu (ST37) acupoints reduced the infarction/hemisphere ratio 8 days after reperfusion and reduced the modified neurological severity score (mNSS) and increased the rotarod test time 4 and 8 days after reperfusion, respectively. In addition, 2 Hz reduced nestin immunoreactive cells in the penumbra area and the ischemic core area; 2 Hz EA also reduced Ki67 immunoreactive cells and increased glial fibrillary acidic protein immunoreactive cells in the penumbra area. These findings suggest that 2 Hz EA at the ST36 and ST37 acupoints has a neuroprotective role. However, additional studies are needed to further investigate these preliminary results.
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23
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The Efficacy of Acupuncture for the Treatment of Cervical Vertigo: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:7597363. [PMID: 28659989 PMCID: PMC5474245 DOI: 10.1155/2017/7597363] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 02/19/2017] [Accepted: 03/27/2017] [Indexed: 11/26/2022]
Abstract
Objective This study aims to evaluate the efficacy and safety of acupuncture for the treatment of cervical vertigo (CV). Methods Randomized controlled trials (RCTs) regarding effectiveness of acupuncture for treating CV were searched in 7 comprehensive databases prior to April 2016. The data analysis was performed by using RevMan version 5.3. Results A total of 10 studies with 914 participants were included. Results showed that acupuncture was more effective than conventional medicine therapy (CMT) in effectiveness, improvement rate of vertigo and headache, and increased average blood flow velocity of vertebral-basilar artery. In the subgroup analysis, the results did not change in different acupuncture methods and drug categories substantially. Sensitivity analysis demonstrated that the results of this meta-analysis were stable. Meanwhile, the long-term safety of acupuncture for CV still remains uncertain. GRADE analysis indicated that the quality of evidence for all outcomes was from very low to low which limited the value of the meta-analysis. Conclusion Based on the systematic review, acupuncture appeared to be a promising therapeutic approach for CV based on low or very low quality of evidence. However, large-scale and high-quality trials are required to provide stronger evidence for the conclusion.
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Electroacupuncture Restores 5-HT System Deficit in Chronic Mild Stress-Induced Depressed Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:7950635. [PMID: 27994633 PMCID: PMC5141535 DOI: 10.1155/2016/7950635] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 08/21/2016] [Accepted: 09/14/2016] [Indexed: 01/08/2023]
Abstract
Objective. The current study is designed to investigate the antidepressant efficacy of electroacupuncture (EA) treatment by evaluating its effect on the synthesis, metabolism, reuptake, and receptors of 5-hydroxytryptamine (5-HT), so as to clarify the molecular mechanisms of EA for antidepression. Materials and Methods. Solitary combined with the chronic unpredictable mild stress (CUMS) was used to establish the rat model with depression. The depressed rats were supplied with EA treatment for 4 weeks, and the behavior change and the following indices including 5-HT, 5-hydroxyindoleacetic acid (5-HIAA), monoamine oxidase A (MAO-A), tryptophan hydroxylase (TPH), 5-HT transporter (SERT), 5-HT1A, and 5-HT2A in hippocampus and prefrontal cortex were examined. Results. EA treatment significantly improved the behavior of rats and increased 5-HT level in hippocampus of depressed rats. Similarly, EA treatment could significantly increase protein and mRNA expression of TPH and 5-HT1A during 5-HT synthesis process in hippocampus of depressed rats. However, EA treatment had no effect on the activity of MAO-A and the expression of SERT protein and mRNA. Conclusion. Antidepressant efficacy of EA treatment can be accomplished through enhancing 5-HT synthesis, upregulating 5-HT1A level, and improving 5-HT content in brain and synaptic gaps.
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25
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Lu KW, Yang J, Hsieh CL, Hsu YC, Lin YW. Electroacupuncture restores spatial learning and downregulates phosphorylated N-methyl-D-aspartate receptors in a mouse model of Parkinson's disease. Acupunct Med 2016; 35:133-141. [PMID: 27531695 DOI: 10.1136/acupmed-2015-011041] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2016] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Parkinson's disease (PD) is a degenerative disorder of the central nervous system. PD can be classified as idiopathic, acquired or hereditary and may be caused by various factors such as oxidative stress, loss of mitochondrial function, neuronal excitotoxicity or calcium imbalance. METHODS We hypothesised that electroacupuncture (EA) at KI3 would reduce neuronal excitotoxicity by regulating N-methyl-D-aspartate (NMDA) receptor function and may represent a novel therapeutic approach for PD. RESULTS Our results showed that deficits in spatial learning (reflected by the escape latency time in the Morris water maze task) and long-term potentiation (LTP) caused by systemic 6-hydroxydopamine (6-OHDA) administration (that damages dopaminergic neurons) could be rescued by EA on day 3. In PD mice, phosphorylated NMDA receptor subunits NR1 and NR2B were elevated (134.03±10.17% and 123.46±3.47% of baseline levels, respectively) but total NR1 and NR2B was unaffected (101.37±3.87% and 102.61±4.22% of baseline, respectively). Elevated levels of pNR1 and pNR2B, and phosphorylated forms of protein kinase A, protein kinase C, α Ca2+/calmodulin-dependent protein kinase extracellular signal-regulated kinases (pERK), and cAMP response element-binding protein were also reduced following EA. CONCLUSIONS These novel findings suggest that EA can rescue learning and LTP deficits in a rodent model of PD. The results point to a possible role for EA-based approaches in the clinical treatment of learning deficits associated with PD.
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Affiliation(s)
- Kung-Wen Lu
- College of Chinese Medicine, School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan.,Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Jun Yang
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Ching-Liang Hsieh
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.,College of Chinese Medicine, Graduate Institute of Integrative Medicine, China Medical University, Taichung, Taiwan
| | - Yu-Chan Hsu
- College of Chinese Medicine, Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan
| | - Yi-Wen Lin
- College of Chinese Medicine, Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan.,Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, Taiwan
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Duan DM, Dong X, Tu Y, Liu P. A microarray study of chronic unpredictable mild stress rat blood serum with electro-acupuncture intervention. Neurosci Lett 2016; 627:160-7. [PMID: 27264487 DOI: 10.1016/j.neulet.2016.05.054] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 05/24/2016] [Accepted: 05/25/2016] [Indexed: 12/21/2022]
Abstract
In the present study, we investigated the changes of microRNA (miRNA) expression upon depression and electro-acupuncture (EA) intervention in chronic unpredictable mild stress (CUMS) rats using microarray analysis. Results showed that EA intervention remarkably improved behavioral indexes in terms of crossing number, rearing number, sucrose preference and body weight of CUMS rats. Microarray analysis revealed that a total of 153 differentially expressed miRNAs were regulated by CUMS, and the expression of 180 differentially expressed miRNAs was changed after EA intervention. Among these miRNAs, two miRNAs were significantly up-regulated and four miRNAs were significantly down-regulated by CUMS. Moreover, four miRNAs were significantly up-regulated and 12 miRNAs were significantly down-regulated after EA intervention. The expressions of miR-383-5p and miR-764-5p were up-regulated after CUMS, while their expressions were down-regulated by EA intervention. Further analysis showed that 1260 possible target genes were predicted for miR-383-5p and miR-764-5p, and 97 pathways and 137 gene ontology (GO) were involved. Among these pathways and GO, about 20 pathways and 21 GO were related to depression. Changes of miR-383-5p and miR-764-5p indicated that EA might exert its therapeutic effect on depression through promoting the neurotrophy and inhibiting the abnormal apoptosis of neurons as well as other correlative signal pathways. In conclusion, our present study enriched the understanding of pathological process of depression and revealed possible mechanisms of EA on depression.
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Affiliation(s)
- Dong Mei Duan
- Department of Traditional Chinese Medicine of South Building, Chinese PLA General Hospital, Beijing 100853, China.
| | - Xianzhe Dong
- Department of Clinical Pharmacology, General Hospital of Chinese PLA, Beijing 100853, China
| | - Ya Tu
- School of Acupuncture and Moxibustion, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Ping Liu
- Department of Clinical Pharmacology, General Hospital of Chinese PLA, Beijing 100853, China
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Electroacupunctre improves motor impairment via inhibition of microglia-mediated neuroinflammation in the sensorimotor cortex after ischemic stroke. Life Sci 2016; 151:313-322. [PMID: 26979777 DOI: 10.1016/j.lfs.2016.01.045] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 01/09/2016] [Accepted: 01/28/2016] [Indexed: 01/05/2023]
Abstract
AIMS Electroacupuncture (EA) is one of the safety and effective therapies for improving neurological and sensorimotor impairment via blockade of inappropriate inflammatory responses. However, the mechanisms of anti-inflammation involved is far from been fully elucidated. MAIN METHODS Focal cerebral ischemic stroke was administered by the middle cerebral artery occlusion and reperfusion (MCAO/R) surgery. The MCAO/R rats were accepted EA treatment at the LI 11 and ST 36 acupoints for consecutive 3days. The neurological outcome, animal behaviors test and molecular biology assays were used to evaluate the MCAO/R model and therapeutic effect of EA. KEY FINDINGS EA treatment for MCAO rats showed a significant reduction in the infarct volumes accompanied by functional recovery in mNSS outcomes, motor function performances. The possible mechanisms that EA treatment attenuated the over-activation of Iba-1 and ED1 positive microglia in the peri-infract sensorimotor cortex. Simultaneously, both tissue and serum protein levels of the tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) were decreased by EA treatment in MCAO/R injured rats. The levels of inflammatory cytokine tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6) were decreased in the peri-infract sensorimotor cortex and blood serum of MCAO/R injured rats after EA treatment. Furthermore, we found that EA treatment prevented from the nucleus translocation of NF-κB p65 and suppressed the expression of p38 mitogen-activated protein kinase (p38 MAPK) and myeloid differentiation factor 88 (MyD88) in the peri-infract sensorimotor cortex. SIGNIFICANCE The findings from this study indicated that EA improved the motor impairment via inhibition of microglia-mediated neuroinflammation that invoked NF-κB p65, p38 MAPK and MyD88 produced proinflammatory cytokine in the peri-infract sensorimotor cortex of rats following ischemic stroke.
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Martins JC, Aguiar LT, Lara EM, Moura JB, Souza LACE, Teixeira-Salmela LF, Faria CDCDM. Assessment of the strength of the lower limb muscles in subjects with stroke with portable dynamometry: a literature review. FISIOTERAPIA EM MOVIMENTO 2016. [DOI: 10.1590/0103-5150.029.001.ar04] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Weakness of the lower limb muscles, which are the main impairments after stroke, is associated with reduced mobility and decreased performance in functional tasks. Therefore, the assessment of strength of these muscles is necessary, which is commonly assessed with portable dynamometry. Aims: To perform a literature review regarding the methods used to assess lower limb strength with portable dynamometry in subjects with stroke and to describe its investigated measurement properties with this population. Materials and Methods: An extensive search was performed on the MEDLINE, SCIELO, LILACS, and PEDro databases, by combining specific key words, followed by active manual search by two independent researchers. Results and Discussion: Thirty studies were included, and the muscular groups of the knee (90%) were the most assessed, followed by the ankle (66.7%) and hip (63.3%) joints. In 5% of the studies, there were not reported any descriptions related to the positioning of the subjects and the equipment, neither regarding the stabilization procedures. Only 50% provided information regarding the number of trials and only 46.7% regarding the contraction times, being three trials and 5s the most commonly applied. Only 10% provided feedback and 23.3% demonstrations, prior to data collection. Only seven studies (23.3%) investigated the measurement properties of portable dynamometry and reported moderate to high reliability levels. Final Considerations: The protocols used for the assessment of the strength of the lower limb muscles with portable dynamometry in subjects with stroke were not standardized. Moreover, only one measurement property was investigated: the reliability, which was considered adequate.
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Liu W, Shang G, Yang S, Huang J, Xue X, Lin Y, Zheng Y, Wang X, Wang L, Lin R, Tao J, Chen L. Electroacupuncture protects against ischemic stroke by reducing autophagosome formation and inhibiting autophagy through the mTORC1-ULK1 complex-Beclin1 pathway. Int J Mol Med 2015; 37:309-18. [PMID: 26647915 PMCID: PMC4716798 DOI: 10.3892/ijmm.2015.2425] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 11/12/2015] [Indexed: 11/06/2022] Open
Abstract
In a previous study by our group, we demonstrated that electroacupuncture (EA) activates the class I phosphoinositide 3-kinase (PI3K)/Akt signaling pathway. There is considerable evidence that the downstream mammalian target of rapamycin complex 1 (mTORC1) plays an important role in autophagy following ischemic stroke. The aim of the present study was to determine whether EA exerts a neuroprotective effect through mTORC1-mediated autophagy following ischemia/reperfusion injury. Our results revealed that EA at the LI11 and ST36 acupoints attenuated motor dysfunction, improved neurological deficit outcomes and decreased the infarct volumes. The number of autophagosomes, autolysosomes and lysosomes was decreased following treatment with EA. Simultaneously, the levels of the autophagosome membrane maker, microtubule-associated protein 1 light chain 3 beta (LC3B)II/I, Unc-51-like kinase 1 (ULK1), autophagy related gene 13 Atg13) and Beclin1 (ser14) were decreased, whereas mTORC1 expression was increased in the peri-infarct cortex. These results suggest that EA protects against ischemic stroke through the inhibition of autophagosome formation and autophagy, which is mediated through the mTORC1-ULK complex-Beclin1 pathway.
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Affiliation(s)
- Weilin Liu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Guanhao Shang
- The Fujian Province Key Laboratory of Motor Functional Rehabilitation, Fuzhou, Fujian 350001, P.R. China
| | - Shanli Yang
- Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350001, P.R. China
| | - Jia Huang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Xiehua Xue
- Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350001, P.R. China
| | - Yunjiao Lin
- The Fujian Province Key Laboratory of Motor Functional Rehabilitation, Fuzhou, Fujian 350001, P.R. China
| | - Yi Zheng
- The Fujian Province Key Laboratory of Motor Functional Rehabilitation, Fuzhou, Fujian 350001, P.R. China
| | - Xian Wang
- The Fujian Province Key Laboratory of Motor Functional Rehabilitation, Fuzhou, Fujian 350001, P.R. China
| | - Lulu Wang
- The Fujian Province Key Laboratory of Motor Functional Rehabilitation, Fuzhou, Fujian 350001, P.R. China
| | - Ruhui Lin
- The Fujian Province Key Laboratory of Motor Functional Rehabilitation, Fuzhou, Fujian 350001, P.R. China
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Lidian Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
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Chiu CW, Lee TC, Hsu PC, Chen CY, Chang SC, Chiang JY, Lo LC. Efficacy and safety of acupuncture for dizziness and vertigo in emergency department: a pilot cohort study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 15:173. [PMID: 26055400 PMCID: PMC4459064 DOI: 10.1186/s12906-015-0704-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 05/29/2015] [Indexed: 12/04/2022]
Abstract
Background Dizziness and vertigo account for roughly 4% of chief symptoms in the emergency department (ED). Pharmacological therapy is often applied for these symptoms, such as vestibular suppressants, anti-emetics and benzodiazepines. However, every medication is accompanied with unavoidable side-effects. There are several research articles providing evidence of acupuncture treating dizziness and vertigo but few studies of acupuncture as an emergent intervention in ED. We performed a pilot cohort study to evaluate the efficacy and safety of acupuncture in treating patients with dizziness and vertigo in ED. Methods A total of 60 participants, recruited in ED, were divided into acupuncture and control group. Life-threatening conditions or central nervous system disorders were excluded to ensure participants’ safety. The clinical effect of treating dizziness and vertigo was evaluated by performing statistical analyses on data collected from questionnaires of Dizziness Handicap Inventory (DHI), Visual Analog Scale (VAS) of dizziness and vertigo, and heart rate variability (HRV). Results The variation of VAS demonstrated a significant decrease (p-value: 0.001 and p-value: 0.037) between two groups after two different durations: 30 mins and 7 days. The variation of DHI showed no significant difference after 7 days. HRV revealed a significant increase in high frequency (HF) in the acupuncture group. No adverse event was reported in this study. Conclusion Acupuncture demonstrates a significant immediate effect in reducing discomforts and VAS of both dizziness and vertigo. This study provides clinical evidence on the efficacy and safety of acupuncture to treat dizziness and vertigo in the emergency department. Trial registration ClinicalTrials.gov ID: NCT02358239. Registered 5 February 2015
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A microarray study of middle cerebral occlusion rat brain with acupuncture intervention. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:496932. [PMID: 25861363 PMCID: PMC4377484 DOI: 10.1155/2015/496932] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 12/24/2014] [Accepted: 02/05/2015] [Indexed: 11/22/2022]
Abstract
Microarray analysis was used to investigate the changes of gene expression of ischemic stroke and acupuncture intervention in middle cerebral artery occlusion (MCAo) rat brain. Results showed that acupuncture intervention had a remarkable improvement in neural deficit score, cerebral blood flow, and cerebral infarction volume of MCAo rats. Microarray analysis showed that a total of 627 different expression genes were regulated in ischemic stroke. 417 genes were upregulated and 210 genes were downregulated. A total of 361 different expression genes were regulated after acupuncture intervention. Three genes were upregulated and 358 genes were downregulated. The expression of novel genes after acupuncture intervention, including Tph1 and Olr883, was further analyzed by Real-Time Quantitative Polymerase Chain Reaction (RT-PCR). Upregulation of Tph1 and downregulation of Olr883 indicated that the therapeutic effect of acupuncture for ischemic stroke may be closely related to the suppression of poststroke depression and regulation of olfactory transduction. In conclusion, the present study may enrich our understanding of the multiple pathological process of ischemic brain injury and indicate possible mechanisms of acupuncture on ischemic stroke.
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Aman JE, Elangovan N, Yeh IL, Konczak J. The effectiveness of proprioceptive training for improving motor function: a systematic review. Front Hum Neurosci 2015; 8:1075. [PMID: 25674059 PMCID: PMC4309156 DOI: 10.3389/fnhum.2014.01075] [Citation(s) in RCA: 168] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 12/30/2014] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Numerous reports advocate that training of the proprioceptive sense is a viable behavioral therapy for improving impaired motor function. However, there is little agreement of what constitutes proprioceptive training and how effective it is. We therefore conducted a comprehensive, systematic review of the available literature in order to provide clarity to the notion of training the proprioceptive system. METHODS Four major scientific databases were searched. The following criteria were subsequently applied: (1) A quantified pre- and post-treatment measure of proprioceptive function. (2) An intervention or training program believed to influence or enhance proprioceptive function. (3) Contained at least one form of treatment or outcome measure that is indicative of somatosensory function. From a total of 1284 articles, 51 studies fulfilled all criteria and were selected for further review. RESULTS Overall, proprioceptive training resulted in an average improvement of 52% across all outcome measures. Applying muscle vibration above 30 Hz for longer durations (i.e., min vs. s) induced outcome improvements of up to 60%. Joint position and target reaching training consistently enhanced joint position sense (up to 109%) showing an average improvement of 48%. Cortical stroke was the most studied disease entity but no clear evidence indicated that proprioceptive training is differentially beneficial across the reported diseases. CONCLUSIONS There is converging evidence that proprioceptive training can yield meaningful improvements in somatosensory and sensorimotor function. However, there is a clear need for further work. Those forms of training utilizing both passive and active movements with and without visual feedback tended to be most beneficial. There is also initial evidence suggesting that proprioceptive training induces cortical reorganization, reinforcing the notion that proprioceptive training is a viable method for improving sensorimotor function.
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Affiliation(s)
- Joshua E Aman
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota Minneapolis, MN, USA ; Center for Clinical Movement Science, University of Minnesota Minneapolis, MN, USA
| | - Naveen Elangovan
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota Minneapolis, MN, USA
| | - I-Ling Yeh
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota Minneapolis, MN, USA
| | - Jürgen Konczak
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota Minneapolis, MN, USA ; Center for Clinical Movement Science, University of Minnesota Minneapolis, MN, USA
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Lee B, Sur B, Shim J, Hahm DH, Lee H. Acupuncture stimulation improves scopolamine-induced cognitive impairment via activation of cholinergic system and regulation of BDNF and CREB expressions in rats. Altern Ther Health Med 2014; 14:338. [PMID: 25231482 PMCID: PMC4180318 DOI: 10.1186/1472-6882-14-338] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Accepted: 08/28/2014] [Indexed: 11/28/2022]
Abstract
Background Acupuncture is an alternative therapy that is widely used to treat various neurodegenerative diseases and effectively improve cognitive and memory impairment. The aim of this study was to examine whether acupuncture stimulation at the Baihui (GV20) acupoint improves memory defects caused by scopolamine (SCO) administration in rats. We also investigated the effects of acupuncture stimulation at GV20 on the cholinergic system as well as the expression of brain-derived neurotrophic factor (BDNF) and cAMP-response element-binding protein (CREB) in the hippocampus. Methods SCO (2 mg/kg, i.p.) was administered to male rats once daily for 14 days. Acupuncture stimulation at GV20 was performed for 5 min before SCO injection. After inducing cognitive impairment via SCO administration, we conducted a passive avoidance test (PAT) and the Morris water maze (MWM) test to assess behavior. Results Acupuncture stimulation at GV20 improved memory impairment as measured by the PAT and reduced the escape latency for finding the platform in the MWM test. Acupuncture stimulation at GV20 significantly alleviated memory-associated decreases in the levels of choline acetyltransferase (ChAT), BDNF and CREB proteins in the hippocampus. Additionally, acupuncture stimulation at GV20 significantly restored the expression of choline transporter 1 (CHT1), vesicular acetylcholine transporter (VAChT), BDNF and CREB mRNA in the hippocampus. These results demonstrate that acupuncture stimulation at GV20 exerts significant neuroprotective effects against SCO-induced neuronal impairment and memory dysfunction in rats. Conclusions These findings suggest that acupuncture stimulation at GV20 might be useful in various neurodegenerative diseases to improve cognitive functioning via stimulating cholinergic enzyme activities and regulating BDNF and CREB expression in the brain.
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Huang SW, Wang WT, Yang TH, Liou TH, Chen GY, Lin LF. The Balance Effect of Acupuncture Therapy Among Stroke Patients. J Altern Complement Med 2014; 20:618-22. [DOI: 10.1089/acm.2014.0003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Wei-Te Wang
- Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, Changhua, Taiwan
| | - Tsung-Hsien Yang
- Department of Chinese Acupuncture and Traumatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Injury Prevention, Taipei Medical University, Taipei, Taiwan
| | - Guan-Yu Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Li-Fong Lin
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
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Siddiqui MJ, Min CS, Verma RK, Jamshed SQ. Role of complementary and alternative medicine in geriatric care: A mini review. Pharmacogn Rev 2014; 8:81-7. [PMID: 25125879 PMCID: PMC4127825 DOI: 10.4103/0973-7847.134230] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 10/28/2013] [Accepted: 06/10/2014] [Indexed: 11/04/2022] Open
Abstract
Since time immemorial homo sapiens are subjected to both health and diseases states and seek treatment for succor and assuagement in compromised health states. Since last two decades the progressive rise in the alternative form of treatment cannot be ignored and population seems to be dissatisfied with the conventional treatment modalities and therefore, resort to other forms of treatment, mainly complementary and alternative medicine (CAM). The use of CAM is predominantly more popular in older adults and therefore, numerous research studies and clinical trials have been carried out to investigate the effectiveness of CAM in the management of both communicable and non-communicable disease. In this current mini review, we attempt to encompass the use of CAM in chronic non-communicable diseases that are most likely seen in geriatrics. The current review focuses not only on the reassurance of good health practices, emphasizing on the holistic development and strengthening the body's defense mechanisms, but also attempts to construct a pattern of self-care and patient empowerment in geriatrics. The issues of safety with CAM use cannot be sidelined and consultation with a health care professional is always advocated to the patient. Likewise, responsibility of the health care professional is to inform the patient about the safety and efficacy issues. In order to substantiate the efficacy and safety of CAMs, evidence-based studies and practices with consolidated standards should be planned and executed.
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Affiliation(s)
- Mohammad Jamshed Siddiqui
- Department of Pharmaceutical Chemistry, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan Campus, Pahang, Malaysia
| | - Chan Sze Min
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Faculty of Science, University of Stratchlyde, United Kingdom
| | - Rohit Kumar Verma
- Department of Pharamcy Practice, School of Pharmacy, International Medical University, Bukit Jalil Campus, Kuala Lumpur, Malaysia
| | - Shazia Qasim Jamshed
- Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan Campus, Pahang, Malaysia
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Effects of acupuncture at GV20 and ST36 on the expression of matrix metalloproteinase 2, aquaporin 4, and aquaporin 9 in rats subjected to cerebral ischemia/reperfusion injury. PLoS One 2014; 9:e97488. [PMID: 24828425 PMCID: PMC4020847 DOI: 10.1371/journal.pone.0097488] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 04/17/2014] [Indexed: 12/04/2022] Open
Abstract
Background/Purpose Ischemic stroke is characterized by high morbidity and mortality worldwide. Matrix metalloproteinase 2 (MMP2), aquaporin (AQP) 4, and AQP9 are linked to permeabilization of the blood-brain barrier (BBB) in cerebral ischemia/reperfusion injury (CIRI). BBB disruption, tissue inflammation, and MMP/AQP upregulation jointly provoke brain edema/swelling after CIRI, while acupuncture and electroacupuncture can alleviate CIRI symptoms. This study evaluated the hypothesis that acupuncture and electroacupuncture can similarly exert neuroprotective actions in a rat model of middle cerebral artery occlusion (MCAO) by modulating MMP2/AQP4/APQ9 expression and inflammatory cell infiltration. Methods Eighty 8-week-old Sprague-Dawley rats were randomly divided into sham group S, MCAO model group M, acupuncture group A, electroacupuncture group EA, and edaravone group ED. The MCAO model was established by placement of a suture to block the middle carotid artery, and reperfusion was triggered by suture removal in all groups except group S. Acupuncture and electroacupuncture were administered at acupoints GV20 (governing vessel-20) and ST36 (stomach-36). Rats in groups A, EA, and ED received acupuncture, electroacupuncture, or edaravone, respectively, immediately after MCAO. Neurological function (assessed using the Modified Neurological Severity Score), infarct volume, MMP2/AQP4/AQP9 mRNA and protein expression, and inflammatory cell infiltration were all evaluated at 24 h post-reperfusion. Results Acupuncture and electroacupuncture significantly decreased infarct size and improved neurological function. Furthermore, target mRNA and protein levels and inflammatory cell infiltration were significantly reduced in groups A, EA, and ED vs. group M. However, MMP2/AQP levels and inflammatory cell infiltration were generally higher in groups A and EA than in group ED except MMP2 mRNA levels. Conclusions Acupuncture and electroacupuncture at GV20 and ST36 both exercised neuroprotective actions in a rat model of MCAO, with no clear differences between groups A and EA. Therefore, acupuncture and electroacupuncture might find utility as adjunctive and complementary treatments to supplement conventional therapy for ischemic stroke.
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Chen F, Qi Z, Luo Y, Hinchliffe T, Ding G, Xia Y, Ji X. Non-pharmaceutical therapies for stroke: mechanisms and clinical implications. Prog Neurobiol 2014; 115:246-69. [PMID: 24407111 PMCID: PMC3969942 DOI: 10.1016/j.pneurobio.2013.12.007] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 12/19/2013] [Accepted: 12/27/2013] [Indexed: 12/14/2022]
Abstract
Stroke is deemed a worldwide leading cause of neurological disability and death, however, there is currently no promising pharmacotherapy for acute ischemic stroke aside from intravenous or intra-arterial thrombolysis. Yet because of the narrow therapeutic time window involved, thrombolytic application is very restricted in clinical settings. Accumulating data suggest that non-pharmaceutical therapies for stroke might provide new opportunities for stroke treatment. Here we review recent research progress in the mechanisms and clinical implications of non-pharmaceutical therapies, mainly including neuroprotective approaches such as hypothermia, ischemic/hypoxic conditioning, acupuncture, medical gases and transcranial laser therapy. In addition, we briefly summarize mechanical endovascular recanalization devices and recovery devices for the treatment of the chronic phase of stroke and discuss the relative merits of these devices.
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Affiliation(s)
- Fan Chen
- Cerebrovascular Diseases Research Institute, Xuanwu Hospital of Capital Medical University, Beijing, Beijing 100053, China
| | - Zhifeng Qi
- Cerebrovascular Diseases Research Institute, Xuanwu Hospital of Capital Medical University, Beijing, Beijing 100053, China
| | - Yuming Luo
- Cerebrovascular Diseases Research Institute, Xuanwu Hospital of Capital Medical University, Beijing, Beijing 100053, China
| | - Taylor Hinchliffe
- The Vivian L. Smith Department of Neurosurgery, The University of Texas Medical School at Houston, Houston, TX 77030, USA
| | - Guanghong Ding
- Shanghai Research Center for Acupuncture and Meridian, Shanghai 201203, China
| | - Ying Xia
- The Vivian L. Smith Department of Neurosurgery, The University of Texas Medical School at Houston, Houston, TX 77030, USA.
| | - Xunming Ji
- Cerebrovascular Diseases Research Institute, Xuanwu Hospital of Capital Medical University, Beijing, Beijing 100053, China.
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Neuroprotective effect of a formula, moschus combined with borneolum synthcticum, from traditional chinese medicine on ischemia stroke in rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:157938. [PMID: 24782904 PMCID: PMC3982284 DOI: 10.1155/2014/157938] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 02/22/2014] [Indexed: 02/02/2023]
Abstract
Moschus compatible with borneolum synthcticum is a well-known herb pair in Traditional Chinese Medicine and the present study aims to assess the neuroprotective effect of a formula composed of this herb pair on ischemia stroke in rats. The middle cerebral artery occlusion model of focal cerebral ischemia in rat was performed by using intraluminal suture method. The behavioral scores, infarct volume, and neuron ultrastructure of model and formula-treated rats were investigated after the 2 h of ischemia and 24 h of reperfusion. Meanwhile the expression levels of caspase-3, caspase-9, Bcl-2, and Bax were measured by western blot analysis. The formula treatment showed obvious neuroprotective effect according to significant decrease of the neurological scores (P < 0.01) and the infarct volumes (P < 0.05) when compared to the MCAO group. We also observed that this formula had antiapoptosis activity on neuron cell under electron microscope. Furthermore, our result supported the idea that pro- and postadministration of this formula had an antiapoptosis effect by decreasing remarkably the expression of caspase-3 and caspase-9 (P < 0.05) as well as increasing significantly the ratio of Bcl-2 to Bax (P < 0.01). All evidences demonstrated the neuroprotective effect of this formula on ischemia stroke due to decrease of brain infract volume and modulation of the expression of apoptosis-related proteins.
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Ho TJ, Chan TM, Ho LI, Lai CY, Lin CH, Macdonald I, Harn HJ, Lin JG, Lin SZ, Chen YH. The possible role of stem cells in acupuncture treatment for neurodegenerative diseases: a literature review of basic studies. Cell Transplant 2014; 23:559-66. [PMID: 24636189 DOI: 10.3727/096368914x678463] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
This review reports on recent findings concerning the effects of acupuncture and electroacupuncture (EA) on stem cell mobilization and differentiation, in particular with regard to neurogenesis. Traditional Chinese acupuncture has a history of over 2,500 years and is becoming more popular worldwide. Evidence has demonstrated that acupuncture may be of benefit in stroke rehabilitation, parkinsonism, dementia, and depression. This article reviews recent studies concerning the effects of acupuncture/EA on stem cell mobilization and on progenitor cell proliferation in the CNS. The reviewed evidence indicates that acupuncture/EA has beneficial effects in several neurodegenerative diseases, and it may prove to be a nondrug method for mobilizing stem cells in the CNS.
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Affiliation(s)
- Tsung-Jung Ho
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
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Electroacupuncture-Induced Neuroprotection against Cerebral Ischemia in Rats: Role of the Dopamine D2 Receptor. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:137631. [PMID: 24348687 PMCID: PMC3856151 DOI: 10.1155/2013/137631] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 07/24/2013] [Accepted: 07/30/2013] [Indexed: 11/21/2022]
Abstract
Background. Cerebral ischemia is known to produce brain damage and related behavioural deficits, including memory deficits and motor disorders. Evidence shows that EA significantly promotes recovery of neurological function and thus improves quality of life. Objective. Evidence exists for the involvement of catecholamines in human neuroplasticity. A better understanding of dopaminergic (DAergic) modulation in this process will be important. Methods. A total of 72 adult male Sprague-Dawley (SD) rats were divided into 6 groups: normal, model, EA, spiperone group, EA + spiperone group, and pergolide. The middle cerebral artery occlusion (MCAO) model was used in all 6 groups except the normal group. A behavioural assessment was conducted at 1, 3, 5, and 7 days after MCAO. The percent of brain infarct area was also determined 7 days after MCAO. Tyrosine hydroxylase (TH) and growth-associated protein 43 (GAP-43) fluorescence double labeling was performed in the striatum. Results. In this study, we found that EA at Fengchi (GB20) acupoints resulted in marked improvements based on a behavioural assessment. Both TTC staining and GAP-43 immunofluorescence labeling results showed that EA treatment reduced ischemia injury and promoted neuroplasticity compared with the model group. The D2R-selective agonist, pergolide, showed similar results, but these results were reversed by the D2R-selective antagonist, spiperone. We also found that there were more colocalization and expression of GAP-43 and TH in the EA and pergolide groups than those in the other groups. Conclusion. These results suggest that the neuroplasticity induced by EA was mediated by D2 autoreceptors in DAergic neurons.
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Zhang Y, Jin H, Ma D, Fu Y, Xie Y, Li Z, Zou Y. Efficacy of Integrated Rehabilitation Techniques of Traditional Chinese Medicine for Ischemic Stroke: A Randomized Controlled Trial. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2013; 41:971-81. [DOI: 10.1142/s0192415x13500651] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study aimed to determine the efficacy of Integrated Rehabilitation Techniques of Traditional Chinese Medicine (IRT-TCM) on patients with ischemic stroke as an alternative therapy to conventional rehabilitation techniques. Sixty-nine patients with ischemic stroke were randomly assigned to receive either IRT-TCM (intervention group, n = 46) or conventional rehabilitation techniques (control group, n = 23). The IRT-TCM consisted of a sequential combination of acupuncture and massage techniques. The Fugl-Meyer Assessment (FMA), National Institutes of Health Stroke Scale (NIHSS), Barthel index (BI) and modified Rankin Scale (mRS) were measured on day 0 (baseline, before treatment), day 21, and day 90. We observed that the scores in FMA and BI were increased, and NIHSS were decreased in both groups on day 21 and 90, compared with the baseline (day 0). Furthermore, significantly better scores in FMA of lower limbs and NIHSS were found in patients treated with IRT-TCM on day 21 and 90. For mRS, the percentage of patients ranking 0 and 1 in the intervention group presented a striking contrast to the control group on day 90 but with no significant difference. The results indicated that, as a feasible alternative therapy, IRT-TCM is beneficial for patients with ischemic stroke. Further research with larger sample size, long-term observation, and strict blinding are still in need to confirm the efficacy of IRT-TCM.
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Affiliation(s)
- Yong Zhang
- Department of Neurology and Stroke Center, Key Laboratory of Chinese Internal Medicine of Chinese Ministry of Education, China
| | - He Jin
- Department of Rehabilitation, Dongzhimen Hospital affiliated to Beijing University of Chinese Medicine, Beijing 100700, China
| | - Dayong Ma
- Department of Neurology and Stroke Center, Key Laboratory of Chinese Internal Medicine of Chinese Ministry of Education, China
| | - Yuanbo Fu
- Department of Neurology and Stroke Center, Key Laboratory of Chinese Internal Medicine of Chinese Ministry of Education, China
| | - Yanming Xie
- Institute of Basic Clinical Research, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Zongheng Li
- Department of Rehabilitation, Dongzhimen Hospital affiliated to Beijing University of Chinese Medicine, Beijing 100700, China
| | - Yihuai Zou
- Department of Neurology and Stroke Center, Key Laboratory of Chinese Internal Medicine of Chinese Ministry of Education, China
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Nguyen CT, Taw MB, Wang MB. Complementary and Integrative Treatments. Otolaryngol Clin North Am 2013; 46:409-22. [DOI: 10.1016/j.otc.2013.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Jin Z, Liang J, Wang J, Kolattukudy PE. Delayed brain ischemia tolerance induced by electroacupuncture pretreatment is mediated via MCP-induced protein 1. J Neuroinflammation 2013; 10:63. [PMID: 23663236 PMCID: PMC3701471 DOI: 10.1186/1742-2094-10-63] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 04/21/2013] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Emerging studies have demonstrated that pretreatment with electroacupuncture (EA) induces significant tolerance to focal cerebral ischemia. The present study seeks to determine the involvement of monocyte chemotactic protein-induced protein 1 (MCPIP1), a recently identified novel modulator of inflammatory reactions, in the cerebral neuroprotection conferred by EA pretreatment in the animal model of focal cerebral ischemia and to elucidate the mechanisms of EA pretreatment-induced ischemic brain tolerance. METHODS Twenty-four hours after the end of the last EA pretreatment, focal cerebral ischemia was induced by middle cerebral artery occlusion (MCAO) for 90 minutes in male C57BL/6 mice and MCPIP1 knockout mice. Transcription and expression of MCPIP1 gene was monitored by qRT-PCR, Western blot and immunohistochemistry. The neurobehavioral scores, infarction volumes, proinflammatory cytokines and leukocyte infiltration in brain and NF-κB signaling were evaluated after ischemia/reperfusion. RESULTS MCPIP1 protein and mRNA levels significantly increased specifically in mouse brain undergoing EA pretreatment. EA pretreatment significantly attenuated the infarct volume, neurological deficits, upregulation of proinflammatory cytokines and leukocyte infiltration in the brain of wild-type mice after MCAO compared with that of the non-EA group. MCPIP1-deficient mice failed to evoke EA pretreatment-induced tolerance compared with that of the control MCPIP1 knockout group without EA treatment. Furthermore, the activation of NF-κB signaling was significantly reduced in EA-pretreated wild-type mice after MCAO compared to that of the non-EA control group and MCPIP1-deficient mice failed to confer the EA pretreatment-induced inhibition of NF-κB signaling after MCAO. CONCLUSIONS Our data demonstrated that MCPIP1 deficiency caused significant lack of EA pretreatment-induced cerebral protective effects after MCAO compared with the control group and that MCPIP1 is involved in EA pretreatment-induced delayed brain ischemia tolerance.
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Affiliation(s)
- Zhuqing Jin
- School of Basic Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China
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Bai YL, Li L, Hu YS, Wu Y, Xie PJ, Wang SW, Yang M, Xu YM, Zhu B. Prospective, randomized controlled trial of physiotherapy and acupuncture on motor function and daily activities in patients with ischemic stroke. J Altern Complement Med 2013; 19:684-9. [PMID: 23600965 DOI: 10.1089/acm.2012.0578] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To assess the value of acupuncture for promoting the recovery of patients with ischemic stroke and to determine whether the outcomes of combined physiotherapy and acupuncture are superior to those with physiotherapy alone. DESIGN Prospective randomized controlled trial. SETTING Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, P. R. China. PARTICIPANTS 120 inpatients and outpatients (84 men and 36 women). INTERVENTIONS Acupuncture, physiotherapy, and physiotherapy combined with acupuncture. MAIN OUTCOME MEASURES Motor function in the limbs was measured with the Fugl-Meyer assessment (FMA). The modified Barthel index (MBI) was used to rate activities of daily living. All evaluations were performed by assessors blinded to treatment group. RESULTS On the first day of therapy (day 0, baseline), FMA and MBI scores did not significantly differ among the treatment groups. Compared with baseline, on the 28th day of therapy the mean FMA scores of the physiotherapy, acupuncture, and combined treatment groups had increased by 65.6%, 57.7%, and 67.2%, respectively; on the 56th day, FMA scores had increased by 88.1%, 64.5%, and 88.6%, respectively (p<0.05). The respective MBI scores in the three groups increased by 85.2%, 60.4%, and 63.4% at day 28 and by 108.0%, 71.2%, and 86.2% at day 56, respectively (p<0.05). However, FMA scores did not significantly differ among the three treatment groups on the 28th day. By the 56th day, the FMA and MBI scores of the physiotherapy group were 46.1% and 33.2% greater, respectively, than those in the acupuncture group p<0.05). No significant differences were seen between the combined treatment group and the other groups. In addition, the FMA subscores for the upper extremities did not reflect any significant improvement in any group on the 56th day. Although the FMA subscores for the upper and lower extremities and the MBI score in the combined treatment group were higher than those in the acupuncture group, the differences were not statistically significant. CONCLUSIONS Acupuncture is less effective for the outcome measures studied than is physiotherapy. Moreover, the therapeutic effect of combining acupuncture with physiotherapy was not superior to that of physiotherapy alone. A larger-scale clinical trial is necessary to confirm these findings.
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Affiliation(s)
- Yu-Long Bai
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, People's Republic of China
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Electroacupuncture acutely improves cerebral blood flow and attenuates moderate ischemic injury via an endothelial mechanism in mice. PLoS One 2013; 8:e56736. [PMID: 23418594 PMCID: PMC3572074 DOI: 10.1371/journal.pone.0056736] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 01/14/2013] [Indexed: 11/19/2022] Open
Abstract
Electroacupuncture (EA) is a novel therapy based on traditional acupuncture combined with modern eletrotherapy that is currently being investigated as a treatment for acute ischemic stroke. Here, we studied whether acute EA stimulation improves tissue and functional outcome following experimentally induced cerebral ischemia in mice. We hypothesized that endothelial nitric oxide synthase (eNOS)-mediated perfusion augmentation was related to the beneficial effects of EA by interventions in acute ischemic injury. EA stimulation at Baihui (GV20) and Dazhui (GV14) increased cerebral perfusion in the cerebral cortex, which was suppressed in eNOS KO, but there was no mean arterial blood pressure (MABP) response. The increased perfusion elicited by EA were completely abolished by a muscarinic acetylcholine receptor (mAChR) blocker (atropine), but not a β-adrenergic receptor blocker (propranolol), an α-adrenergic receptor blocker (phentolamine), or a nicotinic acetylcholine receptor (nAChR) blocker (mecamylamine). In addition, EA increased acetylcholine (ACh) release and mAChR M3 expression in the cerebral cortex. Acute EA stimulation after occlusion significantly reduced infarct volume by 34.5% when compared to a control group of mice at 24 h after 60 min-middle cerebral artery occlusion (MCAO) (moderate ischemic injury), but not 90-min MCAO (severe ischemic injury). Furthermore, the impact of EA on moderate ischemic injury was totally abolished in eNOS KO. Consistent with a smaller infarct size, acute EA stimulation led to prominent improvement of neurological function and vestibule-motor function. Our results suggest that acute EA stimulation after moderate focal cerebral ischemia, but not severe ischemia improves tissue and functional recovery and ACh/eNOS-mediated perfusion augmentation might be related to these beneficial effects of EA by interventions in acute ischemic injury.
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Abstract
Acupuncture is one of the most important parts of Traditional Chinese Medicine, has been used for more than 3000 years as prevention and treatment for various diseases in China as well as in adjacent regions, and is widely accepted in western countries in recent years. More and more clinical trials revealed that acupuncture shows positive effect in stroke, not only as a complementary and alternative medicine for poststroke rehabilitation but also as a preventive strategy which could induce cerebral ischemic tolerance, especially when combined with modern electrotherapy. Acupuncture has some unique characteristics, which include acupoint specificity and parameter-dependent effect. It also involves complicated mechanism to exert the beneficial effect on stroke. Series of clinical trials have shown that acupuncture primarily regulates the release of neurochemicals, hemorheology, cerebral microcirculation, metabolism, neuronal activity, and the function of specific brain region. Animal studies showed that the effects of acupuncture therapy on stroke were possibly via inhibition of postischemic inflammatory reaction, stimulation of neurogenesis and angiogenesis, and influence on neural plasticity. Mechanisms for its preconditioning effect include activity enhancement of antioxidant, regulation of the endocannabinoid system, and inhibition of apoptosis. Although being controversial, acupuncture is a promising preventive and treatment strategy for stroke, but further high-quality clinical trials would be needed to provide more confirmative evidence.
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Affiliation(s)
- Xin Li
- Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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Yu KW, Lin CL, Hung CC, Chou ECL, Hsieh YL, Li TM, Chou LW. Effects of electroacupuncture on recent stroke inpatients with incomplete bladder emptying: a preliminary study. Clin Interv Aging 2012; 7:469-74. [PMID: 23152677 PMCID: PMC3496194 DOI: 10.2147/cia.s37531] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Incomplete bladder emptying (IBE) is defined as having a postvoid residual (PVR) urine volume greater than 100 mL for 2 consecutive days. IBE is common in stroke patients and could necessitate indwelling or intermittent catheterization. The condition is correlated with urinary tract infections, which could impede rehabilitation progress and increase medical costs. Treatment for patients with IBE includes bladder retraining, biofeedback, medication, and botulinum toxin injection, but none of these interventions are completely effective. Methods All patients with acute stroke who were admitted to the rehabilitation ward between August 2010 and April 2011 were included in the study and their PVR urine volume was checked. Electroacupuncture (EA; 1 Hz, 15 minutes) was performed on the acupoints Sanyinjiao (SP6), Ciliao (BL32), and Pangguangshu (BL28) of stroke patients with IBE for a total of ten treatments (five times a week for 2 weeks). Bladder diaries, which included the spontaneous voiding and PVR urine volumes, were recorded during the course of treatment. Results The presence of IBE was not related to sex, history of diabetes mellitus, stroke type (hemorrhagic or ischemic), or stroke location (P > 0.05). Among the 49 patients in the study, nine (18%) had IBE, and seven of the stroke patients with IBE were treated with EA. Increased spontaneous voiding volume and decreased PVR urine volume were noted after ten sessions of EA. Conclusion EA may have beneficial effects on stroke survivors with IBE, thereby making it a potential safe modality with which to improve urinary function.
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Affiliation(s)
- Kuo-Wei Yu
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan
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Evaluation of the effect of laser acupuncture and cupping with ryodoraku and visual analog scale on low back pain. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:521612. [PMID: 23118792 PMCID: PMC3482015 DOI: 10.1155/2012/521612] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2012] [Revised: 07/06/2012] [Accepted: 07/09/2012] [Indexed: 01/07/2023]
Abstract
The purpose of this study was to evaluate the effect of laser acupuncture (LA) and soft cupping on low back pain. In this study, the subjects were randomly assigned to two groups: active group (real LA and soft cupping) and placebo group (sham laser and soft cupping). Visual analog scale (VAS) and Ryodoraku were used to evaluate the effect of treatment on low back pain in this trial. Laser, 40 mW, wavelength 808 nm, pulse rate 20 Hz, was used to irradiate Weizhong (BL40) and Ashi acupoints for 10 minutes. And the Ryodoraku values were measured 2 times, that is, before and 15 minutes after treatment. The results show that there were significant difference between the first day baseline and the fifth day treatment in VAS in the two groups. Therefore, LA combined with soft cupping or only soft cupping was effective on low back pain. However, the Ryodoraku values of Bladder Meridian of the placebo group have been decreased apparently, and didn't come back to their original values. It means that "cupping" plays the role of "leak or purge" in traditional Chinese medicine (TCM). On the other hand, the Ryodoraku values of Bladder Meridian of the active group have been turned back to almost their original values; "mend or reinforcing" effect is attributed to the laser radiation.
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Chen WL, Hsieh CL. Acupuncture research in Taiwan. Taiwan J Obstet Gynecol 2012; 51:179-85. [DOI: 10.1016/j.tjog.2012.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2012] [Indexed: 10/28/2022] Open
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