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Zhang W, Jin HT, Wang F, Zhang JL, Bao Y, Wang S. A randomized controlled study investigating the efficacy of electro-acupuncture and exercise-based swallowing rehabilitation for post-stroke dysphagia: Impacts on brainstem auditory evoked potentials and cerebral blood flow. Medicine (Baltimore) 2024; 103:e37464. [PMID: 38489710 PMCID: PMC10939640 DOI: 10.1097/md.0000000000037464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 02/07/2024] [Accepted: 02/12/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Swallowing rehabilitation behavioral therapy and traditional Chinese acupuncture therapy are widely used in the treatment of post-stroke dysphagia (PSD). This study investigated the therapeutic effect of electro-acupuncture combined with exercise-based swallowing rehabilitation on PSD and its effect on brainstem auditory evoked potential (BAEP) and cerebral blood flow. METHODS The 120 PSD patients were divided into 2 groups (n = 60 each) by simple random grouping method, that is, an experimental and control group, receiving routine swallowing training, or additional intervention with electro-acupuncture at a frequency of 5 times/week. Data in swallowing function, BAEP, and cerebrovascular color Doppler ultrasound parameters were collected before treatment, as well as after treatment. An intergroup comparison was conducted using an independent sample t-test, and an intra-group comparison was conducted among different time points using a paired t-test. The data were analyzed using the SPSS Statistics 22.0 software; P < .05 was considered statistically significant. RESULTS The therapeutic effects were significantly better in the experimental group compared with the control group (P < .05). The standard swallowing function assessment scores were significantly lower in both groups after treatment (P < .05), and the score in the observation group was lower than in the control group (P < .05). The peak latency of BAEP waves III and IV, and the inter-peak latency between peaks III to V and I to V in the 2 groups changed significantly (P < .05). The peak systolic velocity (PSV), end-diastolic velocity (EDV), and mean velocity (MV) were significantly increased in both groups after treatment (P < .05). The pulsatility index decreased significantly in both groups (P < .05), and the PSV, EDV, and MV were higher in the experimental group than in the control group (P < .05). CONCLUSION Electro-acupuncture, combined with swallowing training in the treatment of Post-stroke Dysphagia, effectively improved cerebral microcirculation and conduction velocity, enhanced the motor function of swallowing muscles, and promoted the recovery of swallowing function.
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Affiliation(s)
- Wen Zhang
- Department of Encephalopathy, The Traditional Chinese Medicine Hospital of Wuhan, Jiang’an, Wuhan, Hubei, China
| | - Hai-Tao Jin
- Department of Encephalopathy, The Traditional Chinese Medicine Hospital of Wuhan, Jiang’an, Wuhan, Hubei, China
| | - Fei Wang
- Department of Encephalopathy, The Traditional Chinese Medicine Hospital of Wuhan, Jiang’an, Wuhan, Hubei, China
| | - Jing-Lan Zhang
- Department of Encephalopathy, The Traditional Chinese Medicine Hospital of Wuhan, Jiang’an, Wuhan, Hubei, China
| | - Yuan Bao
- Department of Network Medicine, The Central Hospital of Wuhan, Jiang’an, Wuhan, Hubei, China
| | - Song Wang
- Department of Massage, The Traditional Chinese Medicine Hospital of Wuhan, Jiang’an, Wuhan, Hubei, China
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Xie R, Han Z, Liu G, Chen L. Association between stroke and venous leg ulcers: A Mendelian randomization study. Int Wound J 2024; 21:e14785. [PMID: 38414343 PMCID: PMC10899862 DOI: 10.1111/iwj.14785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 01/22/2024] [Accepted: 02/02/2024] [Indexed: 02/29/2024] Open
Abstract
To investigate any potential bidirectional causal relationships between stroke and venous leg ulcers (VLUs), Mendelian randomization (MR) analyses were carried out in this study. The exposure factor was stroke, the outcome factor was VLUs. The two-sample MR study was carried out based on the online analysis platform (http://app.mrbase.org/). The association of stroke and VLUs was analysed via methods of Inverse Variance Weighted (IVW), Weighted Median, MR-Egger and weighted mode. IVW method suggested no association between stroke and VLUs ((β 1.06; SE 9.321; p = 0.9095)). Weighted median estimator (β 5.906; SE 11.99, p = 0.6223), MR-Egger (β -0.8677; SE 21.89; p = 0.9691) and weighted mode (β 9.336; SE 17.77; p = 0.6089) showed consistent results. Conversely, evidence indicating that the presence of VLUs increased the risk of stroke was lacking. According to this MR study, there is no causal connection between stroke and VLUs, which suggests that therapies targeting stroke may not be effective against VLUs.
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Affiliation(s)
- Ruiye Xie
- Science and Technology Innovation CenterGuangzhou University of Chinese MedicineGuangzhouChina
| | - Zhengyun Han
- Science and Technology Innovation CenterGuangzhou University of Chinese MedicineGuangzhouChina
| | - Guoqing Liu
- Science and Technology Innovation CenterGuangzhou University of Chinese MedicineGuangzhouChina
| | - Lei Chen
- Hainan Provincial Hospital of Traditional Chinese MedicineHaikouChina
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Yuan S, Qiu B, Liang Y, Deng B, Xu J, Tang X, Wu J, Zhou S, Li Z, Li H, Ye Q, Wang L, Cui S, Tang C, Yi W, Yao L, Xu N. Role of TRPV1 in electroacupuncture-mediated signal to the primary sensory cortex during regulation of the swallowing function. CNS Neurosci Ther 2024; 30:e14457. [PMID: 37718934 PMCID: PMC10916430 DOI: 10.1111/cns.14457] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/19/2023] [Accepted: 08/25/2023] [Indexed: 09/19/2023] Open
Abstract
AIMS Electroacupuncture (EA) at the Lianquan (CV23) could alleviate swallowing dysfunction. However, current knowledge of its neural modulation focused on the brain, with little evidence from the periphery. Transient receptor potential channel vanilloid subfamily 1 (TRPV1) is an ion channel predominantly expressed in sensory neurons, and acupuncture can trigger calcium ion (Ca2+ ) wave propagation through active TRPV1 to deliver signals. The present study aimed to investigate whether TRPV1 mediated the signal of EA to the primary sensory cortex (S1) during regulation of swallowing function. METHODS Blood perfusion was evaluated by laser speckle contrast imaging (LSCI), and neuronal activity was evaluated by fiber calcium recording and c-Fos staining. The expression of TRPV1 was detected by RNA-seq analysis, immunofluorescence, and ELISA. In addition, the swallowing function was assessed by in vivo EMG recording and water consumption test. RESULTS EA treatment potentiated blood perfusion and neuronal activity in the S1, and this potentiation was absent after injecting lidocaine near CV23. TRPV1 near CV23 was upregulated by EA-CV23. The blood perfusion at CV23 was decreased in the TRPV1 hypofunction mice, while the blood perfusion and the neuronal activity of the S1 showed no obvious change. These findings were also present in post-stroke dysphagia (PSD) mice. CONCLUSION The TRPV1 at CV23 after EA treatment might play a key role in mediating local blood perfusion but was not involved in transferring EA signals to the central nervous system (CNS). These findings collectively suggested that TRPV1 may be one of the important regulators involved in the mechanism of EA treatment for improving swallowing function in PSD.
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Affiliation(s)
- Si Yuan
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu‐Moxi and RehabilitationGuangzhou University of Chinese MedicineGuangzhouChina
- Department of Rehabilitation of Traditional Chinese MedicineHunan University of Chinese MedicineChangshaChina
| | - Bo Qiu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu‐Moxi and RehabilitationGuangzhou University of Chinese MedicineGuangzhouChina
| | - Ying Liang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu‐Moxi and RehabilitationGuangzhou University of Chinese MedicineGuangzhouChina
| | - Bing Deng
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu‐Moxi and RehabilitationGuangzhou University of Chinese MedicineGuangzhouChina
| | - Jing Xu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu‐Moxi and RehabilitationGuangzhou University of Chinese MedicineGuangzhouChina
| | - Xiaorong Tang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu‐Moxi and RehabilitationGuangzhou University of Chinese MedicineGuangzhouChina
| | - Junshang Wu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu‐Moxi and RehabilitationGuangzhou University of Chinese MedicineGuangzhouChina
| | - Sheng Zhou
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu‐Moxi and RehabilitationGuangzhou University of Chinese MedicineGuangzhouChina
| | - Zeli Li
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu‐Moxi and RehabilitationGuangzhou University of Chinese MedicineGuangzhouChina
| | - Hongzhu Li
- Rehabilitation CenterFirst Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Qiuping Ye
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu‐Moxi and RehabilitationGuangzhou University of Chinese MedicineGuangzhouChina
- Department of Rehabilitation Medicine, The Third Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Lin Wang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu‐Moxi and RehabilitationGuangzhou University of Chinese MedicineGuangzhouChina
| | - Shuai Cui
- Research Institute of Acupuncture and Meridian, College of Acupuncture and MoxibustionAnhui University of Chinese MedicineHefeiChina
| | - Chunzhi Tang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu‐Moxi and RehabilitationGuangzhou University of Chinese MedicineGuangzhouChina
| | - Wei Yi
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu‐Moxi and RehabilitationGuangzhou University of Chinese MedicineGuangzhouChina
| | - Lulu Yao
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu‐Moxi and RehabilitationGuangzhou University of Chinese MedicineGuangzhouChina
| | - Nenggui Xu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu‐Moxi and RehabilitationGuangzhou University of Chinese MedicineGuangzhouChina
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Ji Y, Zhang Y, Wu R, Wang T, Wang J, Liu Z, Liu W. Treatment of diabetic foot with moxibustion: Clinical evidence from meta-analysis. Int Wound J 2024; 21:e14791. [PMID: 38361252 PMCID: PMC10869878 DOI: 10.1111/iwj.14791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 01/28/2024] [Accepted: 02/02/2024] [Indexed: 02/17/2024] Open
Abstract
To assess the efficacy of moxibustion for diabetic foot, and compile the findings of randomised clinical trials. China National Knowledge Infrastructure Database, Medicine, WanFang Database, Embase, Chinese Scientific Journal Database and Web of Science were from the establishment to January, 2024 were searched. Randomised controlled trials, which evaluated the effects of moxibustion were included. A total of 12 randomised controlled trials involving 1196 patients were included. According to the pooled results of this meta-analysis, effective rate (relative risk 1.16, 95% confidence intervals, CI [1.11, 1.22]), healing time (mean difference [MD] -6.27, 95% CI [-8.68, -3.86]), wound area (MD 3.46, 95% CI [0.84, 6.09]), and ankle brachial index (MD 0.14, 95% CI [0.03, 0.24]) were statistically significant compared to the control group. This study suggests that moxibustion treatment has the potential for improving symptoms of diabetic foot. However, future in-depth research on the benefits and harms of moxibustion for the diabetic foot is needed before it can be accepted as an evidence-based treatment.
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Affiliation(s)
- Yue Ji
- Institute of Nephrology and Beijing Key Laboratory, Dongzhimen HospitalBeijing University of Traditional Chinese MedicineBeijingChina
| | - Yalan Zhang
- The Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - Ruoxi Wu
- Department of NephrologyFirst Teaching Hospital of Tianjin University of Traditional Chinese MedicineTianjinChina
| | - Tuoran Wang
- Institute of Acupuncture and MoxibustionChina Academy of Chinese Medical ScienceBeijingChina
| | - Jiayi Wang
- Institute of Nephrology and Beijing Key Laboratory, Dongzhimen HospitalBeijing University of Traditional Chinese MedicineBeijingChina
| | - Zhongjie Liu
- Institute of Nephrology and Beijing Key Laboratory, Dongzhimen HospitalBeijing University of Traditional Chinese MedicineBeijingChina
| | - Weijing Liu
- Institute of Nephrology and Beijing Key Laboratory, Dongzhimen HospitalBeijing University of Traditional Chinese MedicineBeijingChina
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Cheng CJ, Yu HB. Global trends and development of acupuncture for stroke: A review and bibliometric analysis. Medicine (Baltimore) 2024; 103:e36984. [PMID: 38241541 PMCID: PMC10798747 DOI: 10.1097/md.0000000000036984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/22/2023] [Indexed: 01/21/2024] Open
Abstract
The objective of this review is to elaborate on the status, hotspots, and trends of researches on acupuncture for stroke over the past 26 years. Publications about acupuncture for stroke were downloaded from the Web of Science Core Collection, and these papers were published up to December 31, 2022. A bibliometric analysis of acupuncture for stroke was conducted by CiteSpace (6.2.R4) and VOSviewer (1.6.17). In this study, VOSviewer was used for visual analysis of countries, institutions, authors, journals, keywords, and co-cited references. CiteSpace was used to draw a keyword burst map and a co-cited reference burst map. A total of 534 papers were obtained from the Web of Science Core Collection. The number of papers per year showed a rapid upward trend. The most productive country and institution in this field were China (452) and the Fujian University of Traditional Chinese Medicine (43), respectively. Tao Jing had the highest number of articles (34), and EZ Longa was the most popular author (129 co-citations). Neural Regeneration Research (51) was the most productive journal, and Stroke (1346) was the most co-cited journal. An paper written by EZ Longa was the most influential reference, with the highest citation count. The hotspots and frontiers of this area of research were focused on the mechanisms of acupuncture, especially its neural regenerative or neuroprotective effects. This study used CiteSpace and VOSviewer for bibliometric analysis to provide researchers with information on the research status, hotspots, and trends in acupuncture for stroke research over the past 26 years.
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Affiliation(s)
- Chang-Jiang Cheng
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Hai-Bo Yu
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
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Li X, Lu L, Fu X, Li H, Yang W, Guo H, Guo K, Huang Z. Systematic review and meta-analysis of the efficacy and safety of electroacupuncture for poststroke dysphagia. Front Neurol 2023; 14:1270624. [PMID: 38125830 PMCID: PMC10731355 DOI: 10.3389/fneur.2023.1270624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/16/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction Optimal treatment strategies for post-stroke dysphagia (PSD) remain to be explored. Electroacupuncture (EA) has attracted widespread attention due to its simplicity, cheapness, and safety. However, the efficacy of EA in the treatment of PSD lacks high-level evidence-based medical support. This study aimed to systematically evaluate the clinical value of EA in the treatment of PSD. Methods A total of seven databases were searched for relevant literature. All randomized controlled trials (RCTs) on EA alone or EA combined with other interventions for the treatment of PSD were assessed using the modified Jadad scale. The studies with a score of ≥4 were included. The quality of the included studies was then assessed using the Cochrane Collaboration's tool. The meta-analysis was performed using Rev. Man 5.3 software. Results Twelve studies involving 1,358 patients were included in the meta-analysis. Meta-analysis results showed that the EA group was superior to the control group in terms of clinical response rate (OR = 2.63, 95% CI = 1.97 to 3.53) and videofluoroscopic swallowing study (VFSS) score (MD = 0.73, 95% CI = 0.29 to 1.16). There was no significant difference between the two groups in the standardized swallowing assessment (SSA) score (MD = -3.11, 95% CI = -6.45 to 0.23), Rosenbek penetration-aspiration scale (PAS) score (MD = -0.68, 95% CI = -2.78 to 1.41), Swallowing Quality of Life (SWAL-QOL) score (MD = 13.24, 95% CI = -7.74 to 34.21), or incidence of adverse events (OR = 1.58, 95% CI = 0.73 to 3.38). Conclusion This study shows that EA combined with conventional treatment or other interventions can significantly improve the clinical response rate and VFSS score in patients with PSD without increasing adverse reactions.Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=396840.
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Affiliation(s)
- Xuezheng Li
- Postgraduate Cultivation Base of Guangzhou University of Chinese Medicine, Panyu Central Hospital, Guangzhou, Guangdong, China
| | - Lijun Lu
- Postgraduate Cultivation Base of Guangzhou University of Chinese Medicine, Panyu Central Hospital, Guangzhou, Guangdong, China
| | - Xuefeng Fu
- Postgraduate Cultivation Base of Guangzhou University of Chinese Medicine, Panyu Central Hospital, Guangzhou, Guangdong, China
| | - Hao Li
- Postgraduate Cultivation Base of Guangzhou University of Chinese Medicine, Panyu Central Hospital, Guangzhou, Guangdong, China
| | - Wen Yang
- Postgraduate Cultivation Base of Guangzhou University of Chinese Medicine, Panyu Central Hospital, Guangzhou, Guangdong, China
| | - Hua Guo
- Postgraduate Cultivation Base of Guangzhou University of Chinese Medicine, Panyu Central Hospital, Guangzhou, Guangdong, China
| | - Kaifeng Guo
- Department of Rehabilitation Medicine, Guangzhou Panyu Central Hospital, Guangzhou Guangdong, China
| | - Zhen Huang
- Department of Rehabilitation Medicine, Guangzhou Panyu Central Hospital, Guangzhou Guangdong, China
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Fu X, Li H, Yang W, Li X, Lu L, Guo H, Guo K, Huang Z. Electroacupuncture at HT5 + GB20 promotes brain remodeling and significantly improves swallowing function in patients with stroke. Front Neurosci 2023; 17:1274419. [PMID: 38027487 PMCID: PMC10656700 DOI: 10.3389/fnins.2023.1274419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Background This study compared the differences in the degree of brain activation, and swallowing function scales in patients with post-stroke dysphagia after treatment. We explored the mechanism of cortical remodeling and the improvement effect of electroacupuncture on swallowing function in patients and provided a theoretical basis for the clinical application of electroacupuncture. Methods Fifty patients with post-stroke dysphagia were randomized to the control or electroacupuncture group. The control group underwent conventional swallowing rehabilitation for 30 min each time for 12 sessions. In the electroacupuncture group, electroacupuncture was performed based on conventional swallowing rehabilitation for 30 min each time for 12 sessions. Cortical activation tests and swallowing function assessments were performed before and after treatment. Statistical analyses were used to investigate the differences within and between the two groups to explore the treatment effects. Results There were no statistical differences in clinical characteristics and baseline data between the two groups before treatment. Cortical activation and swallowing function were improved to different degrees in both groups after treatment compared with before treatment. After treatment, the electroacupuncture group showed higher LPM (t = 4.0780, p < 0.001) and RPM (t = 4.4026, p < 0.0001) cortical activation and tighter functional connectivity between RS1 and LM1 (t = 2.5336, p < 0.05), RM1 and LPM (t = 3.5339, p < 0.001), RPM and LM1 (t = 2.5302, p < 0.05), and LM1 and LPM (t = 2.9254, p < 0.01) compared with the control group. Correspondingly, the improvement in swallowing function was stronger in the electroacupuncture group than in the control group (p < 0.05). Conclusion This study demonstrated that electroacupuncture based on conventional treatment activated more of the cerebral cortex associated with swallowing and promoted functional connectivity and remodeling of the brain. Accompanying the brain remodeling, patients in the electroacupuncture group also showed greater improvement in swallowing function. Clinical trial registration ClinicalTrials.gov, ChiCTR2300067457.
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Affiliation(s)
- Xuefeng Fu
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Department of Rehabilitation Medicine, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong, China
| | - Hao Li
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Department of Rehabilitation Medicine, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong, China
| | - Wen Yang
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Department of Rehabilitation Medicine, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong, China
| | - Xuezheng Li
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Lijun Lu
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Hua Guo
- Department of Rehabilitation Medicine, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong, China
| | - Kaifeng Guo
- Department of Rehabilitation Medicine, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong, China
| | - Zhen Huang
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Department of Rehabilitation Medicine, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong, China
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Lekoubou A, Nguyen C, Kwon M, Nyalundja AD, Agrawal A. Post-stroke Everything. Curr Neurol Neurosci Rep 2023; 23:785-800. [PMID: 37837566 DOI: 10.1007/s11910-023-01308-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 10/16/2023]
Abstract
PURPOSE OF REVIEW This review aims at providing updates on selected post-stroke complications. We examined recent advances in diagnosing and treating the following post-stroke complications: cognitive impairment, epilepsy, depression, fatigue, tremors, dysphagia, and pain. RECENT FINDINGS Advances in understanding the mechanisms of post-stroke complications, in general, are needed despite advances made in understanding, treating, and preventing these complications. There are growing progresses in integrating new tools to diagnose post-stroke cognitive impairment. The potential role of acute stroke reperfusion treatment in post-stroke epilepsy and its impact on other stroke complications is getting more transparent. Post-stroke depression remains underestimated and new tools to diagnose depression after stroke are being developed. New promising pharmacological approaches to treating post-stroke pain are emerging. Tremors related to stroke are poorly understood and under-evaluated, while treatment towards post-stroke dysphagia has benefited from new non-pharmacological to pharmacological approaches. CONCLUSIONS An integrative approach to stroke complications and collaborations between providers across specialties are more likely to improve stroke outcomes.
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Affiliation(s)
- Alain Lekoubou
- Department of Neurology, Penn State University, Hershey Medical Center, Hershey, PA, USA.
| | - Clever Nguyen
- Department of Neurology, Penn State University, Hershey Medical Center, Hershey, PA, USA
| | - Michelle Kwon
- Department of Neurology, Penn State University, Hershey Medical Center, Hershey, PA, USA
| | - Arsene Daniel Nyalundja
- Faculty of Medicine, Center for Tropical Diseases and Global Health (CTDGH), Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of Congo
| | - Ankita Agrawal
- College of Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
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Chun H, Shin WC, Kim JM, Kim H, Cho JH, Song MY, Chung WS. Visual bibliometric analysis of electroacupuncture research in stroke treatment: a 20-year overview. Front Neurosci 2023; 17:1265854. [PMID: 37901432 PMCID: PMC10600454 DOI: 10.3389/fnins.2023.1265854] [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: 07/25/2023] [Accepted: 09/25/2023] [Indexed: 10/31/2023] Open
Abstract
Background Electroacupuncture has been used as a treatment; however, a visual bibliometric analysis has not yet been performed in this field. In this study, we aimed to suggest future research topics and directions related to the field by examining the last 20 years of research trends and hotspots of electroacupuncture in stroke. Methods We searched the Web of Science database on electroacupuncture as a treatment for stroke published from 2003 to 2022. We analyzed the papers by annual publication, research fields, nations, affiliations, authors, journals, and keywords. VOSviewer software was used to visualize the bibliometric analysis and results. A total of 440 papers were included in the analysis. Results The number of publications has gradually increased every year, and neuroscience has become the most actively studied field. Neural Regeneration Research journal and China had the most publications. Fujian University of Traditional Chinese Medicine, as an affiliated institute, published the most articles. Chen Lidian and Tao Jing presented the largest number of papers, making them the leading contributors in this field. Four clusters were created by analyzing keywords, such as "neuroprotection," "clinical rehabilitation," "neuroplasticity," and "pretreatment-induced tolerance". Conclusion This study is the first to analyze the research trends in electroacupuncture as a treatment for stroke using the VOSviewer. It shows the current state of research in the field by visualizing research trends and hotspots. This will help offer reference data for future studies.
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Affiliation(s)
- Hyonjun Chun
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
- Department of Korean Rehabilitation Medicine, Dong-shin Korean Medicine Hospital, Seoul, Republic of Korea
| | - Woo-Chul Shin
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
- Department of Korean Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Jong-min Kim
- Department of Oriental Neuropsychiatry, Dong-Seo Medical Center, Seoul, Republic of Korea
| | - Hyungsuk Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
- Department of Korean Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Jae-Heung Cho
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
- Department of Korean Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Mi-Yeon Song
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
- Department of Korean Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Won-Seok Chung
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
- Department of Korean Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
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Zhou Q, Ji Y, Lv Y, Xue J, Wang Y, Huang Y. Scientific Evidence of Acupuncture for Post-Stroke Cognitive Impairment: An Overview of Systematic Reviews and Meta-Analyses. Neuropsychiatr Dis Treat 2023; 19:1503-1513. [PMID: 37424960 PMCID: PMC10327922 DOI: 10.2147/ndt.s407162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/22/2023] [Indexed: 07/11/2023] Open
Abstract
Background Acupuncture may be effective to treat post-stroke cognitive impairment (PSCI). We aimed to evaluate the reliability of the systematic reviews/meta-analyses (SRs/MAs) evidence regarding acupuncture treatment of PSCI. Methods The methodological quality was appraised with Methodological Quality of Systematic Reviews 2 (AMSTAR-2). We evaluated reporting quality with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and evidence quality with Grade of Recommendation, Assessment, Development and Evaluation (GRADE) system. Results The inclusion criteria were met by fifteen reviews. All studies assessed by AMSTAR-2 had critically poor methodological quality due to the limitations on the lack of the provision of the list of excluded trails, screening of duplicate study, and protocol registration. For reporting quality, response rate of "yes" was less than 50% in Q5 (protocol and registration topic), Q8 (Search) and Q23 (Additional analysis). Evidence quality of outcome measures was low or worse with GRADE because when the data was qualitatively synthesized, low quality and small sample size trials provided the data. Conclusion Acupuncture may be beneficial for PSCI. Because of limitations and inconsistent conclusions, further research is needed to provide higher evidence for acupuncture on PSCI.
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Affiliation(s)
- Qiongyang Zhou
- Department of Acupuncture and Moxibustion, The First People’s Hospital of Wenling, Wenling, People’s Republic of China
| | - Yue Ji
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
| | - Yanzhu Lv
- Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
| | - Jing Xue
- Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
| | - Yuhui Wang
- Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
| | - Yin Huang
- Department of Acupuncture, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu, People’s Republic of China
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11
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Xiao Y, Lin Y, Chen Q, Wang R, Li Z, Chen D, Huang Y, Peng G. Acupuncture for swallowing disorder after recovery from COVID-19: A protocol for systematic review and meta analysis. Medicine (Baltimore) 2023; 102:e32491. [PMID: 37000050 PMCID: PMC10063305 DOI: 10.1097/md.0000000000032491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Swallowing disorder is a common sequela after recovery from COVID-19. Acupuncture is an important traditional therapy for treating swallowing disorder. However, the efficacy of acupuncture for swallowing disorder after recovery from COVID-19 lacks evidence-based medicine. METHODS All randomized controlled trials of acupuncture for swallowing disorder after recovery from COVID-19 will be retrieved and collected from December 2019 to November 2022 with no language restrictions. PubMed, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure Database, Chinese Biomedical Database, Chinese Science and Technology Journal Database (VIP), and the Wanfang Database will be searched. Two researchers will independently select studies, extract data, and evaluate study quality. The Cochrane risk of bias tool for randomized trials will be used to assess the risk of bias in the included studies. Statistical analyses will be performed using Review Manager version 5.3. RESULTS This study will provide a high-quality and convincing assessment of the efficacy and safety of acupuncture for swallowing disorder after recovery from COVID-19 and will be published in peer-reviewed journals. CONCLUSION Our findings will provide a reference for future clinical decisions and guidance development.
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Affiliation(s)
- Yao Xiao
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yueqi Lin
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qiqi Chen
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Runyi Wang
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zuming Li
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Daman Chen
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuxin Huang
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Guiyuan Peng
- Department of Otolaryngology-Head and Neck, Guangdong Province Traditional Chinese Medical Hospital, Guangzhou, China
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12
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Luo J, Huang B, Zheng H, Yang Z, Xu M, Xu Z, Ma W, Lin R, Feng Z, Wu M, Cui S. Acupuncture combined with balloon dilation for post-stroke cricopharyngeal achalasia: A meta-analysis of randomized controlled trials. Front Neurosci 2023; 16:1092443. [PMID: 36711135 PMCID: PMC9879211 DOI: 10.3389/fnins.2022.1092443] [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: 11/08/2022] [Accepted: 12/22/2022] [Indexed: 01/13/2023] Open
Abstract
Background The purpose of this study was to systematically evaluate the effectiveness of acupuncture combined with balloon dilatation in patients with post-stroke cricopharyngeal achalasia (CPA) according to the effective rate, videofluoroscopy swallowing study (VFSS) score and standardized swallowing function assessment scale (SSA) score through Meta-analysis. Methods English and Chinese language literature published before July 24,2022 were searched in ten electronic databases. The identified articles were screened, data were extracted, and the methodological quality of the included trials was assessed. Using RevMan 5.4.1 software to perform Meta-analysis. Results 10 studies with 517 patients with post-stroke CPA were included. Meta-analysis showed that the effective rate of the experience group was higher than that of the control group [OR = 0.62; 95% CI (2.32, 13.05); I 2 = 0%; p = 0.0001]. Compared to the control group, the SSA score was lower in the experience group [MD = -4.22; 95% CI (-4.57, -3.87); I 2 = 42%; p < 0.00001]. In terms of VFSS scores, the experience group showed greater efficacy differences than control group [MD = 1.53; 95% CI (1.32, 1.75); I 2 = 0%; p < 0.00001]. The subgroup analysis of VFSS score based on the average course of disease (<1 month vs. ≥1 month) showed no significant difference. The subgroup analysis based on average age (>60 years vs. ≤60 years) showed the VFSS score of the experience group was significantly higher than that of the control group, and the effect may be better in the subgroup older than 60 years. The subgroup analysis based on the treatment course (>30 days vs. ≤30 days) showed the VFSS score of the experience group was significantly higher than that of the control group, and the effect may be better in the subgroup the treatment course>30 days. Conclusion Acupuncture combined with balloon dilatation may be an effective method for treating post-stroke CPA. Compared with balloon dilatation, acupuncture combined with balloon can significantly improve the swallowing function of patients, and it is also effective for patients of different courses, ages, and treatment course, while patients over 60 years old and the treatment course over 30 days may have better clinical outcomes.
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Affiliation(s)
- Jing Luo
- Department of Rehabilitation, Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Bingjing Huang
- Department of Rehabilitation, Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Huiyan Zheng
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zeyu Yang
- Department of Rehabilitation, Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Mingzhu Xu
- Department of Rehabilitation, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Zhenhua Xu
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Wenjun Ma
- Department of Rehabilitation, Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Run Lin
- Department of Rehabilitation, Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zitong Feng
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Meng Wu
- Department of Rehabilitation, Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Shaoyang Cui
- Department of Rehabilitation, Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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13
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Zhang D, Ji Y, Lv L, Zhou Q, Liu Z, Zhang C, Chen S. An Overview of Systematic Reviews and Meta-Analyses of Clinical Studies of Acupuncture for Cancer Pain. Integr Cancer Ther 2023; 22:15347354231210288. [PMID: 37942632 PMCID: PMC10637167 DOI: 10.1177/15347354231210288] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/26/2023] [Accepted: 10/11/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Systematic reviews (SRs) and meta-analyses (MAs) for the use of acupuncture for cancer pain have been increasing, but the evidence has not been systematically and comprehensively assessed. We aimed to perform an overview of the evidence quality of SRs/MAs of acupuncture for improving cancer pain. METHODS 8 databases were systematically searched to identify SRs/MAs of acupuncture for improving cancer pain. The A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2), Risk of Bias in Systematic Reviews (ROBIS), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and Grades of Recommendations, Assessment, Development, and Evaluation (GRADE), respectively, were applied by 2 independent reviewers to evaluate the methodological quality, risk of bias, reporting quality, and evidence quality. RESULTS A total of 14 SRs/MAs were included in the present study. By AMSTAR-2, two reviews were rated as having high methodological quality, while 12 were given a critically low rating. All SRs/MAs in Phase 1, Domain 1, and Domain 4, according to ROBIS, were at low risk. Furthermore, 4 reviews in Domain 2, twelve reviews in Domain 3, and ten SRs/MAs in Phase 3, were rated as having low risk of bias. With reporting quality, some reporting flaws were identified in the topic of protocol and registration, additional analyses, and search strategy. According to GRADE, the level of evidence quality was "critically low" to "moderate," and risk of bias was the most common downgraded factor. CONCLUSION Acupuncture may be beneficial in improving cancer pain. However, due to the identified limitations and inconsistent findings, we recommend further rigorous, and more standardized SRs/MAs to provide strong evidence for definitive conclusions.
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Affiliation(s)
- Di Zhang
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yue Ji
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Liu Lv
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | | | | | - Chenlin Zhang
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
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14
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Shao X, Chen B, Zhu L, Zhu L, Zheng J, Pu X, Chen J, Xia J, Wu X, Zhang J, Wu D. The Effects of Adding Di-Tan Decoction (DTD) and/or Electroacupuncture (EA) to Standard Swallowing Rehabilitation Training (SRT) for Improving Poststroke Dysphagia (PSD): A Pilot, Single-Centred, Randomized Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:2011597. [PMID: 36532853 PMCID: PMC9754838 DOI: 10.1155/2022/2011597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/24/2022] [Accepted: 11/26/2022] [Indexed: 01/06/2024]
Abstract
OBJECTIVES To evaluate the effect of adding Di-tan decoction (DTD) and/or electroacupuncture (EA) to standard swallowing rehabilitation training (SRT) on improving PSD. METHODS In total, 80 PSD patients were enrolled and randomly assigned to the DTD, EA, DTD + EA or control group at a 1 : 1 : 1 : 1 ratio. All patients received basic treatment and standard SRT. The DTD group received DTD orally, the EA group received EA, the DTD + EA group received both DTD and EA simultaneously, and the control group received only basic treatment and standard SRT. The interventions lasted for 4 weeks. The outcome measurements included the Standardized Swallowing Assessment (SSA) and Swallowing-Quality of Life (SWAL-QOL), performed and scored from baseline to 2, 4, and 6 weeks after intervention, and the Videofluoroscopic Dysphagia Scale (VDS), scored at baseline and 4 weeks after intervention. Scores were compared over time by repeated-measures analysis of variance (ANOVA) among all groups. Interactions between interventions were explored using factorial design analysis. RESULTS (1) The effective rates (ERs) for PSD treatment were higher in the DTD, EA and DTD + EA groups than in the control group (all P < 0.05). The ER was higher in the DTD + EA group than in the DTD or EA group (both P < 0.05). (2) There were significant group effects, time effects and interactions for the SSA and SWAL-QOL scores (all P < 0.05). All groups showed decreasing trends in SSA scores and increasing trends in SWAL-QOL scores over time from baseline to 6 weeks after intervention (all P < 0.01). (3) Factorial design analysis for ΔVDS showed that there was a significant main effect for DTD intervention (F = 11.877, P < 0.01) and for EA intervention (F = 29.357, P < 0.01). However, there was no significant interaction effect between DTD and EA (F = 0.133, P = 0.717). Multiple comparisons showed that the DTD, EA and DTD + EA groups all had higher ΔVDS values than the control group (P < 0.05). The DTD + EA group had a higher ΔVDS than the DTD or EA group (both P < 0.05). (4) Most adverse reactions were mild and transient. CONCLUSIONS Adding DTD or EA to SRT can better improve PSD than applying SRT alone. Adding DTD and EA simultaneously can accelerate and amplify the recovery of swallowing function versus DTD or EA alone, and both are effective and safe treatments, alone or jointly, for PSD and are a powerful supplement to routine treatments.
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Affiliation(s)
- Xiangzhi Shao
- Department of Rehabilitation, Wenzhou Hospital of Traditional Chinese Medicine, Wenzhou 325000, China
| | - Bing Chen
- Department of Rehabilitation, Wenzhou Hospital of Traditional Chinese Medicine, Wenzhou 325000, China
| | - Lielie Zhu
- Department of Rehabilitation, Wenzhou Hospital of Traditional Chinese Medicine, Wenzhou 325000, China
| | - Lili Zhu
- Department of Rehabilitation, Wenzhou Hospital of Traditional Chinese Medicine, Wenzhou 325000, China
| | - Jinyihui Zheng
- Department of Rehabilitation, Wenzhou Hospital of Traditional Chinese Medicine, Wenzhou 325000, China
| | - Xinyu Pu
- Department of Rehabilitation, Wenzhou Hospital of Traditional Chinese Medicine, Wenzhou 325000, China
| | - Jiajun Chen
- Department of Rehabilitation, Wenzhou Hospital of Traditional Chinese Medicine, Wenzhou 325000, China
| | - Jianning Xia
- Department of Rehabilitation, Wenzhou Hospital of Traditional Chinese Medicine, Wenzhou 325000, China
| | - Xinming Wu
- Department of Rehabilitation, Wenzhou Hospital of Traditional Chinese Medicine, Wenzhou 325000, China
| | - Jiacheng Zhang
- Department of Rehabilitation, Wenzhou Hospital of Traditional Chinese Medicine, Wenzhou 325000, China
| | - Dengchong Wu
- Department of Rehabilitation, Wenzhou Hospital of Traditional Chinese Medicine, Wenzhou 325000, China
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15
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The Effects of Electroacupuncture as an Adjunct Therapy on Poststroke Aphasia: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:1271205. [PMID: 35966732 PMCID: PMC9374558 DOI: 10.1155/2022/1271205] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 06/06/2022] [Accepted: 06/27/2022] [Indexed: 11/21/2022]
Abstract
Background To systematically collate, appraise, and synthesize evidence of electroacupuncture (EA) as an adjunct therapy for poststroke aphasia (PSA) from randomized controlled trials (RCTs) through a systematic review and meta-analysis. Methods An electronic search was conducted in eight databases to identify RCTs evaluating EA adjuvant therapy versus speech and language therapy (SLT). Methodological quality of the included trails was assessed by the Cochrane risk of bias. The software Review Manager 5.4 was used for data analysis. Results Nineteen RCTs enrolling a total of 1263 subjects were identified. The use of EA combined with speech and language therapy (SLT) showed significant improvements in effective rate (RR 1.31, 95% CI [1.21, 1.41]), oral expression score (SMD 1.34, 95% CI [1.13, 1.56]), comprehension score (SMD 1.95, 95% CI [0.88, 3.03]), repetition score (SMD 1.84, 95% CI [0.75, 2.93]), naming score (SMD 1.97, 95% CI [0.81, 3.13]), and reading score (SMD 1.55, 95% CI [1.07, 2.04]) compared to the use of SLT alone. Conclusions The pooled data indicate that EA combined with SLT for the treatment of PSA may improve clinical effectiveness, compared with SLT alone. Future high quality RCTs with large samples are still needed to confirm and expand our findings.
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16
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Yuan S, Deng B, Ye Q, Wu Z, Wu J, Wang L, Xu Q, Yao L, Xu N. Excitatory neurons in paraventricular hypothalamus contributed to the mechanism underlying acupuncture regulating the swallowing function. Sci Rep 2022; 12:5797. [PMID: 35388042 PMCID: PMC8987055 DOI: 10.1038/s41598-022-09470-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 03/11/2022] [Indexed: 11/20/2022] Open
Abstract
Paraventricular hypothalamus (PVH) is demonstrated to regulate stress, feeding behaviors, and other related homeostatic processes. However, no direct evidence has been investigated for the role of PVH in swallowing function. Acupuncture therapy at Lianquan (CV23) acupoint has been reported to improve the swallowing function in clinical trials, but its underlying mechanism still needs to be uncovered. Thus, we aimed to explore whether PVH involved the acupuncture mediated regulating swallowing function. Chemogenetics, electromyography (EMG) recording, and immunofluorescence staining methods were combined to demonstrate that neurons in PVH could be activated by electroacupuncture (EA) stimulation at CV23, and this neuronal cluster was represented as excitatory neurons. Furthermore, we mapped both the inputs and outputs of PVH neurons using viral tracing. The neurons in PVH projected with the brain regions, including parabrachial nucleus (PBN) and the solitary tract nucleus (NTS), which both participated in the swallowing process. The EA function regulating the swallowing was attenuated after inhibiting the neurons in PVH in the post stroke dysphagia. In conclusion, this study suggested that EA at CV23 could regulate swallowing function involving the excitatory neurons in PVH.
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Affiliation(s)
- Si Yuan
- South China Research Center for Acupuncture and Moxibustion, Guangzhou Higher Education Mega Center, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, 232 East Ring Road, Panyu District, Guangzhou, 510006, People's Republic of China
| | - Bing Deng
- South China Research Center for Acupuncture and Moxibustion, Guangzhou Higher Education Mega Center, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, 232 East Ring Road, Panyu District, Guangzhou, 510006, People's Republic of China
| | - Qiuping Ye
- South China Research Center for Acupuncture and Moxibustion, Guangzhou Higher Education Mega Center, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, 232 East Ring Road, Panyu District, Guangzhou, 510006, People's Republic of China.,Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, No. 600, Tianhe Road, Guangzhou, 510630, Guangdong, China
| | - Zhennan Wu
- South China Research Center for Acupuncture and Moxibustion, Guangzhou Higher Education Mega Center, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, 232 East Ring Road, Panyu District, Guangzhou, 510006, People's Republic of China
| | - Junshang Wu
- South China Research Center for Acupuncture and Moxibustion, Guangzhou Higher Education Mega Center, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, 232 East Ring Road, Panyu District, Guangzhou, 510006, People's Republic of China
| | - Lin Wang
- South China Research Center for Acupuncture and Moxibustion, Guangzhou Higher Education Mega Center, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, 232 East Ring Road, Panyu District, Guangzhou, 510006, People's Republic of China
| | - Qin Xu
- South China Research Center for Acupuncture and Moxibustion, Guangzhou Higher Education Mega Center, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, 232 East Ring Road, Panyu District, Guangzhou, 510006, People's Republic of China
| | - Lulu Yao
- South China Research Center for Acupuncture and Moxibustion, Guangzhou Higher Education Mega Center, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, 232 East Ring Road, Panyu District, Guangzhou, 510006, People's Republic of China.
| | - Nenggui Xu
- South China Research Center for Acupuncture and Moxibustion, Guangzhou Higher Education Mega Center, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, 232 East Ring Road, Panyu District, Guangzhou, 510006, People's Republic of China.
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