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Zhang Y, Tang YW, Peng YT, Yan Z, Zhou J, Yue ZH. Acupuncture, an effective treatment for post-stroke neurologic dysfunction. Brain Res Bull 2024; 215:111035. [PMID: 39069104 DOI: 10.1016/j.brainresbull.2024.111035] [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: 06/01/2024] [Revised: 07/19/2024] [Accepted: 07/25/2024] [Indexed: 07/30/2024]
Abstract
Stroke episodes represent a significant subset of cerebrovascular diseases globally, often resulting in diverse neurological impairments such as hemiparesis, spasticity, dysphagia, sensory dysfunction, cognitive impairment, depression, aphasia, and other sequelae. These dysfunctions markedly diminish patients' quality of life and impose substantial burdens on their families and society. Consequently, the restoration of neurological function post-stroke remains a primary objective of clinical treatment. Acupuncture, a traditional Chinese medicine technique, is endorsed by the World Health Organization (WHO) for stroke treatment due to its distinct advantages in managing cerebrovascular diseases, including ischemic stroke. Numerous clinical studies have substantiated the efficacy of acupuncture in ameliorating neurological dysfunctions following stroke. This review systematically examines the improvements in post-stroke neurological dysfunction attributable to acupuncture treatment and elucidates potential mechanisms of action proposed in recent years. Additionally, this article aims to present novel therapeutic concepts and strategies for the clinical management of post-stroke neurological dysfunction.
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Affiliation(s)
- You Zhang
- College of Acupuncture, Massage and Rehabilitation, Hunan University of Chinese Medicine, Changsha 410208, China
| | - Yi-Wen Tang
- College of Acupuncture, Massage and Rehabilitation, Hunan University of Chinese Medicine, Changsha 410208, China
| | - Yu-Ting Peng
- College of Acupuncture, Massage and Rehabilitation, Hunan University of Chinese Medicine, Changsha 410208, China
| | - Zi Yan
- College of Acupuncture, Massage and Rehabilitation, Hunan University of Chinese Medicine, Changsha 410208, China
| | - Jin Zhou
- College of Acupuncture, Massage and Rehabilitation, Hunan University of Chinese Medicine, Changsha 410208, China
| | - Zeng-Hui Yue
- College of Acupuncture, Massage and Rehabilitation, Hunan University of Chinese Medicine, Changsha 410208, China.
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Ye Q, Hu J, Dai Y, Wen H, Dou Z. Mapping research trends regarding the mechanism of dysphagia from 1993 to 2023: a bibliometrics study and visualization analysis. Front Neurol 2024; 15:1363928. [PMID: 39026580 PMCID: PMC11254800 DOI: 10.3389/fneur.2024.1363928] [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: 01/08/2024] [Accepted: 06/17/2024] [Indexed: 07/20/2024] Open
Abstract
As a common consequence of various neurogenic disorders, dysphagia has a significant impact on the quality of life for patients. To promote the development the field of swallowing, it will be helpful to clarify the pathological and therapeutic mechanisms of dysphagia. Through visual analysis of related papers from 1993 to 2023 in the Web of Science Core Collection (WoSCC) database, the research status and development trend of the pathogenesis of dysphagia were discussed. The co-occurrence study was finished using CiteSpace 6.2 R4 software, including keywords, countries, institutions, and authors. Finally, 1,184 studies satisfied the inclusion requirements. The findings of the visualization analysis suggested that aspiration and gastroesophageal reflux disease would be the areas of greatest interest for researchers studying the mechanism of dysphagia. As for the latest occurred research trends, fMRI, signals and machine learning emerging into the field of view of researchers. Based on an analysis of country co-occurrence, United States, Japan and China rank the top three, in terms of the number of publications on dysphagia. University System of Ohio is the organization that has published the most amount of articles regarding the mechanism of dysphagia. Other highly published schools in the top three include State University System of Florida and Northwestern University. For the prolific authors, German, Rebecca Z published the most articles at present, whose own research team working closely together. Several closely cooperating research teams have been formed at present, including the teams centered around German, Rebecca Z, Warnecke, Tobias and Hamdy Shaheen. This study intuitively analyzed the current research status of the mechanism of dysphagia, provided researchers with research hotspots in this field.
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Affiliation(s)
- Qiuping Ye
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jiahui Hu
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Yong Dai
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Hongmei Wen
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zulin Dou
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Wang Y, Feng W, Peng J, Ye F, Song J, Bao X, Li C. Development and validation of a risk prediction model for aspiration in patients with acute ischemic stroke. J Clin Neurosci 2024; 124:60-66. [PMID: 38652929 DOI: 10.1016/j.jocn.2024.04.022] [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: 02/14/2024] [Revised: 03/22/2024] [Accepted: 04/19/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Aspiration is a frequently observed complication in individuals diagnosed with acute ischemic stroke, leading to potentially severe consequences. However, the availability of predictive tools for assessing aspiration probabilities remains limited. Hence, our study aimed to develop and validate a nomogram for accurately predicting aspiration probability in patients with acute ischemic stroke. METHODS We analyzed 30 potential risk factors associated with aspiration in 359 adult patients diagnosed with acute ischemic stroke. Advanced statistical techniques, such as Least absolute shrinkage and selection operator (LASSO) and Multivariate Logistic regression, were employed to identify independent predictors. Subsequently, we developed a nomogram prediction model based on these predictors, which underwent internal validation through 1000 bootstrap resampling. Two additional cohorts (Cohort A n = 64; Cohort B, n = 105) were included for external validation. The discriminatory power and calibration performance of the nomogram were assessed using rigorous methods, including the Hosmer-Lemeshow test, area under the receiver operating characteristic curve (AUC), calibration curve analyses, and decision curve analyses (DCA). RESULTS The nomogram was established based on four variables: sputum suction, brain stem infarction, temporal lobe infarction, and Barthel Index score. The predictive model exhibited satisfactory discriminative ability, with an area under the receiver operating characteristic curve of 0.853 (95 % confidence interval, 0.795-0.910), which remained consistent at 0.852 (95 % confidence interval, 0.794-0.912) during the internal validation. The Hosmer-Lemeshow test (P = 0.394) and calibration curve demonstrated favorable consistency between the predicted and observed outcomes in the development cohort. The AUC was 0.872 (95 % confidence interval, 0.783-0.962) in validation cohort A and 0.877 (95 % confidence interval, 0.764-0.989) in validation cohort B, demonstrating sustained accuracy. DCA showed a good net clinical benefit of the nomogram. CONCLUSIONS A nomogram for predicting the probability of aspiration in patients with acute ischemia has been successfully developed and validated.
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Affiliation(s)
- Yina Wang
- Department of Neurology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China; Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Weijiao Feng
- Department of Neurology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China
| | - Jie Peng
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Fen Ye
- Department of Neurology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China
| | - Jun Song
- Department of Otolaryngology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China
| | - Xiaoyan Bao
- Department of Nephrology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China
| | - Chaosheng Li
- Department of Neurology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China.
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Tang X, Shi J, Lin S, He Z, Cui S, Di W, Chen S, Wu J, Yuan S, Ye Q, Yang X, Shang Y, Zhang Z, Wang L, Lu L, Tang C, Xu N, Yao L. Pyramidal and parvalbumin neurons modulate the process of electroacupuncture stimulation for stroke rehabilitation. iScience 2024; 27:109695. [PMID: 38680657 PMCID: PMC11053320 DOI: 10.1016/j.isci.2024.109695] [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: 10/20/2023] [Revised: 02/09/2024] [Accepted: 04/05/2024] [Indexed: 05/01/2024] Open
Abstract
Electroacupuncture (EA) stimulation has been shown to be beneficial in stroke rehabilitation; however, little is known about the neurological mechanism by which this peripheral stimulation approach treats for stroke. This study showed that both pyramidal and parvalbumin (PV) neuronal activity increased in the contralesional primary motor cortex forelimb motor area (M1FL) after ischemic stroke induced by focal unilateral occlusion in the M1FL. EA stimulation reduced pyramidal neuronal activity and increased PV neuronal activity. These results were obtained by a combination of fiber photometry recordings, in vivo and in vitro electrophysiological recordings, and immunofluorescence. Moreover, EA was found to regulate the expression/function of N-methyl-D-aspartate receptors (NMDARs) altered by stroke pathology. In summary, our findings suggest that EA could restore disturbed neuronal activity through the regulation of the activity of pyramidal and PV neurons. Furthermore, NMDARs we shown to play an important role in EA-mediated improvements in sensorimotor ability during stroke rehabilitation.
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Affiliation(s)
- Xiaorong Tang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Jiahui Shi
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Shumin Lin
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Zhiyin He
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Shuai Cui
- Research Institute of Acupuncture and Meridian, Anhui University of Chinese Medicine, Hefei 230000, Anhui Province, China
- College of Acupuncture and Moxibustion, Anhui University of Chinese Medicine, Hefei 230000, Anhui Province, China
| | - Wenhui Di
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Siyun Chen
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Junshang Wu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Si Yuan
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Qiuping Ye
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Xiaoyun Yang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Ying Shang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Zhaoxiang Zhang
- State Key Laboratory of Chemical Oncogenomics, Guangdong Provincial Key Laboratory of Chemical Genomics, Peking University, Shenzhen 518055, China
| | - Lin Wang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Liming Lu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Chunzhi Tang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Nenggui Xu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Lulu Yao
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
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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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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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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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Fu X, Li H, Yang W, Li X, Lu L, Guo H, Wu Z, Guo K, Xu H, Huang Z. Electroacupuncture at HT5 + GB20 produces stronger activation effect on swallowing cortex and muscle than single points. Heliyon 2023; 9:e21922. [PMID: 38034817 PMCID: PMC10682618 DOI: 10.1016/j.heliyon.2023.e21922] [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: 04/17/2023] [Revised: 08/25/2023] [Accepted: 10/31/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction This study aimed to investigate the effects of electroacupuncture on cortical activation and swallowing muscle groups. The study examined brain activation in healthy subjects performing swallowing tasks during electroacupuncture. Additionally, the study analyzed electromyographic signals of swallowing muscle groups after electroacupuncture. Methods Twenty-seven healthy subjects were randomly separated into three groups. They underwent electroacupuncture at HT5 acupoint (HT5 group), or GB20 acupoint (GB20 group), or HT5 + GB20 acupoint (HT5 + GB20 group) for 30 min of intervention. Subjects performed a swallowing task while receiving electroacupuncture. Functional near-infrared spectroscopy (fNIRS) was used to detect cortical activation and functional connectivity (FC). The mean amplitude values of the swallowing muscle groups after electroacupuncture were also measured. Statistical analysis was used to investigate the differences between the three groups. The protocol was registered with the China Clinical Trials Registry with the registration number ChiCTR2300067457. Results Compared with the HT5 group, the HT5 + GB20 group showed higher cortical activation in the LM1 (t = 2.842, P < 0.05) and a tighter FC in the RM1 and LM1 (t = 2.4629, P < 0.05) with considerably increased mean amplitude values of the swallowing muscle groups (t = 5.2474, P < 0.0001). Increased FC was found in the HT5 + GB20 group compared to the GB20 group between the RM1 and RS1 (t = 2.9997, P < 0.01), RM1 and RPM (t = 2.2116, P < 0.05), RM1 and LM1 (t = 3.2078, P < 0.01), RPM and LM1 (t = 2.7440, P < 0.05). However, there were no statistically significant differences in cortical activation or mean amplitude values of swallowing muscle groups. Conclusion This study showed that electroacupuncture at HT5 + GB20 acupoints particularly engaged the cerebral cortex related to swallowing, resulting in tighter functional connectivity and higher amplitude values of swallowing muscle groups than electroacupuncture at single acupoints. The results may reveal the mechanism of electroacupuncture for post-stroke swallowing dysphagia.
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Affiliation(s)
- Xuefeng Fu
- Department of Rehabilitation Medicine, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong, 511400, China
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510006, China
| | - Hao Li
- Department of Rehabilitation Medicine, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong, 511400, China
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510006, China
| | - Wen Yang
- Department of Rehabilitation Medicine, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong, 511400, China
| | - Xuezheng Li
- Department of Rehabilitation Medicine, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong, 511400, China
| | - Lijun Lu
- Department of Rehabilitation Medicine, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong, 511400, China
| | - Hua Guo
- Department of Rehabilitation Medicine, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong, 511400, China
| | - Zhehao Wu
- Department of Rehabilitation Medicine, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong, 511400, China
| | - Kaifeng Guo
- Department of Rehabilitation Medicine, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong, 511400, China
| | - Haoming Xu
- South China Normal University, Guangzhou, Guangdong, 510631, China
| | - Zhen Huang
- Department of Rehabilitation Medicine, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong, 511400, China
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510006, China
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Li L, Xu F, Yang S, Kuang P, Ding H, Huang M, Guo C, Yuan Z, Xiao X, Wang Z, Zhang P. Tongue acupuncture for the treatment of post-stroke dysphagia: a meta-analysis of randomized controlled trials. Front Neurosci 2023; 17:1124064. [PMID: 37304013 PMCID: PMC10247969 DOI: 10.3389/fnins.2023.1124064] [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: 12/14/2022] [Accepted: 04/12/2023] [Indexed: 06/13/2023] Open
Abstract
Objectives Post-stroke dysphagia is the most common neurological impairment after stroke. The swallowing process is controlled by a network made up of the cerebral cortex, subcortical area, and brainstem structure. The disruption of the swallowing network after stroke leads to dysphagia. The affected swallowing muscles after stroke mainly include the laryngeal muscles (suprahyoid muscle and thyrohyoid muscle) and infrahyoid muscle. These muscles experience kinematic effects and muscle strength weakens, resulting in reduced movement in the swallowing process. Acupuncture can change the excitability of cerebral cortical nerve cells, promote the recovery of neurological function, and enhance neuromuscular excitability, ultimately improving the control of swallowing-related nerves and muscles and promoting swallowing functional recovery. In this meta-analysis, we systematically evaluate the clinical efficacy of acupuncture in the treatment of post-stroke dysphagia. Methods Randomized controlled trials of tongue acupuncture therapy for post-stroke dysphagia were searched and selected from seven electronic databases (PubMed, CBM, Cochrane, Embase, CNKI, VPCS, and Wan fang). The Cochrane Collaboration tool was used to conduct methodological quality assessment. Rev. Man 5.4 software was utilized to perform data analysis. Results A total of 15 studies with 1,094 patients were included. Meta-analysis Showed that WST score WST score (MD = -0.56, 95% CI (-1.23, 0.12), Z = 1.62, p < 0.00001), SSA score (MD = -1.65, 95% CI (-2.02, -1.28), Z = 8.77, p < 0.00001). These results suggested that the treatment group (tongue acupuncture or tongue acupuncture combined with other therapies) was superior to the control group in reducing WST scores and SSA scores. The clinical efficacy of the tongue acupuncture group was better compared with the control group (MD = 3.83, 95% CI (2.61, 5.62), Z = 6.88, p < 0.00001). Conclusion The meta-analysis showed that the total effective rate of patients with dysphagia after stroke in the treatment group (acupuncture, tongue acupuncture, and acupuncture combined with other therapy) was higher than that in the control group. These results indicated that acupuncture, tongue acupuncture, and acupuncture combined with other therapy can improve post-stroke dysphagia.
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Affiliation(s)
- Li Li
- Department of Acupuncture, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China
| | - Fei Xu
- Key Laboratory of Acupuncture and Massage for Treatment of Encephalopathy, College of Acupuncture, Tuina and Rehabilitation, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Shengping Yang
- Key Laboratory of Acupuncture and Massage for Treatment of Encephalopathy, College of Acupuncture, Tuina and Rehabilitation, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Peng Kuang
- Key Laboratory of Acupuncture and Massage for Treatment of Encephalopathy, College of Acupuncture, Tuina and Rehabilitation, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Haoying Ding
- Key Laboratory of Acupuncture and Massage for Treatment of Encephalopathy, College of Acupuncture, Tuina and Rehabilitation, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Mei Huang
- Department of Acupuncture, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China
| | - Chunyan Guo
- Department of Acupuncture, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China
| | - Zishui Yuan
- Department of Acupuncture, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China
| | - Xiao Xiao
- Department of Acupuncture, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China
| | - Zuhong Wang
- Department of Acupuncture, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China
| | - Pengyue Zhang
- Key Laboratory of Acupuncture and Massage for Treatment of Encephalopathy, College of Acupuncture, Tuina and Rehabilitation, Yunnan University of Traditional Chinese Medicine, Kunming, China
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10
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Lin J, Kong Y, Chen H, Zhu M, Lv Q, Xu B, Zhu F. Effects of acupuncture on obstructive sleep apnea-hypopnea syndrome: A meta-analysis. Res Nurs Health 2023; 46:220-235. [PMID: 36808731 DOI: 10.1002/nur.22302] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 01/04/2023] [Accepted: 01/26/2023] [Indexed: 02/21/2023]
Abstract
Our study aimed to systematically evaluate the effect of acupuncture in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Literature search of four Chinese databases and six English databases for studies published from the inception of each database to March 1, 2022 and identify relevant studies published in Chinese or English. Related randomized controlled trials of acupuncture for the treatment of OSAHS were included to analyze the efficacy of acupuncture. Two researchers independently reviewed all of the retrieved studies to screen for eligible studies and extract the required relevant data. Included studies were subjected to a methodological quality assessment using the Cochrane Manual 5.1.0, and to a meta-analysis using Cochrane Review Manager version 5.4. A total of 19 studies with 1365 participants were examined. Compared with the control group, the apnea-hypopnea index, lowest oxygen saturation, Epworth Sleepiness Scale, interleukin-6, tumor necrosis factor α, and nuclear factor κ-B indicators all exhibited statistically significant changes. Thus, acupuncture was effective in alleviating the state of hypoxia and sleepiness and reduced the inflammatory response and disease severity among reported patients with OSAHS. Therefore, acupuncture could be widely used in the clinical treatment of OSAHS patients as a complementary strategy and warrants further study.
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Affiliation(s)
- Jiamin Lin
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Yue Kong
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
- 900TH Hospital of Joint Logistic Support Force, Fuzhou, China
| | - Hailan Chen
- The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Meilin Zhu
- 900TH Hospital of Joint Logistic Support Force, Fuzhou, China
| | - Qian Lv
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Baoling Xu
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Fangfang Zhu
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
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11
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Yao L, Ye Q, Liu Y, Yao S, Yuan S, Xu Q, Deng B, Tang X, Shi J, Luo J, Wu J, Wu Z, Liu J, Tang C, Wang L, Xu N. Electroacupuncture improves swallowing function in a post-stroke dysphagia mouse model by activating the motor cortex inputs to the nucleus tractus solitarii through the parabrachial nuclei. Nat Commun 2023; 14:810. [PMID: 36781899 PMCID: PMC9925820 DOI: 10.1038/s41467-023-36448-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 02/01/2023] [Indexed: 02/15/2023] Open
Abstract
As a traditional medical therapy, stimulation at the Lianquan (CV23) acupoint, located at the depression superior to the hyoid bone, has been shown to be beneficial in dysphagia. However, little is known about the neurological mechanism by which this peripheral stimulation approach treats for dysphagia. Here, we first identified a cluster of excitatory neurons in layer 5 (L5) of the primary motor cortex (M1) that can regulate swallowing function in male mice by modulating mylohyoid activity. Moreover, we found that focal ischemia in the M1 mimicked the post-stroke dysphagia (PSD) pathology, as indicated by impaired water consumption and electromyographic responses in the mylohyoid. This dysfunction could be rescued by electroacupuncture (EA) stimulation at the CV23 acupoint (EA-CV23) in a manner dependent on the excitatory neurons in the contralateral M1 L5. Furthermore, neuronal activation in both the parabrachial nuclei (PBN) and nucleus tractus solitarii (NTS), which was modulated by the M1, was required for the ability of EA-CV23 treatment to improve swallowing function in male PSD model mice. Together, these results uncover the importance of the M1-PBN-NTS neural circuit in driving the protective effect of EA-CV23 against swallowing dysfunction and thus reveal a potential strategy for dysphagia intervention.
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Affiliation(s)
- Lulu Yao
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Qiuping Ye
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China.,Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, China
| | - Yun Liu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China.,Department of Physiology, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, 100700, Beijing, China
| | - Shuqi Yao
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Si Yuan
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Qin Xu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Bing Deng
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Xiaorong Tang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Jiahui Shi
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Jianyu Luo
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Junshang Wu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Zhennan Wu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Jianhua Liu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China.,Acupuncture Research Team, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
| | - Chunzhi Tang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Lin Wang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China.
| | - Nenggui Xu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China.
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12
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Zhang Z, Yan L, Xing X, Zhu L, Wu H, Xu S, Wan P, Ding R. Brain Activation Site of Laryngeal Elevation During Swallowing: An fMRI Study. Dysphagia 2023; 38:268-277. [PMID: 35760876 DOI: 10.1007/s00455-022-10464-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 04/28/2022] [Indexed: 01/27/2023]
Abstract
The object of this study is to investigate dysphagia caused by reduced laryngeal elevation in patients poststroke. The central mechanism of laryngeal elevation during swallowing was explored by comparing the brain activation area before and after treatment with that of healthy subjects. The treatment group included patients diagnosed with dysphagia poststroke that showed reduced laryngeal elevation. They were treated with electrical stimulation at the motor points of the muscles related to laryngeal elevation. Functional magnetic resonance imaging (fMRI) using the blood oxygenation level-dependent (BOLD) was used to observe brain activation of the normal healthy control group and treatment group during voluntary swallowing. Independent sample t test and paired sample t test were used to analyze the differences in brain activation between and within the groups. Compared with the control group, no activation was observed in the brainstem and putamen regions of the experimental group before treatment. Statistics showed that the experimental group had a wider range of brain activation than the control group pretreatment, including the left supplementary motor area, the cingulate gyrus, the inferior frontal gyrus, the right thalamus, and the right putamen. After the electrical stimulation, the brain stem subregion, the left cerebellar lobule IV and V, and parts of the cerebral cortex were more active, while the left supplementary motor area, paracentral lobule, and occipital lobule were less active post-treatment. (1) The brainstem and putamen are the specific brain regions that control laryngeal movement. (2) The enhanced activation of the cortical-basal ganglia-thalamic circuit after stroke is a compensatory mechanism. (3) The improvement of hyoid bone elevation was related to the enhanced activation of the IV and V lobes of the cerebellar hemisphere. The over-activation of the supplementary motor area poststroke would subside once the motor function improved.
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Affiliation(s)
- Zhiyi Zhang
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
- Department of Rehabilitation, Shanghai Seventh People's Hospital, Shanghai, 200137, China
| | - Ling Yan
- Department of Rehabilitation Medicine, Shanghai Ruijin Rehabilitation Hospital, Shanghai, 200023, China
| | - Xiangxin Xing
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
- Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, 201203, China
| | - Lequn Zhu
- Department of Radiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China
| | - Haoyue Wu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Shuangjing Xu
- Department of Neurological Rehabilitation, Kunshan Rehabilitation Hospital, Suzhou, 215300, Jiangsu Province, China
| | - Ping Wan
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
| | - Ruiying Ding
- Department of Communication Science and Disorders, Elmhurst University, Elmhurst, IL, 60126, USA.
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13
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Li F, Quan J, Wen Q. Effect of electroacupuncture and scalp acupuncture combined with language rehabilitation training on cognitive and speech functions of aphasia patients after craniocerebral injury. Am J Transl Res 2022; 14:5923-5930. [PMID: 36105057 PMCID: PMC9452345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 07/22/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To explore the clinical effect of electroacupuncture and scalp acupuncture combined with language rehabilitation training on cognitive and speech functions of patients with aphasia after craniocerebral injury. METHODS Seventy patients with aphasia after craniocerebral injury from January 2020 and January 2021 were retrospectively collected after filtering. Among them, 35 patients received language rehabilitation training and were included into a control group, and 35 patients who received electroacupuncture and scalp acupuncture combined with language rehabilitation training were included in a study group. Aphasia quotient score, Loewenstein occupational therapy cognitive assessment (LOTCA) score and Boston Diagnostic Aphasia Examination (BDAE) score of the two groups were compared. The relative risk factors of cognitive function and speech function in the patients were explored by multiple regression analysis. RESULTS The pretreatment aphasia quotient and LOTCA score between the two groups showed no obvious distinction (P>0.05). After treatment, the LOTCA and BDAE scores in the study group were obviously better than those in the control group (P<0.05). CONCLUSIONS The effect of electroacupuncture and scalp acupuncture combined with language training is remarkable in treating aphasia after severe craniocerebral injury. This combined approach, which can improve the language and cognitive disorders of patients, has valuable application and research prospects in clinic.
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Affiliation(s)
- Fei Li
- Department of Science and Education, The Number Two Hospital of BaodingBaoding 071000, Hebei, China
| | - Jianrong Quan
- Department of Internal Medicine, Li County Hospital of Traditional Chinese MedicineBaoding 071400, Hebei, China
| | - Qingliang Wen
- Rehabilitation Division, The Number Three Hospital of XingtaiXingtai 054000, Hebei, China
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14
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Yao L, Liang W, Du X, Chen Y, Huang X. Effect of acupuncture on long-term outcomes in patients with post-stroke dysphagia. NeuroRehabilitation 2022; 51:433-441. [PMID: 35871375 DOI: 10.3233/nre-220113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Acupuncture has been used to treat patients with post-stroke neurological dysfunction. OBJECTIVE The purpose of our observational study was to observe the long-term efficacy of acupuncture and investigate whether the acupuncture treatment could short the recovery time of patients with post-stroke dysphagia. METHODS Medical records were reviewed to select patients who met the inclusion criteria for post-stroke dysphagia. Exposure factor was defined as received acupuncture during inpatient. Clinical data were obtained at the 6-month follow-up. The primary outcome was the time to improve the score of Food Intake Level Scale (FILS, 0-10) by 3 grades. Cox regression models were used to assess the relationship between acupuncture and recovery of dysphagia. RESULTS In acupuncture group, the median time to achieve clinical improvement of dysphagia was 97 days (95% CI, 93-124) compared with 119 days (95% CI, 108-145) in control group, with a statistically significant difference between the two groups (HR = 1.48; 95% CI 1.14-1.92; P = 0.003). At 6 months, 78 patients (60.5%) in acupuncture group reached excellent function and 61 patients (47.3%) in control group (RR = 1.28; 95% CI, 1.02-1.62; P = 0.045). 106 patients (82.2%) in acupuncture group achieved favorable function and 91 patients (70.5%) in control group (RR = 1.17; 95% CI, 1.02-1.35; P = 0.039). The outcome of adjusted multivariable Cox regression models showed that there was a difference in the recovery time of dysphagia between groups, HR = 1.79, 95% CI 1.34-2.39. The rates of adverse events were similar in both groups. CONCLUSIONS Acupuncture can promote the recovery of post-stroke dysphagia, and has a better long-term efficacy. Besides, it can reduce the degree of disability and improve the quality of life.
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Affiliation(s)
- Lulu Yao
- Department of Traditional Chinese Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Wei Liang
- Department of Traditional Chinese Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xin Du
- Department of Acupuncture and Moxibustion,Beijing Hospital of Traditional Chinese Medicine, Beijing, China
| | - Yujing Chen
- Department of Traditional Chinese Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiaobo Huang
- Department of Traditional Chinese Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
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15
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Karmon G, Sragovich S, Hacohen-Kleiman G, Ben-Horin-Hazak I, Kasparek P, Schuster B, Sedlacek R, Pasmanik-Chor M, Theotokis P, Touloumi O, Zoidou S, Huang L, Wu PY, Shi R, Kapitansky O, Lobyntseva A, Giladi E, Shapira G, Shomron N, Bereswill S, Heimesaat MM, Grigoriadis N, McKinney RA, Rubinstein M, Gozes I. Novel ADNP Syndrome Mice Reveal Dramatic Sex-Specific Peripheral Gene Expression With Brain Synaptic and Tau Pathologies. Biol Psychiatry 2022; 92:81-95. [PMID: 34865853 DOI: 10.1016/j.biopsych.2021.09.018] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/19/2021] [Accepted: 09/17/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND ADNP is essential for embryonic development. As such, de novo ADNP mutations lead to an intractable autism/intellectual disability syndrome requiring investigation. METHODS Mimicking humans, CRISPR (clustered regularly interspaced short palindromic repeats)-Cas9 editing produced mice carrying heterozygous Adnp p.Tyr718∗ (Tyr), a paralog of the most common ADNP syndrome mutation. Phenotypic rescue was validated by treatment with the microtubule/autophagy-protective ADNP fragment NAPVSIPQ (NAP). RESULTS RNA sequencing of spleens, representing a peripheral biomarker source, revealed Tyr-specific sex differences (e.g., cell cycle), accentuated in females (with significant effects on antigen processing and cellular senescence) and corrected by NAP. Differentially expressed, NAP-correctable transcripts, including the autophagy and microbiome resilience-linked FOXO3, were also deregulated in human patient-derived ADNP-mutated lymphoblastoid cells. There were also Tyr sex-specific microbiota signatures. Phenotypically, Tyr mice, similar to patients with ADNP syndrome, exhibited delayed development coupled with sex-dependent gait defects. Speech acquisition delays paralleled sex-specific mouse syntax abnormalities. Anatomically, dendritic spine densities/morphologies were decreased with NAP amelioration. These findings were replicated in the Adnp+/- mouse, including Foxo3 deregulation, required for dendritic spine formation. Grooming duration and nociception threshold (autistic traits) were significantly affected only in males. Early-onset tauopathy was accentuated in males (hippocampus and visual cortex), mimicking humans, and was paralleled by impaired visual evoked potentials and correction by acute NAP treatment. CONCLUSIONS Tyr mice model ADNP syndrome pathology. The newly discovered ADNP/NAP target FOXO3 controls the autophagy initiator LC3 (microtubule-associated protein 1 light chain 3), with known ADNP binding to LC3 augmented by NAP, protecting against tauopathy. NAP amelioration attests to specificity, with potential for drug development targeting accessible biomarkers.
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Affiliation(s)
- Gidon Karmon
- Elton Laboratory for Molecular Neuroendocrinology, Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Sagol School of Neuroscience and Adams Super Center for Brain Studies, Tel Aviv University, Tel Aviv, Israel
| | - Shlomo Sragovich
- Elton Laboratory for Molecular Neuroendocrinology, Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Sagol School of Neuroscience and Adams Super Center for Brain Studies, Tel Aviv University, Tel Aviv, Israel
| | - Gal Hacohen-Kleiman
- Elton Laboratory for Molecular Neuroendocrinology, Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Sagol School of Neuroscience and Adams Super Center for Brain Studies, Tel Aviv University, Tel Aviv, Israel
| | - Inbar Ben-Horin-Hazak
- Elton Laboratory for Molecular Neuroendocrinology, Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Sagol School of Neuroscience and Adams Super Center for Brain Studies, Tel Aviv University, Tel Aviv, Israel
| | - Petr Kasparek
- Department of Transgenic Models of Diseases and Czech Centre for Phenogenomics, Institute of Molecular Genetics of the Czech Academy of Sciences, Vestec, Czech Republic
| | - Björn Schuster
- Department of Transgenic Models of Diseases and Czech Centre for Phenogenomics, Institute of Molecular Genetics of the Czech Academy of Sciences, Vestec, Czech Republic
| | - Radislav Sedlacek
- Department of Transgenic Models of Diseases and Czech Centre for Phenogenomics, Institute of Molecular Genetics of the Czech Academy of Sciences, Vestec, Czech Republic
| | - Metsada Pasmanik-Chor
- Bioinformatics Unit, George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Paschalis Theotokis
- Department of Neurology, Laboratory of Experimental Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Olga Touloumi
- Department of Neurology, Laboratory of Experimental Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sofia Zoidou
- Department of Neurology, Laboratory of Experimental Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Linxuan Huang
- Department of Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Pei You Wu
- Department of Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Roy Shi
- Department of Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Oxana Kapitansky
- Elton Laboratory for Molecular Neuroendocrinology, Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Sagol School of Neuroscience and Adams Super Center for Brain Studies, Tel Aviv University, Tel Aviv, Israel
| | - Alexandra Lobyntseva
- Elton Laboratory for Molecular Neuroendocrinology, Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Sagol School of Neuroscience and Adams Super Center for Brain Studies, Tel Aviv University, Tel Aviv, Israel
| | - Eliezer Giladi
- Elton Laboratory for Molecular Neuroendocrinology, Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Sagol School of Neuroscience and Adams Super Center for Brain Studies, Tel Aviv University, Tel Aviv, Israel
| | - Guy Shapira
- Department of Cell and Developmental Biology and Edmond J. Safra Center for Bioinformatics, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Noam Shomron
- Department of Cell and Developmental Biology and Edmond J. Safra Center for Bioinformatics, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Stefan Bereswill
- Gastrointestinal Microbiology Research Group, Institute for Microbiology, Infectious Diseases and Immunology, Charité-University Medicine Berlin, Berlin, Germany
| | - Markus M Heimesaat
- Gastrointestinal Microbiology Research Group, Institute for Microbiology, Infectious Diseases and Immunology, Charité-University Medicine Berlin, Berlin, Germany
| | - Nikolaos Grigoriadis
- Department of Neurology, Laboratory of Experimental Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - R Anne McKinney
- Department of Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Moran Rubinstein
- Elton Laboratory for Molecular Neuroendocrinology, Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Sagol School of Neuroscience and Adams Super Center for Brain Studies, Tel Aviv University, Tel Aviv, Israel; Goldschleger Eye Research Institute, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Illana Gozes
- Elton Laboratory for Molecular Neuroendocrinology, Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Sagol School of Neuroscience and Adams Super Center for Brain Studies, Tel Aviv University, Tel Aviv, Israel.
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16
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Yang Y, Deng P, Si Y, Xu H, Zhang J, Sun H. Acupuncture at GV20 and ST36 Improves the Recovery of Behavioral Activity in Rats Subjected to Cerebral Ischemia/Reperfusion Injury. Front Behav Neurosci 2022; 16:909512. [PMID: 35775011 PMCID: PMC9239252 DOI: 10.3389/fnbeh.2022.909512] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/16/2022] [Indexed: 12/02/2022] Open
Abstract
Traditional acupuncture and electroacupuncture (EA) have been widely performed to treat ischemic stroke. To provide experimental support for the clinical application of acupuncture to ameliorate post-stroke sequelae, in this study, we investigated the therapeutic effect of acupuncture and EA on CIRI following middle cerebral artery occlusion (MCAO) in rats. The animals were randomly divided into five groups: sham-operated (S), model (M), traditional acupuncture (A) treatment, electroacupuncture (EA) treatment, and drug (D; edaravone) therapies. Neurological behavioral characteristics (neurological deficit score, forelimb muscle strength, sensorimotor function, body symmetry, sucrose consumption, and mood) were examined in all the groups on days 1, 3, 5, and 7 after reperfusion. Expressions of vascular endothelial growth factor (VEGF) and hypoxia-inducible factor-1α (HIF-1α) were detected by immunohistochemistry. Both acupuncture and EA significantly reduced neurological deficits and improved forelimb muscle strength, sensorimotor function, body symmetry recovery, and neurovascular regeneration in the rats after ischemia/reperfusion injury. The efficacies of both acupuncture and EA were comparable to that of edaravone, a commonly used medicine for stroke in the clinic. Thus, our data suggest that acupuncture and EA therapy at acupoints GV20 and ST36 might represent alternative or complementary treatments to the conventional management of ischemic stroke, providing additional support for the experimental evidence for acupuncture therapy in clinical settings. In summary, EA might provide alternative or complementary treatment strategies for treating patients with apoplexy in the clinic. However, potential mechanisms underlying the role of acupuncture require further investigation.
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Affiliation(s)
- Yang Yang
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Peiying Deng
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yingkui Si
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Hong Xu
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Jianmin Zhang
- CAMS Key Laboratory for T Cell and Immunotherapy, State Key Laboratory of Medical Molecular Biology, Department of Immunology, School of Basic Medicine, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
- *Correspondence: Jianmin Zhang,
| | - Hua Sun
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
- Hua Sun,
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Publication Trends in Rehabilitative Effects of Acupuncture: A Visual Analysis of the Literature. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:7705256. [PMID: 35449821 PMCID: PMC9017514 DOI: 10.1155/2022/7705256] [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: 01/12/2022] [Accepted: 03/23/2022] [Indexed: 12/04/2022]
Abstract
Objectives To conduct a comprehensive analysis of scientific outputs in 2011–2021 regarding the rehabilitative effects of acupuncture on diseases. Methods The study was conducted in the form of knowledge graph and data visualization, with data being drawn from the Web of Science Core Collection database. Results Articles and reviews were the dominant types; China, Guangzhou University of Chinese Medicine and Medicine ranked was the active country, institution, and journal, respectively, in terms of issued articles. Systematic reviews and the meta-analyses of stroke and pain were extensively carried out in the past decade, whose principal interventions were manual acupuncture, electroacupuncture, scalp acupuncture, and dry needling correspondingly at Baihui (DU20) and Zusanli (ST36). And most frequently utilized rehabilitation assessment criteria were the Fugl-Meyer Assessment Scale and the Barthel Index. More recently, motor function and chronic obstructive pulmonary disease have captured researchers' attention, which might be the futuristic frontier. Conclusions This article provided a relatively panoramic picture of the scientific outputs in acupuncture for disease rehabilitation, which may help readers embrace the heated topic and grasp the recent research focus on this field.
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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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Yao LL, Yuan S, Wu ZN, Luo JY, Tang XR, Tang CZ, Cui S, Xu NG. Contralateral S1 function is involved in electroacupuncture treatment-mediated recovery after focal unilateral M1 infarction. Neural Regen Res 2021; 17:1310-1317. [PMID: 34782576 PMCID: PMC8643050 DOI: 10.4103/1673-5374.327355] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Acupuncture at acupoints Baihui (GV20) and Dazhui (GV14) has been shown to promote functional recovery after stroke. However, the contribution of the contralateral primary sensory cortex (S1) to recovery remains unclear. In this study, unilateral local ischemic infarction of the primary motor cortex (M1) was induced by photothrombosis in a mouse model. Electroacupuncture (EA) was subsequently performed at acupoints GV20 and GV14 and neuronal activity and functional connectivity of contralateral S1 and M1 were detected using in vivo and in vitro electrophysiological recording techniques. Our results showed that blood perfusion and neuronal interaction between contralateral M1 and S1 is impaired after unilateral M1 infarction. Intrinsic neuronal excitability and activity were also disturbed, which was rescued by EA. Furthermore, the effectiveness of EA treatment was inhibited after virus-mediated neuronal ablation of the contralateral S1. We conclude that neuronal activity of the contralateral S1 is important for EA-mediated recovery after focal M1 infarction. Our study provides insight into how the S1–M1 circuit might be involved in the mechanism of EA treatment of unilateral cerebral infarction. The animal experiments were approved by the Committee for Care and Use of Research Animals of Guangzhou University of Chinese Medicine (approval No. 20200407009) April 7, 2020.
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Affiliation(s)
- Lu-Lu Yao
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Si Yuan
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Zhen-Nan Wu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Jian-Yu Luo
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Xiao-Rong Tang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Chun-Zhi Tang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Shuai Cui
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province; Research Institute of Acupuncture and Meridian, Anhui University of Chinese Medicine, Hefei, Anhui Province, China
| | - Neng-Gui Xu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
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Du B, Li Y, Zhang B, Zhao W, Zhou L. Effect of neuromuscular electrical stimulation associated with swallowing-related muscle training for post-stroke dysphagia: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25108. [PMID: 33725989 PMCID: PMC7982218 DOI: 10.1097/md.0000000000025108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Swallowing dysfunction is a common dysfunction after stroke, and its incidence exceeds 50%. Aspiration pneumonia and malnutrition induced by dysphagia not only cause psychological shock to patients after stroke, but also burden the medical payment. Neuromuscular electrical stimulation, which stimulates the cortex and cortical bulb pathways to improve swallowing function, has been one of the emerging treatments for the post-stroke deglutition disorder. These therapy operators require the proficiency in professional knowledge, limiting clinical large sample studies, so there is an absence of evidence-based medicine. The research is to evaluate the effectiveness of neuromuscular electrical stimulations combined with swallowing-related muscle training to treat swallowing dysfunction after stroke. METHODS Computer retrieval performed in the 9 databases, including PubMed, Embase, Web of science, Cochrane Library, ClinicalTrials, China Biomedical Literature Database (CBM), China Knowledge Network Database (CNKI), Wanfang Database (WanFang), and China VIP Database (VIP). Taking the published literature from the establishment of the database until December 20, 2020. Literature searching is related to neuromuscular electrical stimulation randomized controlled trials on the effect of swallowing in stroke. In addition, we will do the manual search in Baidu Academic and Google Academic database as a supplementary search. The correlative randomized controlled clinical studies retrieval time range from the establishment of the database to December 20, 2020. Two investigators will screen the literature according to the inclusion and exclusion criteria independently, during that period they will evaluate the quality of the included studies and extract data from studies. The extracted data are dichotomous data will be represented by relative risk, continuous data will be represented by mean difference or standard mean deviation. If there exists heterogeneity and the final data summary analysis select random effect model. On the contrary, the fixed effect model is selected. Then, RevMan5.3 software was used when analyzing included literature. Meanwhile, the analysis results were illustrated by drawing. RESULTS This review will summarize available trials aimed at providing a comprehensive estimation of effectiveness of neuromuscular electrical stimulation associated with swallowing muscle training for post-stroke dysphagia. CONCLUSION This review based on a comprehensive analysis of currently published randomized controlled trials on post-stroke dysphagia, that provide reliable evidence-based medicine evidence for the efficacy of neuromuscular electrical stimulation associated with swallowing rehabilitation training. REGISTRATION NUMBER INPLASY202110009.
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