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Cai S, Zhou Y, Yang S, Liu Y, Han Y, Wang D, Shi S. The neural effects of acupuncture for stroke: a protocol for systematic review and meta-analysis based on fMRI. Front Neurosci 2024; 18:1443834. [PMID: 39308953 PMCID: PMC11412939 DOI: 10.3389/fnins.2024.1443834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 08/28/2024] [Indexed: 09/25/2024] Open
Abstract
Background Stroke is one of the most common causes of death and is the main cause of persistent and acquired disability in adults worldwide. Acupuncture is recommended by the World Health Organization as an alternative and complementary strategy for stroke treatment. However, the mechanism of the neural effects of acupuncture on stroke is still lacking a uniform conclusion. The purpose of this study is to clarify the neural effects of acupuncture for stroke from the perspective of neuroimaging. Methods Seven databases, including PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure, VIP Database, Wan-Fang Data, and Chinese Biomedical Database, will be searched comprehensively according to the search strategy. All of them will be retrieved from the date of database establishment to December 31, 2023. All randomized controlled trials and observational studies will be considered for inclusion. The risk of bias will be assessed by the Cochrane Risk of Bias tool. Functional imaging of the whole brain in the resting functional state will be the primary outcome. A meta-analysis of primary outcome will be performed using Seed-based D Mapping with Permutation of Subject Images software. The data will be synthesized using a random effects model. Meta-analysis of other clinical data will be performed using RevMan 5.3 software. Publication bias will be assessed through funnel plots. Reports will adhere to the Preferred Reporting Items for Systematic Review and Meta-Analysis. Conclusion This study will aggregate the results of independent studies to provide overall evidence for the neural effects of acupuncture for stroke. Clinical Trial Registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=500306, Identifier CRD42024500306.
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Affiliation(s)
- Shaojie Cai
- Heilongjiang University of Chinese Medicine, Harbin, China
- The Second Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yihao Zhou
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Siyu Yang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yichang Liu
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yixiao Han
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Dongyan Wang
- The Second Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Shuai Shi
- The Second Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
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Yi Y, Zhao W, Lv S, Zhang G, Rong Y, Wang X, Yang J, Li M. Effectiveness of non-pharmacological therapies for treating post-stroke depression: A systematic review and network meta-analysis. Gen Hosp Psychiatry 2024; 90:99-107. [PMID: 39084147 DOI: 10.1016/j.genhosppsych.2024.07.011] [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: 05/20/2024] [Revised: 07/19/2024] [Accepted: 07/20/2024] [Indexed: 08/02/2024]
Abstract
OBJECTIVE Post-stroke depression (PSD) is a common neurological and psychiatric sequelae following a stroke, often surpassing the primary effects of the stroke due to its strong correlation with high mortality rates. In recent years, non-pharmacological therapy has garnered significant attention as a supplementary treatment for PSD, becoming widely adopted in clinical practice. However, the efficacy of specific intervention strategies remains unclear. This study aimed to conduct a network meta-analysis (NMA) of published studies to compare the efficacy of different non-pharmacological therapies for treating PSD. METHOD We systematically searched five databases from inception through March 2024 to identify randomized controlled trials (RCTs) evaluating non-pharmacological therapies for the treatment of PSD. We considered individual intervention and intervention class. Intervention classes included traditional Chinese medicine (TCM), non-invasive electrotherapy stimulation (NIES), psychotherapy (PT), exercise therapy, hyperbaric oxygen, and combined interventions. The NMA was conducted using R and Stata software, following a frequency-based methodology. Assessment of methodological quality and risk of bias was conducted using the Risk of Bias assessment tool 2.0. Therapies were ranked using the P-score, and box-plots visualization, meta-regression, and sensitivity analysis, were performed to assess transitivity, heterogeneity, and consistency, respectively. RESULTS The NMA included 43 studies with a total of 3138 participants. Random-effects models revealed significant efficacy for acupuncture (ACUP) (P-score = 0.92; pooled standardized mean difference (95% CI): -3.12 (-4.63 to -1.60)) and transcranial direct current stimulation (P-score = 0.85; -2.78 (-5.06 to -0.49)) compared to the treatment as usual (TAU) group. In categorical comparisons, TCM_PT (P-score = 0.82; -1.91 (-3.54 to -0.28)), TCM (P-score = 0.79; -1.65 (-2.33 to -0.97)), and NIES (P-score = 0.74; -1.54 (-2.62 to -0.46)) showed significant differences compared to TAU group. Furthermore, our results indicated no significant difference between PT and the control groups. However, Confidence in Network Meta-Analysis results indicated very low overall evidence grade. CONCLUSION Limited evidence suggests that ACUP may be the most effective non-pharmacological therapy for improving PSD, and TCM_PT is the best intervention class. However, the evidence quality is very low, underscoring the need for additional high-quality RCTs to validate these findings, particularly given the limited number of RCTs available for each therapy.
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Affiliation(s)
- Yunhao Yi
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250014, China
| | - Weijie Zhao
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250014, China
| | - Shimeng Lv
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250014, China
| | - Guangheng Zhang
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250014, China
| | - Yuanhang Rong
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250014, China
| | - Xin Wang
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250014, China
| | - Jingrong Yang
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250014, China
| | - Ming Li
- Office of Academic Affairs, Shandong University of Traditional Chinese Medicine, Jinan 250355, China.
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Wu N, Chen JH, Wang T, Yang BB, Xing SY, Gao SZ, Ni DW, Du GJ, Song T, Han YF, Sun GH, Gao QQ, Xu CL, Dai YT. Altered brain activity associated with premature ejaculation improved by electroacupuncture in rats. Sex Med 2024; 12:qfae047. [PMID: 39220342 PMCID: PMC11365699 DOI: 10.1093/sexmed/qfae047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 06/27/2024] [Accepted: 07/31/2024] [Indexed: 09/04/2024] Open
Abstract
Background Premature ejaculation (PE) is linked with abnormal brain activity that is modifiable by electroacupuncture (EA). Aim In this study we aimed to explore the central pathological mechanism underlying EA in treating PE. Methods Six-week-old male Sprague-Dawley rats were divided into a PE group (n = 8) and a control group (n = 8) according to ejaculatory frequency during copulatory behavior. All rats underwent EA at the Zusanli acupoint (ST-36) for 4 weeks. Magnetic resonance imaging data were collected before and after EA. Outcomes The behavioral parameters, plasma norepinephrine levels, fractional amplitude of low frequency fluctuation (fALFF), and regional homogeneity (ReHo) were evaluated. Results The PE group ejaculated more times with shorter latency compared with controls. After EA, the ejaculation frequency of the PE group decreased, and the ejaculation latency period increased, with no changes observed in the control group. Norepinephrine levels were higher in the PE group than in the controls and were positively correlated with ejaculation frequency and negatively correlated with ejaculation latency. The PE group showed lower fALFF in the right striatum and higher ReHo in the brainstem compared with controls. After EA, controls showed decreased fALFF in the right striatum, left olfactory bulb, and dorsal fornix and increased ReHo in the right interpeduncular nucleus, as well as decreased ReHo in the left striatum, prelimbic system, right basal forebrain region, septal region, and olfactory bulb, while the model group exhibited increased fALFF in the right hypothalamic region, decreased fALFF in the left globus pallidum and right basal forebrain region and increased ReHo in the right interpeduncular nucleus, as well as decreased ReHo in the left striatum, olfactory bulb, basal forebrain region, dentate gyrus, right dysgranular insular cortex, and striatum. Compared with the controls after EA, the model group showed increased ReHo of the right hypothalamic region and decreased ReHo of the right dysgranular insular cortex. Clinical Implications These findings might enhance the understanding of PE and contribute to new, targeted therapies for PE. Strengths and Limitations The therapeutic effects might be achieved by EA inhibiting the activity in brain regions involved in ejaculatory behavior. However, the curative effect of acupuncture might be underestimated due to some curative effects of sham acupuncture used in the control group. Conclusion In conclusion, the ejaculatory frequency of rats may be reduced and ejaculation latency could be extended by EA at ST-36, which might be achieved by the effects of this treatment on brain activity.
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Affiliation(s)
- Ning Wu
- Department of Andrology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing 210008, China
- Department of Urology, The People’s Hospital of Jiaozuo, No. 263 Jiefang Middle Road, Jiaozuo 454002, China
| | - Jian-huai Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China
| | - Tong Wang
- Department of Andrology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing 210008, China
| | - Bai-bing Yang
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Si-yan Xing
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Song-zhan Gao
- Department of Andrology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Da-wei Ni
- Department of Andrology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing 210008, China
| | - Guang-jun Du
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Tao Song
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - You-feng Han
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Guo-hai Sun
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Qing-qiang Gao
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Chun-lu Xu
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Yu-tian Dai
- Department of Andrology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing 210008, China
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Zhang Y, Lu H, Ren X, Zhang J, Wang Y, Zhang C, Zhao X. Immediate and long-term brain activation of acupuncture on ischemic stroke patients: an ALE meta-analysis of fMRI studies. Front Neurosci 2024; 18:1392002. [PMID: 39099634 PMCID: PMC11294246 DOI: 10.3389/fnins.2024.1392002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/11/2024] [Indexed: 08/06/2024] Open
Abstract
Background Acupuncture, as an alternative and complementary therapy recommended by the World Health Organization for stroke treatment, holds potential in ameliorating neurofunctional deficits induced by ischemic stroke (IS). Understanding the immediate and long-term effects of acupuncture and their interrelation would contribute to a better comprehension of the mechanisms underlying acupuncture efficacy. Methods Activation likelihood estimation (ALE) meta-analysis was used to analyze the brain activation patterns reported in 21 relevant functional neuroimaging studies. Among these studies, 12 focused on the immediate brain activation and 9 on the long-term activation. Single dataset analysis were employed to identify both immediate and long-term brain activation of acupuncture treatment in IS patients, while contrast and conjunction analysis were utilized to explore distinctions and connections between the two. Results According to the ALE analysis, immediately after acupuncture treatment, IS patients exhibited an enhanced cluster centered around the right precuneus (PCUN) and a reduced cluster centered on the left middle frontal gyrus (MFG). After long-term acupuncture treatment, IS patients showed an enhanced cluster in the left PCUN, along with two reduced clusters in the right insula (INS) and hippocampus (HIP), respectively. Additionally, in comparison to long-term acupuncture treatment, the right angular gyrus (ANG) demonstrated higher ALE scores immediately after acupuncture, whereas long-term acupuncture resulted in higher scores in the left superior parietal gyrus (SPG). The intersecting cluster activated by both of them was located in the left cuneus (CUN). Conclusion The findings provide initial insights into both the immediate and long-term brain activation patterns of acupuncture treatment for IS, as well as the intricate interplay between them. Both immediate and long-term acupuncture treatments showed distinct patterns of brain activation, with the left CUN emerging as a crucial regulatory region in their association. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, CRD42023480834.
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Affiliation(s)
- Yuan Zhang
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Graduate College, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Hai Lu
- Department of Traditional Chinese Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Xuesong Ren
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Junfeng Zhang
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Graduate College, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yu Wang
- Department of Rehabilitation, Second Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Chunhong Zhang
- Department of Acupuncture and Moxibustion, Baoan Pure Traditional Chinese Medicine Treatment Hospital, Shenzhen, China
| | - Xiaofeng Zhao
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
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Guan C, Feng Y, Cao L, Wang Y, Zhang Q, Liu L, Xie H, Yu K, Shen X, Wu Y, Wang N. Acupuncture for stroke: A bibliometric analysis of global research from 2000 to 2022. Heliyon 2024; 10:e33827. [PMID: 39050433 PMCID: PMC11268209 DOI: 10.1016/j.heliyon.2024.e33827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 06/26/2024] [Accepted: 06/27/2024] [Indexed: 07/27/2024] Open
Abstract
Objective This study aimed to explore the global and future research trends in acupuncture interventions for stroke between 2000 and 2022 using bibliometric analysis. Method A bibliometric analysis of literature from 2000 to 2022 in the Web of Science Core Collection was conducted in this study. The analysis utilized CiteSpace, VOSviewer, and Scimago Graphica software to identify the major contributors to publications, including authors, countries, institutions, journals, references, and keywords. Results The bibliometric analysis yielded a total of 860 publications. There was a gradual increase in the number of publications over the study period. China published the most articles. Evidence-Based Complementary and Alternative Medicine was the journal with the greatest number of publications. The most frequently used keywords were "acupuncture," "stroke," and "electroacupuncture." Conclusion These analysis uncovers the research trends in acupuncture for stroke spanning 2000 to 2022 and points to prospective research frontiers. This study provides a deeper and more thorough understanding of the connotations of acupuncture for stroke and guidance and support for future research in this field.
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Affiliation(s)
- Chong Guan
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, 200040, China
- National Clinical Research Center for Geriatric Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yashuo Feng
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, 200040, China
- National Clinical Research Center for Geriatric Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Lu Cao
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Yiyuan Wang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Qun Zhang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Li Liu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Hongyu Xie
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Kewei Yu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Xueyan Shen
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Yi Wu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, 200040, China
- National Clinical Research Center for Geriatric Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Nianhong Wang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, 200040, China
- National Clinical Research Center for Geriatric Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China
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Liang X, Ma L, Zhang L, Yang D, Zeng L. Effects of Huoxue Qufeng Decoction combined with Tongguan Liquefying Acupoint Penetration therapy on swallowing function and quality of life in patients with ischemic stroke. Am J Transl Res 2024; 16:3046-3054. [PMID: 39114710 PMCID: PMC11301454 DOI: 10.62347/wwyp7009] [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: 03/06/2024] [Accepted: 06/09/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVE To analyze the effects of Huoxue Qufeng Decoction combined with Tongguan Liquefying Acupoint Penetration therapy on swallowing function and quality of life in patients with ischemic stroke. METHODS A total of 145 patients with post-stroke dysphagia admitted to Dingxi People's Hospital from January 2019 to May 2022 were selected with 65 patients in the control group and 80 patients in the observation group. The control group received Huoxue Qufeng Decoction alone, while the observation group received additional Tongguan Liquefying Acupoint Penetration therapy. Clinical efficacy, NIH Stroke Scale (NIHSS) score, Water Swallow Test, Swallowing Function Assessment (SSA) score, MD Anderson Dysphagia Inventory (MDADI) score, overall incidence of adverse events, and Swallowing Quality of Life (SWAL-QOL) score were compared between the two groups. RESULTS The total response rate in the observation group was higher than that in the control group, with a statistically significant difference (P<0.01). After treatment, the SSA score and NIHSS score were statistically lower in the observation group than in the control group (P<0.01). The MDADI and SWAL-QOL scores were higher in the observation group than in the control group, with a statistically significant difference (both P<0.01). The total effective rate reflected by the Water Swallow Test was significantly higher in the observation group than in the control group (P<0.05). There was no significant difference in the incidence of adverse events between the two groups (P>0.05). Univariate analysis revealed that age and treatment plan were factors influencing the recovery of swallowing function. Logistic multivariate regression analysis further identified age and treatment plan as independent risk factors affecting patient prognosis (P<0.05). CONCLUSION Huoxue Qufeng Decoction combined with Tongguan Liquefying Acupoint Penetration has a significant effect on post-stroke dysphagia, effectively improving swallowing function and enhancing quality of life.
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Affiliation(s)
- Xuzhong Liang
- Department of Pharmacy, Dingxi People’s HospitalNo. 22 Anding Road, Anding District, Dingxi 743000, Gansu, China
| | - Li Ma
- Department of Cardiovascular II, The First People’s Hospital of Lanzhou CityNo. 1 Wujiayuan West Street, Qilihe District, Lanzhou 730050, Gansu, China
| | - Lixia Zhang
- Pharmacy Intravenous Admixture Service, Dingxi People’s HospitalNo. 22 Anding Road, Anding District, Dingxi 743000, Gansu, China
| | - Dongnian Yang
- Department of Medical, Gansu Second People’s HospitalNo. 396 Dingxinan Road, Chengguan District, Lanzhou 730000, Gansu, China
| | - Lanrui Zeng
- Department of Rehabilitation, Gansu Second People’s HospitalNo. 396 Dingxinan Road, Chengguan District, Lanzhou 730000, Gansu, China
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Lin M, Gong J, Wu L, Lin X, Zhang Y, Lin W, Huang H, Zhu C. ADCY3: the pivotal gene in classical ketogenic diet for the treatment of epilepsy. Front Cell Neurosci 2024; 18:1305867. [PMID: 38841200 PMCID: PMC11150708 DOI: 10.3389/fncel.2024.1305867] [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: 10/02/2023] [Accepted: 04/15/2024] [Indexed: 06/07/2024] Open
Abstract
Objective Epilepsy is a common neurological disorder characterized by recurrent epilepsy episodes. As a non-pharmacological treatment, the ketogenic diet has been widely applied in treating epilepsy. However, the exact therapeutic mechanism of the ketogenic diet for epilepsy remains unclear. This study investigates the molecular mechanisms of the ketogenic diet in regulating fatty acid metabolism and activating the ADCY3-initiated cAMP signaling pathway to enhance neuronal inhibition and thereby treat epilepsy. Methods and results Meta-analysis reveals that the ketogenic diet is superior to the conventional diet in treating epilepsy. Animal experiments demonstrate that the ketogenic diet is more effective than the conventional diet in treating epilepsy, with the best results achieved using the classic ketogenic diet. Transcriptome sequencing analysis identifies six essential genes, among which ADCY3 shows increased expression in the ketogenic diet. In vivo experiments confirm that the activation of the cAMP-PKA signaling pathway by ADCY3 enhances neuronal inhibition and improves epilepsy control. Conclusion Clinical observations indicate that the ketogenic diet improves patient epilepsy episodes by regulating the ADCY3-initiated cAMP signaling pathway.
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Affiliation(s)
- Mingxing Lin
- Department of Pediatrics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jiayin Gong
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Luyan Wu
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xin Lin
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yuying Zhang
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Wanhui Lin
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Huapin Huang
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Key Laboratory of Molecular Neurology, Fuzhou, China
- Department of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Chaofeng Zhu
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
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Li S, Xing X, Hua X, Zhang Y, Wu J, Shan C, Wang H, Zheng M, Xu J. Electroacupuncture modulates abnormal brain connectivity after ischemia reperfusion injury in rats: A graph theory-based approach. Brain Behav 2024; 14:e3504. [PMID: 38698583 PMCID: PMC11066419 DOI: 10.1002/brb3.3504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 03/29/2024] [Accepted: 04/06/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Electroacupuncture (EA) has been shown to facilitate brain plasticity-related functional recovery following ischemic stroke. The functional magnetic resonance imaging technique can be used to determine the range and mode of brain activation. After stroke, EA has been shown to alter brain connectivity, whereas EA's effect on brain network topology properties remains unclear. An evaluation of EA's effects on global and nodal topological properties in rats with ischemia reperfusion was conducted in this study. METHODS AND RESULTS There were three groups of adult male Sprague-Dawley rats: sham-operated group (sham group), middle cerebral artery occlusion/reperfusion (MCAO/R) group, and MCAO/R plus EA (MCAO/R + EA) group. The differences in global and nodal topological properties, including shortest path length, global efficiency, local efficiency, small-worldness index, betweenness centrality (BC), and degree centrality (DC) were estimated. Graphical network analyses revealed that, as compared with the sham group, the MCAO/R group demonstrated a decrease in BC value in the right ventral hippocampus and increased BC in the right substantia nigra, accompanied by increased DC in the left nucleus accumbens shell (AcbSh). The BC was increased in the right hippocampus ventral and decreased in the right substantia nigra after EA intervention, and MCAO/R + EA resulted in a decreased DC in left AcbSh compared to MCAO/R. CONCLUSION The results of this study provide a potential basis for EA to promote cognitive and motor function recovery after ischemic stroke.
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Affiliation(s)
- Si‐Si Li
- School of Rehabilitation ScienceShanghai University of Traditional Chinese MedicineShanghaiChina
- Department of Physical Medicine and RehabilitationThe Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Xiang‐Xin Xing
- Center of Rehabilitation MedicineYueyang Hospital of Integrated Traditional Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghaiChina
| | - Xu‐Yun Hua
- Department of Traumatology and OrthopedicsYueyang Hospital of Integrated Traditional Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghaiChina
| | - Yu‐Wen Zhang
- Institute of Science and Technology for Brain‐Inspired IntelligenceFudan UniversityShanghaiChina
| | - Jia‐Jia Wu
- Center of Rehabilitation MedicineYueyang Hospital of Integrated Traditional Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghaiChina
| | - Chun‐Lei Shan
- School of Rehabilitation ScienceShanghai University of Traditional Chinese MedicineShanghaiChina
- Center of Rehabilitation MedicineYueyang Hospital of Integrated Traditional Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghaiChina
- Engineering Research Center of Traditional Chinese Medicine Intelligent RehabilitationMinistry of EducationShanghaiChina
| | - He Wang
- Institute of Science and Technology for Brain‐Inspired IntelligenceFudan UniversityShanghaiChina
| | - Mou‐Xiong Zheng
- Department of Traumatology and OrthopedicsYueyang Hospital of Integrated Traditional Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghaiChina
| | - Jian‐Guang Xu
- School of Rehabilitation ScienceShanghai University of Traditional Chinese MedicineShanghaiChina
- Engineering Research Center of Traditional Chinese Medicine Intelligent RehabilitationMinistry of EducationShanghaiChina
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Marchewka R, Trzmiel T, Hojan K. The Effect of Extremely Low-Frequency Magnetic Field on Stroke Patients: A Systematic Review. Brain Sci 2024; 14:430. [PMID: 38790409 PMCID: PMC11119128 DOI: 10.3390/brainsci14050430] [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: 03/26/2024] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND The aim of this study was to review the current state of scientific evidence on the effect of extremely low-frequency magnetic fields stimulation (ELF-MFs) on stroke patients. METHODS A systematic review of PubMed, ScienceDirect, PeDro and Embase databases was conducted. Only articles published in English, involving adult participants and focusing on individuals who had experienced a stroke, specifically examining the impact of ELF-MFs on post-stroke patients and had well-defined criteria for inclusion and exclusion of participants, were included. The methodological quality of the included studies was assessed using the Quality Assessment Tool for Quantitative Studies (QATQS). RESULTS A total of 71 studies were identified through database and reference lists' search, from which 9 were included in the final synthesis. All included studies showed a beneficial effect of ELF-MFs on stroke patients, however seven of the included studies were carried by the same research group. Improvements were observed in domains such as oxidative stress, inflammation, ischemic lesion size, functional status, depressive symptoms and cognitive abilities. CONCLUSIONS The available literature suggests a beneficial effect of ELF-MFs on post-stroke patients; however, the current data are too limited to broadly recommend the use of this method. Further research with improved methodological quality is necessary.
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Affiliation(s)
- Renata Marchewka
- Neurorehabilitation Ward, Greater Poland Provincial Hospital, 60-480 Poznan, Poland; (R.M.); (K.H.)
| | - Tomasz Trzmiel
- Department of Occupational Therapy, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Katarzyna Hojan
- Neurorehabilitation Ward, Greater Poland Provincial Hospital, 60-480 Poznan, Poland; (R.M.); (K.H.)
- Department of Occupational Therapy, Poznan University of Medical Sciences, 60-781 Poznan, Poland
- Department of Rehabilitation, Greater Poland Cancer Centre, 61-866 Poznan, Poland
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10
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Zhou F, Wang Z, Xiong K, Zhang M, Wang Q, Wang Y, Li X. Olfactory three needle regulates the proliferation of olfactory bulb neural stem cells and ameliorates brain injury after subarachnoid hemorrhage by regulating Wnt/β-catenin signaling. Heliyon 2024; 10:e28551. [PMID: 38596082 PMCID: PMC11002047 DOI: 10.1016/j.heliyon.2024.e28551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 03/14/2024] [Accepted: 03/20/2024] [Indexed: 04/11/2024] Open
Abstract
Background Subarachnoid hemorrhage (SAH) is a serious cerebrovascular emergency. The incidence of SAH and hazard ratio of death increase with age. Objective In this study, we aimed to observe the effects and potential mechanisms of olfactory three needle (OTN) on cognitive impairment, neuronal activity, and neural stem cell differentiation in SAH rats. Methods Sprague-Dawley (SD) rats were randomly divided into five groups: Sham, SAH group, SAH + Nimodipine (NMP) group, and SAH + OTN group. The rats in the SAH + OTN group received the OTN electroacupuncture treatment. For treatment with recombinant DKK1 (a Wnt/β-catenin inhibitor), mice were injected with DKK1. Results Our results found that OTN improved cognitive impairment and hippocampal neuron damage in SAH rats. Furthermore, OTN promoted the proliferation of neural stem cells in SAH rats. Mechanistically, OTN activated Wnt/β-catenin signaling in SAH rats, as indicated by the increased expression levels of Wnt1, β-Catenin, LMNB1, and p-GSK-3β. DKK1 reversed the improvement effect of OTN on cognitive impairment and neuronal damage in SAH rats. Meanwhile, DKK1 blocked the promoting effect of OTN on the proliferation of NSCs in SAH rats. Conclusions OTN electroacupuncture may be an effective therapeutic strategy for SAH.
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Affiliation(s)
- Feng Zhou
- Department of Neurosurgery, The Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712020, China
| | - Zhenzhi Wang
- Department of Chinese and Western Medicine, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712046, China
| | - Kang Xiong
- Department of Chinese and Western Medicine, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712046, China
| | - Meiling Zhang
- Department of Chinese and Western Medicine, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712046, China
| | - Qiang Wang
- Combination of Acupuncture and Medicine Innovation Research Center, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712046, China
| | - Yuan Wang
- Combination of Acupuncture and Medicine Innovation Research Center, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712046, China
| | - Xiong Li
- Department of Chinese and Western Medicine, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712046, China
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11
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Chen P, Wang W, Ban W, Zhang K, Dai Y, Yang Z, You Y. Deciphering Post-Stroke Sleep Disorders: Unveiling Neurological Mechanisms in the Realm of Brain Science. Brain Sci 2024; 14:307. [PMID: 38671959 PMCID: PMC11047862 DOI: 10.3390/brainsci14040307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/15/2024] [Accepted: 03/17/2024] [Indexed: 04/28/2024] Open
Abstract
Sleep disorders are the most widespread mental disorders after stroke and hurt survivors' functional prognosis, response to restoration, and quality of life. This review will address an overview of the progress of research on the biological mechanisms associated with stroke-complicating sleep disorders. Extensive research has investigated the negative impact of stroke on sleep. However, a bidirectional association between sleep disorders and stroke exists; while stroke elevates the risk of sleep disorders, these disorders also independently contribute as a risk factor for stroke. This review aims to elucidate the mechanisms of stroke-induced sleep disorders. Possible influences were examined, including functional changes in brain regions, cerebrovascular hemodynamics, neurological deficits, sleep ion regulation, neurotransmitters, and inflammation. The results provide valuable insights into the mechanisms of stroke complicating sleep disorders.
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Affiliation(s)
- Pinqiu Chen
- Key Laboratory of Molecular Pharmacology and Drug Evaluation, Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, School of Pharmacy, Yantai University, Yantai 264005, China; (P.C.)
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, China
| | - Wenyan Wang
- Key Laboratory of Molecular Pharmacology and Drug Evaluation, Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, School of Pharmacy, Yantai University, Yantai 264005, China; (P.C.)
| | - Weikang Ban
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, China
| | - Kecan Zhang
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, China
| | - Yanan Dai
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, China
| | - Zhihong Yang
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, China
| | - Yuyang You
- School of Automation, Beijing Institute of Technology, Beijing 100081, China
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12
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LI M, WANG Y, RAN D, YANG X, DENG S, SHI L, MENG Z. Effects of anterior sciatic nerve acupuncture on lower limb paralysis after cerebral infarction: study protocol for a randomized controlled trial. J TRADIT CHIN MED 2024; 44:205-211. [PMID: 38213256 PMCID: PMC10774733 DOI: 10.19852/j.cnki.jtcm.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 10/16/2022] [Indexed: 01/13/2024]
Abstract
Stroke is the main cause of disability in the middle and old age. Hemiplegia, especially lower limb paralysis, often leads to the loss of self-care ability and a series of secondary injuries. The main method to improve hemiplegic limb movement is exercise therapy, but there are still many patients with disabilities after rehabilitation treatment. As one of the non-pharmacological therapies for stroke, acupuncture has been recognized to improve motor function in patients. Here, we propose a new method, anterior sciatic nerve acupuncture, which can stimulate both the femoral nerve and the sciatic nerve. We designed this study to determine the effect of this method on lower limb motor function. Sixty participants recruited with hemiplegia after cerebral infarction will be randomly assigned to the test group or control group in a 1:1 ratio. The control group will receive Xingnao Kaiqiao acupuncture, and the test group will receive anterior sciatic nerve acupuncture on this basis. All participants will get acupuncture treatment once a day, 6 times a week for 2 weeks. The primary outcome is Fugl-Meyer Assessment of Lower Extremity and the secondary outcomes are Modified Ashworth Scale and Modified Barthel Index. Data will be collected before treatment, 1 week after treatment, and 2 weeks after treatment, and then statistical analysis will be performed. This study can preliminarily verify the effect of anterior sciatic nerve acupuncture on improving lower limb motor function in patients with cerebral infarction, which may provide an alternative approach for clinical treatment of hemiplegia.
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Affiliation(s)
- Menghan LI
- 1 Department of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China; National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300193, China; Graduate department, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Yu WANG
- 2 Department of Massage and Rehabilitation, Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300250, China
| | - Dawei RAN
- 3 Department of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China; National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300193, China
| | - Xinming YANG
- 3 Department of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China; National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300193, China
| | - Shizhe DENG
- 3 Department of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China; National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300193, China
| | - Lei SHI
- 3 Department of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China; National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300193, China
| | - Zhihong MENG
- 3 Department of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China; National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300193, China
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13
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Rao Y, Ge L, Wu J. A systematic review and coordinate-based meta-analysis of fMRI studies on acupuncture at LR 3. Front Neurosci 2024; 18:1341567. [PMID: 38348133 PMCID: PMC10859399 DOI: 10.3389/fnins.2024.1341567] [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: 11/20/2023] [Accepted: 01/03/2024] [Indexed: 02/15/2024] Open
Abstract
Objectives The acupoint LR3 (Taichong) is frequently utilized in clinical acupuncture. However, its underlying neural mechanisms remain not fully elucidated, with speculations suggesting its close association with specific brain activity patterns. Methods A comprehensive literature search was undertaken across several online databases, such as PubMed, Web of Science, Embase, Cochrane Library, CNKI (China National Knowledge Infrastructure), Wanfang Database, VIP Database, and the Chinese Biomedical Database. Two independent researchers handled the study selection, quality assessment, and data extraction processes. Using the seed-based d-mapping meta-analysis approach, we evaluated the brain regions activated by LR3 acupuncture in healthy subjects. Subsequent subgroup analysis was stratified by fMRI types, and regression analyses were performed considering the duration of acupuncture, depth of needle insertion, and needle diameter. The identified active brain regions were then intricately projected onto large-scale functional networks. Results A total of 10 studies met the criteria for inclusion, encompassing 319 healthy right-handed participants. The meta-analysis indicates that acupuncture at the LR3 activates regions such as the right postcentral gyrus, left thalamus, left middle frontal gyrus, and right superior frontal gyrus. Additionally, meta-regression analysis highlights that increased acupuncture duration correlates with progressively intensified activation of the right superior frontal gyrus. Subgroup analysis posits that variations in the type of fMRI employed might account for heterogeneity in the pooled results. Concurrently, functional network analysis identifies the primary activated regions as aligning with the Basal ganglia network, Auditory network, Left executive control network, Posterior salience network, Right executive control network, and Sensorimotor networks. Conclusion Acupuncture at the LR3 in healthy subjects selectively activates brain regions linked to pain perception, emotional processing, and linguistic functions. Extending the needle retention duration intensifies the activation of the right superior frontal gyrus. These findings enrich our comprehension of the neurobiological underpinnings of acupuncture's role in pain mitigation and emotional regulation.
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Affiliation(s)
- Yawen Rao
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
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14
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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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15
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Shi J, Zhang X, Chen J, Shen R, Cui H, Wu H. Acupuncture and moxibustion therapy for cognitive impairment: the microbiome-gut-brain axis and its role. Front Neurosci 2024; 17:1275860. [PMID: 38274501 PMCID: PMC10808604 DOI: 10.3389/fnins.2023.1275860] [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: 08/10/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
Cognitive impairment poses a significant burden on individuals, families, and society worldwide. Despite the lack of effective treatment strategies, emerging evidence suggests that the microbiome-gut-brain (MGB) axis may play a critical role in the pathogenesis of cognitive impairment. While targeted treatment is not yet comprehensive, recently, acupuncture and moxibustion therapy has participated increasingly in the treatment of degenerative diseases and has achieved a certain therapeutic effect. In this review, the possible mechanisms by which acupuncture and moxibustion therapy may improve cognitive impairment through the MGB axis are reviewed, including regulating gut microbial homeostasis, improving intestinal inflammation mediated by the neuroendocrine-immune system, and enhancing intestinal barrier function. We also discuss common acupoints and corresponding mechanism analysis to provide insights into further exploration of mechanisms that target the MGB axis and thereby intervene in cognitive impairment.
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Affiliation(s)
- Jiatian Shi
- Department of Acupuncture and Moxibustion, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xinyue Zhang
- Department of Acupuncture and Moxibustion, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jianhua Chen
- Department of Mental Health, Shanghai Mental Health Center, Shanghai, China
| | - Ruishi Shen
- Department of Acupuncture and Moxibustion, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Huashun Cui
- Department of Acupuncture and Moxibustion, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Huangan Wu
- Department of Acupuncture and Moxibustion, Yueyang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
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16
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Zhou Y, Dai A, Feng S, Zhu T, Liu M, Shi J, Wang D. Immediate neural effects of acupuncture manipulation time for stroke with motor dysfunction: a fMRI pilot study. Front Neurosci 2024; 17:1297149. [PMID: 38249582 PMCID: PMC10796520 DOI: 10.3389/fnins.2023.1297149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/13/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Acupuncture is widely utilized as a beneficial intervention for the treatment of motor dysfunction after stroke, and its effectiveness depends on the stimulation dose. Manipulation time is an important factor affecting the dose. This trial aimed use fMRI to explore the immediate neural effects in stroke patients with motor dysfunction by different acupuncture manipulation times, to reveal the neural mechanism of acupuncture manipulation. Methods Thirty participants were divided into three groups according to different acupuncture times. Each group received the same acupoint prescription, although the continuous manipulation time of each acupoint in three groups was 1-min, 2-min, and 3-min, respectively. The NIHSS, FMA and fMRI-BOLD in each participant we obtained before and after acupuncture manipulation. Then, we used the regional homogeneity (ReHo) algorithm to analyze the changes of brain function and to compare the neural effects at different acupuncture manipulation times. Results There were no significant differences in NIHSS and FMA scores between and within groups. Longitudinal analysis of ReHo values indicated that the right inferior frontal gyrus was activated in the 1-min group, the right insula in the 2-min group, and the right inferior temporal gyrus in the 3-min group. Compared with the 1-min group, the 2-min group showed the ReHo values of the right precentral gyrus was decreased, and the 3-min group showed the left cerebellum posterior lobe was increased, the right posterior cingulate gyrus and the right anterior cingulate gyrus were decreased. Compared with the 2-min group, the 3-min group showed the ReHo values of the right cerebellum anterior lobe was increased. Conclusion Our findings suggest that acupuncture at different manipulation times caused different changes of the neural effects in stroke patients, and the volume of activated voxel clusters is positively correlated with the manipulation time. Longer acupuncture manipulation could drive SMN and DMN in stroke patients, which may be the potential neurological mechanism of acupuncture manipulation affecting the recovery of motor dysfunction.
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Affiliation(s)
- Yihao Zhou
- Heilongjiang University of Chinese Medicine, Harbin, China
- The First Affiliated Hospital of Yunnan University of Chinese Medicine, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China
| | - Anhong Dai
- Yan’an Hospital Affiliated to Kunming Medical University, Kunming, China
| | - Sifeng Feng
- The First Affiliated Hospital of Yunnan University of Chinese Medicine, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China
| | - Tao Zhu
- The First Affiliated Hospital of Yunnan University of Chinese Medicine, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China
| | - Meifang Liu
- The First Affiliated Hospital of Yunnan University of Chinese Medicine, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China
| | - Jing Shi
- The First Affiliated Hospital of Yunnan University of Chinese Medicine, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China
| | - Dongyan Wang
- Second Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
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17
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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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18
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Zhang J, Ji C, Zhai X, Ren S, Tong H. Global trends and hotspots in research on acupuncture for stroke: a bibliometric and visualization analysis. Eur J Med Res 2023; 28:359. [PMID: 37735698 PMCID: PMC10512511 DOI: 10.1186/s40001-023-01253-w] [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: 01/10/2023] [Accepted: 07/29/2023] [Indexed: 09/23/2023] Open
Abstract
Acupuncture has been widely used in stroke and post-stroke rehabilitation (PSR), but there is no literature on the bibliometric analysis of acupuncture for stroke. This study aimed to characterize the global publications and analyze the trends of acupuncture for stroke in the past 40 years. We identified 1157 publications from the Web of Science Core Collection. The number of publications grew slowly in the first three decades from 1980 until it started to grow after 2010, with significant growth in 2011-2012 and 2019-2020. China, the USA, and South Korea are the top three countries in this field, and China has formed good internal cooperative relations. Early studies focused on the clinical efficacy of acupuncture for stroke. In the last five years, more emphasis has been placed on the effectiveness of acupuncture in treating sequelae and complications, combined with neuroimaging studies to explore the mechanisms of brain injury repair and neurological recovery. Acupuncture for stroke has a vast research potential, and researchers from different countries/regions and organizations still need to remove academic barriers to enhance communication and collaboration.
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Affiliation(s)
- Jiale Zhang
- Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Chenyang Ji
- Science and Technology College of Jiangxi, University of Traditional Chinese Medicine, Nanchang, 330004, China
| | - Xu Zhai
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, 100102, China.
| | - Shuo Ren
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250011, China.
| | - Hongxuan Tong
- Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
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19
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Min YJ, Yao HH, Wang L, Cheng LH, Hong ES. Comparison and effect of moxibustion and acupuncture on Nogo/NgR signaling pathway in rats with cerebral ischemia/reperfusion injury. J Tradit Complement Med 2023; 13:430-440. [PMID: 37693099 PMCID: PMC10491986 DOI: 10.1016/j.jtcme.2023.03.006] [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: 09/27/2022] [Revised: 03/04/2023] [Accepted: 03/10/2023] [Indexed: 04/03/2023] Open
Abstract
Background and aim In China, acupuncture and moxibustion have been used effectively to treat various diseases for thousands of years. However, the evidence for a difference in the efficacies of moxibustion and acupuncture in cerebral infarction treatment is scarce. We aimed to compare the effects of acupuncture and moxibustion treatment on the Nogo/NgR signaling pathway in rats with cerebral ischemia/reperfusion (I/R) injury. Experimental procedure Eighty male SD rats were randomly divided into five groups, based on treatment received: sham surgery (sham group), middle cerebral artery occlusion (MCAO, MCAO group), MCAO and NEP(1-40) inhibitor injection (MCAO + block group), MCAO and moxibustion (MCAO + moxi group), and MCAO and minimal acupuncture (MCAO + MA group). Neurological status was evaluated before treatment, and cerebral infarction volume (IV) and neurological function; Nogo-A, NgR, p75NTR, and LINGO-1 expressions; and NgR and LINGO-1 co-expression were assessed after treatment. Results and conclusion After treatment, barring Nogo-A mRNA and protein expression in the MCAO + block group, the Longa score and IV significantly decreased; Nogo-A, NgR, p75NTR, and LINGO-1 mRNA and protein expressions as well as NgR and LINGO-1 co-expression significantly decreased in cerebral tissues; whereas the BWT score increased (P < 0.01) in the MCAO + moxi group, compared with the MCAO group. Except for NgR and LINGO-1 protein expressions, there were no significant differences in the abovementioned parameters between rats that underwent acupuncture and moxibustion. Acupuncture and moxibustion have similar effects on Nogo/NgR signaling pathway inhibition after cerebral infarction.
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Affiliation(s)
- You-jiang Min
- School of Traditional Chinese Medicine, Nanchang Medical College, Nanchang, 330052, Jiangxi, China
- Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, 330006, Jiangxi, China
| | - Hai-hua Yao
- Shanghai Eighth People's Hospital, Shanghai, 200235, Shanghai, China
| | - Li Wang
- School of Traditional Chinese Medicine, Nanchang Medical College, Nanchang, 330052, Jiangxi, China
| | - Li-hong Cheng
- Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, 330006, Jiangxi, China
| | - En-si Hong
- Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, 330006, Jiangxi, China
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Lin CC, Chen HY, Tseng CY, Yang CC. Effect of Acupuncture on Recovery of Consciousness in Patients with Acute Traumatic Brain Injury: A Multi-Institutional Cohort Study. Healthcare (Basel) 2023; 11:2267. [PMID: 37628465 PMCID: PMC10454345 DOI: 10.3390/healthcare11162267] [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: 07/18/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Traumatic brain injury (TBI) causes cognitive dysfunction and long-term impairments. This study aims to examine the effectiveness of acupuncture on the recovery of consciousness in TBI patients. This is a retrospective, multi-institutional cohort study. We enrolled patients with newly diagnosed TBI from 1 January 2007 to 3 August 2021, aged 20 years and older, from the Chang Gung Research Database (CGRD). The outcome was defined based on the difference between the first and last Glasgow Coma Scale (GCS). A total of 2163 TBI patients were analyzed, and 237 (11%) received acupuncture in the treatment period. Generally, the initial GCS was lower in the acupuncture users (11 vs. 14). For the results of our study, a higher proportion of acupuncture patients achieved significant improvement (GCS differences ≥ 3) compared to non-acupuncture users (46.0% vs. 22.4%, p-value < 0.001). The acupuncture users had a 2.11 times higher chance of achieving a significant improvement when considering all assessable covariates (adjusted odds ratio (aOR) 2, 11, 95% confidence interval [CI]: 1.31-3.40; p-value = 0.002). Using 1:1 propensity score matching (PSM), the acupuncture users still had better outcomes than the non-acupuncture users (45.3% vs. 32.9%, p-value = 0.020). In conclusion, this study suggests that acupuncture treatment may be beneficial for TBI patients.
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Affiliation(s)
- Chun-Chieh Lin
- Division of Acupuncture and Traumatology, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 33378, Taiwan; (C.-C.L.); (C.-Y.T.)
| | - Hsing-Yu Chen
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan;
- Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 33378, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Chu-Yao Tseng
- Division of Acupuncture and Traumatology, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 33378, Taiwan; (C.-C.L.); (C.-Y.T.)
| | - Chien-Chung Yang
- Division of Acupuncture and Traumatology, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 33378, Taiwan; (C.-C.L.); (C.-Y.T.)
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
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21
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Liu Y, Gong Y, Wu XL, Hao XM, Liu JP, Li YY, Yang KZ, Gao XY, Zhang J, Zhang L, Zhang XD, Wang J, Liu QG. Fire acupuncture for anti-LGI1 antibody autoimmune encephalitis: a case report. Front Neurosci 2023; 17:1203915. [PMID: 37539383 PMCID: PMC10395828 DOI: 10.3389/fnins.2023.1203915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/19/2023] [Indexed: 08/05/2023] Open
Abstract
Autoimmune encephalitis, a class of encephalitis, is clinically characterized by multifocal or diffuse brain injury, including aberrant mental behavior, convulsions, and near-event memory impairment. In this article, we describe a female patient with autoimmune encephalitis who tested positive for leucine-rich glioma inactivated 1 (LGI1) antibodies and had hippocampal inflammatory edema in the lesion area. During the first 3 months of her illness, the patient primarily experienced memory loss, the onset of rigid twitching in her extremities that lasted for 1 min while in remission, and incontinence. After gamma globulin administration, methylprednisolone shock, and other symptomatic therapies during hospitalization, the patient's psychiatric symptoms and seizures improved considerably; however, she did not fully recover her memory. After receiving fire acupuncture for 6 months, the patient's understanding, orientation, and calculation skills improved considerably. Her memory and mental state were also improved at the follow-up visit. In this case, the use of fire acupuncture for the treatment of autoimmune encephalitis resulted in favorable outcomes with important benefits for conditions affecting the central nervous system; however, more convincing data are required to support the effectiveness of this treatment method.
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Affiliation(s)
- Yu Liu
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yu Gong
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xiao-li Wu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xiao-min Hao
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Ji-peng Liu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yin-yin Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Ke-zhen Yang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xin-yu Gao
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jing Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Lin Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xu-dong Zhang
- Department of Chinese Medicine, Beijing Jishuitan Hospital, Beijing, China
| | - Jun Wang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Qing-guo Liu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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22
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Sun Z, Lin YR, Lu MJ, Huang KY, Sun K, Zhang JB. Acupuncture for gait disturbance of patients with subacute and chronic stroke: a systematic review and meta-analysis protocol. BMJ Open 2023; 13:e071590. [PMID: 37344117 DOI: 10.1136/bmjopen-2023-071590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2023] Open
Abstract
INTRODUCTION Hemiparetic gait is one of the most common sequelae of a stroke. Acupuncture has shown potential in correcting hemiplegic gait patterns and improving motor function recovery after stroke. However, controversial findings and a lack of supportive evidence on the effectiveness of acupuncture for post-stroke hemiplegia. The intelligent gait analysis system provides a new perspective for the study of hemiparetic gait. This systematic review aims to collect relevant studies and critically evaluate the efficacy and safety of acupuncture in alleviating gait disturbance of post-stroke hemiplegia based on quantified gait parameters. METHODS AND ANALYSIS A comprehensive search of PubMed, Embase, Cochrane stroke group trials register, Cochrane Central Register of Controlled Trials, CINAHL, AMED, three Chinese databases (Chinese Biomedical Literatures database (CBM), National Knowledge Infrastructure (CNKI), and Wan fang Digital Periodicals), four trails registries (The WHO International Clinical Trials Registry Platform, The Chinese Clinical Trial Registry, The US National Institutes of Health Ongoing Trials Register, and The Australian New Zealand Clinical Trials Registry) will be conducted to identify randomised controlled trials of acupuncture for gait disturbance in post-stroke patients. No restrictions on language or publication status. The primary outcomes are gait temporospatial parameters (eg, step length, stride length, step width, step frequency (cadence), walking speed, etc), and gait kinematic parameters (eg, hip peak flex/extend angle, knee peak flex/extend angle, ankle peak dorsi/plantar-flexion angle, etc). We will assess bias using the approach recommended by the Cochrane Handbook for Systematic Reviews of Interventions. A meta-analysis will be conducted to synthesise the evidence for each outcome measure. The χ2 test and I2 statistic will be used for assessing heterogeneity between studies. ETHICS AND DISSEMINATION No ethical approval is needed because no primary data is collected. Scientific conferences or peer-reviewed journals will publish the findings. PROSPERO REGISTRATION NUMBER CRD42022384348.
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Affiliation(s)
- Zheng Sun
- Department of Acupuncture and Moxibustion, The Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yi-Ren Lin
- Department of Chinese Rehabilitaiton Center, The Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Meng-Jiang Lu
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China
| | - Kai-Yu Huang
- Department of Acupuncture, Ningbo Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, China
| | - Ke Sun
- Department of Acupuncture and Message, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jian-Bin Zhang
- Department of Acupuncture and Moxibustion, The Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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23
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Cheng S, Xin R, Zhao Y, Wang P, Feng W, Liu P. Evaluation of fMRI activation in post-stroke patients with movement disorders after repetitive transcranial magnetic stimulation: a scoping review. Front Neurol 2023; 14:1192545. [PMID: 37404941 PMCID: PMC10315664 DOI: 10.3389/fneur.2023.1192545] [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: 03/23/2023] [Accepted: 05/25/2023] [Indexed: 07/06/2023] Open
Abstract
Background Movement disorders are one of the most common stroke residual effects, which cause a major stress on their families and society. Repetitive transcranial magnetic stimulation (rTMS) could change neuroplasticity, which has been suggested as an alternative rehabilitative treatment for enhancing stroke recovery. Functional magnetic resonance imaging (fMRI) is a promising tool to explore neural mechanisms underlying rTMS intervention. Object Our primary goal is to better understand the neuroplastic mechanisms of rTMS in stroke rehabilitation, this paper provides a scoping review of recent studies, which investigate the alteration of brain activity using fMRI after the application of rTMS over the primary motor area (M1) in movement disorders patients after stroke. Method The database PubMed, Embase, Web of Science, WanFang Chinese database, ZhiWang Chinese database from establishment of each database until December 2022 were included. Two researchers reviewed the study, collected the information and the relevant characteristic extracted to a summary table. Two researchers also assessed the quality of literature with the Downs and Black criteria. When the two researchers unable to reach an agreement, a third researcher would have been consulted. Results Seven hundred and eleven studies in all were discovered in the databases, and nine were finally enrolled. They were of good quality or fair quality. The literature mainly involved the therapeutic effect and imaging mechanisms of rTMS on improving movement disorders after stroke. In all of them, there was improvement of the motor function post-rTMS treatment. Both high-frequency rTMS (HF-rTMS) and low-frequency rTMS (LF-rTMS) can induce increased functional connectivity, which may not directly correspond to the impact of rTMS on the activation of the stimulated brain areas. Comparing real rTMS with sham group, the neuroplastic effect of real rTMS can lead to better functional connectivity in the brain network in assisting stroke recovery. Conclusion rTMS allows the excitation and synchronization of neural activity, promotes the reorganization of brain function, and achieves the motor function recovery. fMRI can observe the influence of rTMS on brain networks and reveal the neuroplasticity mechanism of post-stroke rehabilitation. The scoping review helps us to put forward a series of recommendations that might guide future researchers exploring the effect of motor stroke treatments on brain connectivity.
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Affiliation(s)
- Siman Cheng
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Rong Xin
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Yan Zhao
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Pu Wang
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Wuwei Feng
- Department of Neurology, Medical University of South Carolina, Charleston, SC, United States
| | - Peng Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
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24
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Wen Q, Hong X, He K, Liu B, Li M. Can acupuncture reverse oxidative stress and neuroinflammatory damage in animal models of vascular dementia?: A preclinical systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e33989. [PMID: 37335660 DOI: 10.1097/md.0000000000033989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Vascular dementia is a cognitive dysfunction syndrome caused by cerebral vascular factors such as ischemic stroke and hemorrhagic stroke. The effect of acupuncture on vascular dementia models is ambiguous, and there is controversy about whether acupuncture has a placebo effect. Oxidative stress and inflammation are the most essential mechanisms in preclinical studies of vascular dementia. However, there is no meta-analysis on the mechanism of vascular dementia in animal models. It is necessary to explore the efficacy of acupuncture through Meta-analysis of preclinical studies. METHODS Three major databases, PubMed, Embase and Web of Science (including medline), were searched in English until December 2022.The quality of the including literature was assessed using SYRCLE's risk of bias tool. Review Manager 5.3 was used to statistically summarize the included studies and the statistical effect values were expressed by SMD. The outcomes included: behavioral tests (escape latency, number of crossings), pathological sections (Nissl and TUNEL staining), oxidative stress markers (ROS, MDA, SOD, GSH-PX) and neuroinflammatory factors (TNF-α, IL-1β, IL-6). RESULTS A total of 31 articles were included in this meta-analysis. The results showed that the escape latency, the contents of ROS, MDA, IL-1β, and IL-6 were decreased, and the contents of SOD and Nissl-positive neurons were increased in the acupuncture group as compared with the non-group (P < .05). Compared with the impaired group, the acupuncture group also had the above advantages (P < .05). In addition, the acupuncture group also increased the number of crossings and GSH-PX content, and decreased the expression of TUNEL-positive neurons and TNF-α (P < .05). CONCLUSIONS From behavioral tests to slices and pathological markers in animal models of vascular dementia, it can be proved that acupuncture is effective in targeting oxidative stress and neuroinflammatory damage, and acupuncture is not a placebo effect. Nevertheless, attention needs to be paid to the gap between animal experiments and clinical applications.
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Affiliation(s)
- Qin Wen
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
- Yuangang Street Community Health Service Center, Guangzhou, China
| | - Xueqin Hong
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Kunze He
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Buping Liu
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Min Li
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
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25
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Lin D, Gao J, Lu M, Han X, Tan Z, Zou Y, Cui F. Scalp acupuncture regulates functional connectivity of cerebral hemispheres in patients with hemiplegia after stroke. Front Neurol 2023; 14:1083066. [PMID: 37305743 PMCID: PMC10248137 DOI: 10.3389/fneur.2023.1083066] [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: 10/28/2022] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Background Stroke is a common cause of acquired disability on a global scale. Patients with motor dysfunction after a stroke have a reduced quality of life and suffer from an economic burden. Scalp acupuncture has been proven to be an effective treatment for motor recovery after a stroke. However, the neural mechanism of scalp acupuncture for motor function recovery remains to be researched. This study aimed to investigate functional connectivity (FC) changes in region of interest (ROI) and other brain regions to interpret the neural mechanism of scalp acupuncture. Methods Twenty-one patients were included and randomly divided into patient control (PCs) and scalp acupuncture (SAs) groups with left hemiplegia due to ischemic stroke, and we also selected 20 matched healthy controls (HCs). The PCs were treated with conventional Western medicine, while the SAs were treated with scalp acupuncture (acupuncture at the right anterior oblique line of vertex temporal). All subjects received whole-brain resting-state functional magnetic resonance imaging (rs-fMRI) scan before treatment, and the patients received a second scan after 14 days of treatment. We use the National Institutes of Health Stroke Scale (NIHSS) scores and the analyses of resting-state functional connectivity (RSFC) as the observational indicators. Results The contralateral and ipsilateral cortex of hemiplegic patients with cerebral infarction were associated with an abnormal increase and decrease in basal internode function. An abnormal increase in functional connectivity mainly exists in the ipsilateral hemisphere between the cortex and basal ganglia and reduces the abnormal functional connectivity in the cortex and contralateral basal ganglia. Increased RSFC was observed in the bilateral BA6 area and bilateral basal ganglia and the connectivity between bilateral basal ganglia nuclei improved. However, the RSFC of the conventional treatment group only improved in the unilateral basal ganglia and contralateral BA6 area. The RSFC in the left middle frontal gyrus, superior temporal gyrus, precuneus, and other healthy brain regions were enhanced in SAs after treatment. Conclusion The changes in functional connectivity between the cerebral cortex and basal ganglia in patients with cerebral infarction showed a weakening of the bilateral hemispheres and the enhancement of the connections between the hemispheres. Scalp acupuncture has the function of bidirectional regulation, which makes the unbalanced abnormal brain function state restore balance.
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Affiliation(s)
- Dan Lin
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jinyang Gao
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Mengxin Lu
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xiao Han
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhongjian Tan
- Department of Radiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yihuai Zou
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Fangyuan Cui
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
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26
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Li L, Wang X, Guo J, Chen Y, Wang Z. Effect of acupuncture in the acute phase of intracerebral hemorrhage on the prognosis and serum BDNF: a randomized controlled trial. Front Neurosci 2023; 17:1167620. [PMID: 37123377 PMCID: PMC10133506 DOI: 10.3389/fnins.2023.1167620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 03/28/2023] [Indexed: 05/02/2023] Open
Abstract
Background Intracerebral hemorrhage (ICH) is a common cerebrovascular disease, with a high rate of disability. In the literature on Chinese traditional medicine, there is increasing evidence that acupuncture can help hematoma absorption and improve neurological deficits after cerebral hemorrhage. Brain-derived neurotrophic factor (BDNF), one of the most studied neurotrophic factors, is involved in a variety of neurological functions and plays an important role in brain injury recovery. We investigated the effect of acupuncture intervention in the acute phase of ICH on the prognosis and serum BDNF levels of several patient groups. Objective To investigate the influence of acupuncture on the prognosis and brain-derived neurotrophic factor (BDNF) levels in patients in the acute phase of ICH. Methods From November 2021 to May 2022, 109 subjects were consecutively enrolled, including patients with ICH, who were randomized into the acupuncture group (AG) and sham acupuncture group (SAG), and a control group (CG). The CG received the same acupuncture intervention as the AG, and the SAG received sham acupuncture, with 14 interventions in each group. The level of consciousness of patients with ICH was assessed and serum BDNF levels were measured in all three groups before the intervention and at 3 weeks after onset, and the level of consciousness and outcomes were assessed at 12 weeks after onset. Results After the intervention, the level of consciousness of the AG improved significantly (P < 0.05); the BDNF level of only the AG increased significantly (P < 0.05); the changes in Glasgow Coma Scale (GCS) score and BDNF level were significantly greater in the AG than in the SAG (P < 0.05), especially for locomotion (P < 0.05). At 12 weeks post-onset, the AG showed better outcomes and recovery of consciousness than the SAG (P < 0.05).
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Affiliation(s)
| | | | | | | | - Zhenyu Wang
- Department of Rehabilitation Medicine, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
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27
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Zhuo B, Deng S, Li B, Zhu W, Zhang M, Qin C, Meng Z. Possible Effects of Acupuncture in Poststroke Aphasia. Behav Neurol 2023; 2023:9445381. [PMID: 37091130 PMCID: PMC10115536 DOI: 10.1155/2023/9445381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 12/30/2022] [Accepted: 04/02/2023] [Indexed: 04/25/2023] Open
Abstract
Neural plasticity promotes the reorganization of language networks and is an essential recovery mechanism for poststroke aphasia (PSA). Neuroplasticity may be a pivotal bridge to elucidate the potential recovery mechanisms of acupuncture for aphasia. Therefore, understanding the neuroplasticity mechanism of acupuncture in PSA is crucial. However, the underlying therapeutic mechanism of neuroplasticity in PSA after acupuncture needs to be explored. Excitotoxicity after brain injury affects the activity of neurotransmitters and disrupts the transmission of normal neuron information. Thus, a helpful strategy of acupuncture might be to improve PSA by affecting the availability of these neurotransmitters and glutamate receptors at synapses. In addition, the regulation of neuroplasticity by acupuncture may also be related to the regulation of astrocytes. Considering the guiding significance of acupuncture for clinical treatment, it is necessary to carry out further study about the influence of acupuncture on the recovery of aphasia after stroke. This study summarizes the current research on the neural mechanism of acupuncture in treating PSA. It seeks to elucidate the potential effect of acupuncture on the recovery of PSA from the perspective of synaptic plasticity and integrity of gray and white matter.
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Affiliation(s)
- Bifang Zhuo
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Shizhe Deng
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Boxuan Li
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Weiming Zhu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Menglong Zhang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Chenyang Qin
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Zhihong Meng
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
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28
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Yin Z, Wang Z, Li Y, Zhou J, Chen Z, Xia M, Zhang X, Wu J, Zhao L, Liang F. Neuroimaging studies of acupuncture on Alzheimer's disease: a systematic review. BMC Complement Med Ther 2023; 23:63. [PMID: 36823586 PMCID: PMC9948384 DOI: 10.1186/s12906-023-03888-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 02/14/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Acupuncture effectively improves cognitive function in Alzheimer's disease (AD). Many neuroimaging studies have found significant brain alterations after acupuncture treatment of AD, but the underlying central modulation mechanism is unclear. OBJECTIVE This review aims to provide neuroimaging evidence to understand the central mechanisms of acupuncture in patients with AD. METHODS Relevant neuroimaging studies about acupuncture for AD were retrieved from eight English and Chinese medicine databases (PubMed, Embase, Cochrane Library, Web of Science, SinoMed, CNKI, WF, VIP) and other resources from inception of databases until June 1, 2022, and their methodological quality was assessed using RoB 2.0 and ROBINS - I. Brain neuroimaging information was extracted to investigate the potential neural mechanism of acupuncture for AD. Descriptive statistics were used for data analysis. RESULTS Thirteen neuroimaging studies involving 275 participants were included in this review, and the overall methodological quality of included studies was moderate. The approaches applied included task-state functional magnetic resonance imaging (ts-fMRI; n = 9 studies) and rest-state functional magnetic resonance imaging (rs-fMRI; n = 4 studies). All studies focused on the instant effect of acupuncture on the brains of AD participants, including the cingulate gyrus, middle frontal gyrus, and cerebellum, indicating that acupuncture may regulate the default mode, central executive, and frontoparietal networks. CONCLUSION This study provides evidence of the neural mechanisms underlying the effect of acupuncture on AD involving cognitive- and motor-associated networks. However, this evidence is still in the preliminary investigation stage. Large-scale, well-designed, multimodal neuroimaging trials are still required to provide comprehensive insight into the central mechanism underlying the effect of acupuncture on AD. (Systematic review registration at PROSPERO, No. CRD42022331527).
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Affiliation(s)
- Zihan Yin
- grid.411304.30000 0001 0376 205XSchool of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China ,Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Ziqi Wang
- grid.517561.1the Fourth People’s Hospital of Chengdu, Chengdu, China
| | - Yaqin Li
- grid.411304.30000 0001 0376 205XSchool of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jun Zhou
- grid.411304.30000 0001 0376 205XSchool of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhenghong Chen
- grid.411304.30000 0001 0376 205XSchool of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China ,Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Manze Xia
- grid.411304.30000 0001 0376 205XSchool of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China ,Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Xinyue Zhang
- grid.411304.30000 0001 0376 205XSchool of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China ,Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Jiajing Wu
- grid.417409.f0000 0001 0240 6969School of Nursing, Zunyi Medical University, Zunyi, China
| | - Ling Zhao
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China. .,Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China.
| | - Fanrong Liang
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China. .,Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China.
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29
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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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Yang N, Chen S, Liu S, Ling S, Chen L. Increased low frequency fluctuation in the brain after acupuncture treatment in CSVDCI patients: A randomized control trial study. Front Neurosci 2023; 17:1125418. [PMID: 36922926 PMCID: PMC10010105 DOI: 10.3389/fnins.2023.1125418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/02/2023] [Indexed: 03/02/2023] Open
Abstract
Background Cerebral small vessel disease (CSVD) is one of two cognition-impairing diseases. Acupuncture (Acu) is a flexible treatment with few adverse effects and is thus widely used to treat neurological problems. Methods We recruited a total of 60 patients and assigned them to two groups (n = 30 each group). During the study, some participants were excluded by quality control, and a total of 44 subjects (25 Acu and 19 controls) were completed to investigate the therapeutic efficacy of acupuncture on CSVD cognitive impairment (CSVDCI). The following demographic and clinical variables were compared between the two groups: gender, age, education, smoking, alcohol, Montreal cognitive assessment (MoCA), symbol digit modalities test (SDMT), verbal fluency test (VFT), digit span task (DST), Boston naming test (BNT) scores, and amplitude of low-frequency fluctuation (ALFF) under the typical band (0.01-0.08 Hz). Mixed effect analysis was utilized to test for differences between the two groups before and after the treatment. Results Following acupuncture treatment, the Acu group scored higher on MoCA, SDMT, VFT, DST, and BNT compared to controls (P < 0.05). The brain regions showing substantially greater ALFF values in the Acu group were the right inferior temporal gyrus, left middle occipital gyrus, left superior occipital gyrus, left insula, bilateral postcentral gyrus, right superior parietal gyrus, right cerebellum, right precuneus, and right precentral gyrus (P < 0.005, no correction). The ALFF values in the right inferior temporal gyrus (P = 0.027), left middle occipital gyrus (P = 0.005), left superior occipital gyrus (P = 0.011), and right superior parietal gyrus (P = 0.043) were positively associated with MoCA. Conclusion We found that acupuncture modulates the functional activity of temporal, occipital, and parietal regions of the brain in CSVDCI patients.
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Affiliation(s)
- Nan Yang
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.,Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, Guangdong, China
| | - Sina Chen
- Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, Guangdong, China
| | - Shuxue Liu
- Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, Guangdong, China
| | - Shuiqiao Ling
- Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, Guangdong, China
| | - Lidian Chen
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
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Yang X, Shi L, Ran D, Li M, Qin C, An Z. The treatment of post-stroke dysarthria with a combination of different acupuncture types and language rehabilitation training: a systematic review and network meta-analysis. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:1281. [PMID: 36618810 PMCID: PMC9816828 DOI: 10.21037/atm-22-5583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022]
Abstract
Background This study used a network meta-analysis to evaluate the efficacy of various different acupuncture types and language rehabilitation training on post-stroke dysarthria (PSD), and examined the possible mechanisms involved. There are often clinical studies comparing the effects of different acupuncture methods on dysarthria after stroke. The efficacy of these methods can be ranked by network meta-analysis. This is necessary for clinical acupoints selection. The results of this study illustrated the comparison of the therapeutic effects of 6 different acupuncture types, which can provide some reference for clinical acupoints selection and research. Methods A comprehensive search for clinical studies related to the use of acupuncture to treat PSD was conducted in eight English and Chinese databases. Patients were divided into six groups based on the acupoints selected, namely, tongue, neck, scalp, body, combination, and traditional acupuncture. The recovery of neurological function in the patients was assessed based on the curative impact and the National Institutes of Health Stroke Scale (NIHSS) score. The quality of the included studies was evaluated using the Cochrane risk bias assessment tool and the STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) criteria. A network meta-analysis was performed using the network-meta package of Stata 15.1 software based on frequency. The heterogeneity test, consistency test, head-to-head mixed comparison, efficacy ranking, and publication bias study were all performed. Results A total of 47 studies were finally included. There was a total of 4,197 patients in the eligible studies. The model for network meta-analysis proved robust, with minimal heterogeneity and high consistency. Combined acupuncture combined with language rehabilitation training was the most effective in treating dysarthria symptoms, followed by tongue acupuncture (TA) and nape acupuncture (NA). In addition, the combined effect of acupuncture and language training was superior to that of acupuncture alone. In terms of recovery of nerve function, traditional acupuncture and body acupuncture were more effective. To facilitate the recovery of nerve function, increasing the frequency of acupoints is necessary. Conclusions Combined acupuncture may have the most beneficial healing effect on PSD, followed by acupuncture of the tongue and the nape of the neck. In terms of recovery of nerve function, traditional acupuncture and body acupuncture may have more effective.
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Affiliation(s)
- Xinming Yang
- Clinical Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Lei Shi
- Clinical Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Dawei Ran
- Clinical Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Menghan Li
- Clinical Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Chenyang Qin
- Clinical Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Zimeng An
- Clinical Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
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Electroacupuncture Promotes Neuroplasticity of Central Auditory Pathway: An Auditory Evoked Potentials Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:6855775. [DOI: 10.1155/2022/6855775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/09/2022] [Accepted: 11/09/2022] [Indexed: 11/22/2022]
Abstract
Our previous studies found that electroacupuncture at the right Zhongzhu acupoint (TE3) can enhance auditory recovery in rats with noise-induced hearing loss. Here, we investigated the changes in auditory brainstem response (ABR) and long late latency (LLR) evoked potential to explain the mechanisms of electroacupuncture at TE3. The auditory evoked potentials were recorded, including ABR and LLR, at baseline and on day 3 (D3), D5, and D8 after baseline. The 2-Hz electroacupuncture at the right TE3 was applied on D3, D4, and D5 in the electroacupuncture group but not in the control group. In ABR, compared with the control group, the latency shift of waves I (0.298 ± 0.033 vs −0.045 ± 0.057 ms), III (0.718 ± 0.038 vs −0.163 ± 0.130 ms), and V (1.160 ± 0.082 vs −0.207 ± 0.138 ms) on D3 (all
) and of wave V (0.616 ± 0.433 vs −0.352 ± 0.209 ms,
) on D5 was greater in the electroacupuncture group than that in the control group. Moreover, the interpeak latency shift of I–III (0.420 ± 0.041 vs −0.118 ± 0.177 ms) and I–V (0.863 ± 0.088 vs −0.162 ± 0.156 ms) on D3 (both
) and of III–V (0.342 ± 0.193 vs −0.190 ± 0.110 ms) and I–V (0.540 ± 0.352 vs −0.343 ± 0.184 ms) on D5 (both
) was greater in the electroacupuncture group than that in the control group. In LLR, the latency shift of P0 was greater in the electroacupuncture group than in the control group on D3 (3.956 ± 2.975 vs −1.178 ± 1.358 ms,
) and D5 (2.200 ± 1.889 vs −0.311 ± 1.078 ms,
). These findings indicate that electroacupuncture at the right TE3 can modulate the neuroplasticity of the central auditory pathway, including the brain stem and the primary and secondary auditory cortex.
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Jiang H, Zhang Q, Zhao Q, Chen H, Nan X, Liu M, Yin C, Liu W, Fan X, Meng Z, Du Y. Manual Acupuncture or Combination of Rehabilitation Therapy to Treat Poststroke Dysphagia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:8803507. [PMID: 36285156 PMCID: PMC9588332 DOI: 10.1155/2022/8803507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 09/13/2022] [Accepted: 09/29/2022] [Indexed: 01/24/2023]
Abstract
Backgroundand Objective. Poststroke dysphagia is one of the most common stroke complications with high morbidity and long course, while acupuncture treatment is easily accepted by patients due to its reliability, feasibility, simple operation, low price, and quick effect. Our objective was to evaluate the efficacy of manual acupuncture in poststroke dysphagia patients. Methods. Databases including Medline, Web of Science, PubMed, Cochrane Library databases, EMBASE, CNKI (China National Knowledge Infrastructure), WanFang (WanFang Database), and VIP (Chongqing VIP) were searched from inception until Aug 19, 2022. Data were analyzed using Revman 5.3, Stata 14.0, and TSA 0.9.5.10 Beta software. Evidence quality evaluation was performed by using GRADE profiler 3.6. Results. A total of 33 randomized control trials (RCTs) enrolled 2680 patients. Meta-analysis results revealed that compared to rehabilitation, acupuncture decreased water swallow test (WST) and standard swallowing assessment (SSA) scores. Meanwhile, in contrast to rehabilitation alone, integration of acupuncture with rehabilitation effectively decreased WST and SSA scores; improved swallowing scores of videofluoroscopic swallowing study (VFSS), swallowing scores of Fujishima Ichiro, Barthel index (BI), and swallowing quality of life questionnaire (SWAL-QOL); reduced the aspiration rates as well as aspiration pneumonia; and shortened the duration of empty swallowing and the duration of 5 mL water swallowing. Pooled analysis did not reveal any significant differences in dysphagia outcome severity scores (DOSS) (p=0.15 > 0.05p) between the acupuncture group combined with rehabilitation group and the rehabilitation group alone. After the risk-of-bias assessment, these studies were not of low quality, except in terms of allocation concealment and blindness. Evidence quality evaluation showed that allocation concealment and blindness led to a downgrade and primary outcomes' evaluation of acupuncture combined with rehabilitation were ranked as moderate-quality evidence while acupuncture alone was ranked as low-quality. Conclusion. This meta-analysis provided positive pieces of evidences that acupuncture and acupuncture combined with rehabilitation were better than using rehabilitation alone in the treatment of poststroke dysphagia.
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Affiliation(s)
- Hailun Jiang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
- Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China
| | - Qiang Zhang
- BeiJing Daxing District Hospital of Integrated Chinese and Western Medicine, Beijing 102600, China
| | - Qi Zhao
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China
| | - Hao Chen
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
- Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China
| | - Xi Nan
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
- Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China
| | - Miao Liu
- BeiJing Daxing District Hospital of Integrated Chinese and Western Medicine, Beijing 102600, China
| | - Chunsheng Yin
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
- Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China
| | - Wei Liu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
- Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China
| | - Xiaonong Fan
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China
| | - Zhihong Meng
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China
| | - Yuzheng Du
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China
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Li J, Huang Z, Li K, Jian X, Liang B. Study on the Effect of Self-Made Lifei Dingchuan Decoction Combined with Western Medicine on Cough Variant Asthma. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9803552. [PMID: 36132547 PMCID: PMC9484939 DOI: 10.1155/2022/9803552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/01/2022] [Accepted: 08/23/2022] [Indexed: 01/17/2023]
Abstract
Aims To observe the clinical efficacy of self-made Lifei Dingchuan decoction combined with western medicine in the treatment of cough variant asthma (phlegm-heat accumulation in the lung syndrome). Materials and Methods The clinical data of 90 patients with cough variant asthma who were hospitalized in the Department of Respiratory Medicine of our hospital from January 2020 to April 2022 were selected as the research objects, and they were equally divided into the observation group and the reference group according to different treatment methods, 45 cases in each group. The group was treated with traditional montelukast sodium chewable tablet and salmeterol fluticasone mixed powder inhalation, and the observation group was treated with self-made Lifei Dingchuan decoction on the basis of the control group, saturation, pH, partial pressure of oxygen in arterial blood, partial pressure of carbon dioxide, length of stay, and hospitalization costs. Results After the patients underwent self-made Lifei Dingchuan decoction, there were significant differences between the observation group and the reference group in terms of heart rate, respiratory rate, blood oxygen saturation, pH value, arterial blood oxygen partial pressure, carbon dioxide partial pressure, and within the group. There was a statistical difference (P < 0.05). The adverse reactions in patients with cough variant asthma after treatment showed that the red throat, shortness of breath, chest tightness, and dry mouth in the observation group were significantly different from those in the control group (P < 0.05). After investigation, follow-up, and statistics, the hospitalization time, hospitalization cost, asthma exacerbation control time, effective rate, and recurrence rate were compared between the two groups, and the differences between the two groups were statistically significant (P < 0.05). Conclusion The study on the clinical efficacy and low hospitalization cost of the self-prepared lung and asthma-restorative soup in patients with cough variant asthma significantly improved the patients' arterial oxygen saturation, acid-base value, arterial partial pressure of oxygen, and partial pressure of carbon dioxide and effectively controlled the heart rate and respiratory rate with high safety, which is worth further promotion.
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Affiliation(s)
- Jiachun Li
- Department of Respiratory Medicine, Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Traditional Chinese Medicine, Foshan, Guangdong 528000, China
| | - Ziliang Huang
- The Third School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510145, China
- Department of Traditional Chinese Medicine, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, Qingyuan, Guangdong 511518, China
| | - Keying Li
- The Eighth School of Clinical Medicine, Guangzhou University of Chinese Medicine, Foshan, Guangdong 528000, China
| | - Xiaoyun Jian
- Department of Respiratory Medicine, Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Traditional Chinese Medicine, Foshan, Guangdong 528000, China
| | - Binghui Liang
- Department of Respiratory Medicine, Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Traditional Chinese Medicine, Foshan, Guangdong 528000, China
- The Eighth School of Clinical Medicine, Guangzhou University of Chinese Medicine, Foshan, Guangdong 528000, China
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Ning Y, Zheng S, Feng S, Yao H, Feng Z, Liu X, Dong L, Jia H. The altered intrinsic functional connectivity after acupuncture at shenmen (HT7) in acute sleep deprivation. Front Neurol 2022; 13:947379. [PMID: 35959405 PMCID: PMC9360611 DOI: 10.3389/fneur.2022.947379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 07/06/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Accumulating evidence has shown that acupuncture could significantly improve the sleep quality and cognitive function of individuals suffering from insufficient sleep. Numerous animal studies have confirmed the effects and mechanisms of acupuncture on acute sleep deprivation (SD). However, the role of acupuncture on individuals after acute SD remains unclear. Methods In the current study, we recruited 30 healthy subjects with regular sleep. All subjects received resting-state fMRI scans during the rested wakefulness (RW) state and after 24 h of total SD. The scan after 24 h of total SD included two resting-state fMRI sessions before and after needling at Shenmen (HT7). Both edge-based and large-scale network FCs were calculated. Results The edge-based results showed the suprathreshold edges with abnormal between-network FC involving all paired networks except somatosensory motor network (SMN)-SCN between the SD and RW state, while both decreased and increased between-network FC of edges involving all paired networks except frontoparietal network (FPN)-subcortical network (SCN) between before and after acupuncture at HT7. Compared with the RW state, the large-scale brain network results showed decreased between-network FC in SMN-Default Mode Network (DMN), SMN-FPN, and SMN-ventral attention network (VAN), and increased between-network FC in Dorsal Attention Network (DAN)-VAN, DAN-SMN between the RW state and after 24 h of total SD. After acupuncture at HT7, the large-scale brain network results showed decreased between-network FC in DAN-VAN and increased between-network FC in SMN-VAN. Conclusion Acupuncture could widely modulate extensive brain networks and reverse the specific between-network FC. The altered FC after acupuncture at HT7 may provide new evidence to interpret neuroimaging mechanisms of the acupuncture effect on acute SD.
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Affiliation(s)
- Yanzhe Ning
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Sisi Zheng
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Sitong Feng
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Hao Yao
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhengtian Feng
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xinzi Liu
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Linrui Dong
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Hongxiao Jia
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- *Correspondence: Hongxiao Jia
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Wang Y, Wang L, Wang Y, Lu M, Xu L, Liu R, Wei J, Wan J, Zhang H, Zou Y. Sensorimotor Responses in Post-Stroke Hemiplegic Patients Modulated by Acupuncture at Yanglingquan (GB34): A fMRI Study Using Intersubject Functional Correlation (ISFC) Analysis. Front Neurol 2022; 13:900520. [PMID: 35734477 PMCID: PMC9208550 DOI: 10.3389/fneur.2022.900520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 05/02/2022] [Indexed: 11/29/2022] Open
Abstract
Motor dysfunction is common in patients with stroke. Acupuncture has become an acceptable alternative method for stroke rehabilitation. Previous studies have shown various functional connectivity changes activated by acupuncture. We introduced intersubject correlation (ISC) and intersubject functional correlation (ISFC) analyses into the functional magnetic resonance imaging (fMRI) for ischemic stroke to seek a common activation and suppression pattern triggered by acupuncture. In this study, 63 ischemic stroke patients with motor dysfunction and 42 normal controls were analyzed. Three functional scans were conducted during the resting state, motor task, and acupuncture at Yanglingquan (GB34) task. Twenty-two sensory, motor, and movement-imagination cortices in the bilateral hemispheres were selected as the region of interest (ROI). We performed ISC and ISFC analyses among these ROIs in three fMRI runs on patients and controls. Subgroup analyses by course or severity were also conducted. The results showed that acupuncture at GB34 triggered ISFC among upper limb motor, upper limb/hand/face, lower limb, tongue/larynx sensory, and movement imagination regions in the patient group. Subgroup ISC and ISFC analyses showed that patients tended to have increasing responses in the early stage of stroke (within 1 month) and decreasing responses afterward (1–3 months). Patients with mild clinical functional damage (NIHSS 2–4) tended to generate more responses via acupuncture than those with moderate damage (NIHSS 5–15). Our findings may help understand the clinical effects and modulatory features of acupuncture based on the group-level post-stroke neuroplasticity.
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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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Lu CY, Lee SR, Chang CJ, Chen PC. Adjuvant therapy with traditional Chinese medicine and long-term mortality in patients with stroke: A nationwide population-based cohort study in Taiwan. Maturitas 2022; 158:47-54. [DOI: 10.1016/j.maturitas.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 10/01/2021] [Accepted: 12/08/2021] [Indexed: 11/29/2022]
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Shen Y, Wang W, Wang Y, Yang L, Yuan C, Yang Y, Wu F, Wang J, Deng Y, Wang X, Liu H. Not Only in Sensorimotor Network: Local and Distant Cerebral Inherent Activity of Chronic Ankle Instability—A Resting-State fMRI Study. Front Neurosci 2022; 16:835538. [PMID: 35197822 PMCID: PMC8859266 DOI: 10.3389/fnins.2022.835538] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/10/2022] [Indexed: 12/26/2022] Open
Abstract
BackgroundIncreasing evidence has proved that chronic ankle instability (CAI) is highly related to the central nervous system (CNS). However, it is still unclear about the inherent cerebral activity among the CAI patients.PurposeTo investigate the differences of intrinsic functional cerebral activity between the CAI patients and healthy controls (HCs) and further explore its correlation with clinical measurement in CAI patients.Materials and MethodsA total of 25 CAI patients and 39 HCs were enrolled in this study. Resting-state functional magnetic resonance imaging (rs-fMRI) was used to detect spontaneous cerebral activity. The metrics of amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), and regional homogeneity (ReHo) of the two groups were compared by two-sample t-test. The brain regions that demonstrated altered functional metrics were selected as the regions of interest (ROIs). The functional connectivity (FC) was analyzed based on the ROIs. The Spearman correlation was calculated between rs-fMRI metrics and clinical scale scores.ResultsCompared with HCs, CAI patients showed higher ALFF and ReHo values in the right postcentral gyrus, the right precentral gyrus, and the right middle frontal gyrus, while lower fALFF values in the orbital-frontal cortex (OFC, p < 0.01 after correction). Increasing FC between the right precentral gyrus and the right postcentral gyrus while decreasing FC between the right precentral gyrus and the anterior cingulum cortex (ACC), the right middle frontal gyrus and the left middle temporal gyrus, and the OFC and left inferior parietal lobule (IPL) was observed. In addition, in the CAI group, the ReHo value negatively correlated with the Cumberland Ankle Instability Tool score in the right middle frontal gyrus (r = −0.52, p = 0.007).ConclusionThe CAI patients exhibited enhanced and more coherent regional inherent neuronal activity within the sensorimotor network while lower regional inherent activity in pain/emotion modulation related region. In addition, the information exchanges were stronger within the sensorimotor network while weaker between distant interhemispheric regions. Besides, the increased inherent activity in the right middle frontal gyrus was related to clinical severity. These findings may provide insights into the pathophysiological alteration in CNS among CAI patients.
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Affiliation(s)
- Yiyuan Shen
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Weiwei Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yin Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
- Department of Radiology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Liqin Yang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China
| | - Chengjie Yuan
- Department of Orthopedic, Huashan Hospital, Fudan University, Shanghai, China
| | - Yang Yang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Fei Wu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Junlong Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yan Deng
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xu Wang
- Department of Orthopedic, Huashan Hospital, Fudan University, Shanghai, China
- Xu Wang,
| | - Hanqiu Liu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
- *Correspondence: Hanqiu Liu,
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Li M, Ding R, Yang X, Ran D. Study on Biomarkers Related to the Treatment of Post-Stroke Depression and Alternative Medical Treatment Methods. Neuropsychiatr Dis Treat 2022; 18:1861-1873. [PMID: 36052274 PMCID: PMC9426768 DOI: 10.2147/ndt.s370848] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 08/17/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE PSD is a syndrome that occurs after a stroke, which manifests as a series of depressive symptoms and corresponding physiological symptoms. Relevant studies have shown that the drug therapy is often accompanied by drug side effects and patient resistance. Acupuncture has attracted attention as a treatment method without adverse reactions of patients. The purpose of this study was to investigate the possible mechanism of action of acupuncture in PSD. PATIENTS AND METHODS Download depression and stroke datasets from public databases. Bioinformatics methods were used to analyze the key gene targets related to stroke and depression. Functional enrichment analysis assesses important pathways. Further screen PSD-related biological pathways and genes. After the experimental model was established, the expression differences of key genes and related pathways were compared between the model group and the control group through acupuncture treatment and qPCR verification. RESULTS Depression and stroke-related genes were obtained by bioinformatics methods, and then important biological processes and biological pathways related to depression and stroke were analyzed by GO and KEGG. And further screen out the disease targets closely related to PSD. In the follow-up animal experiments, we confirmed that acupuncture can intervene on these key pathways and targets, and then play a role in the targeted therapy of diseases. CONCLUSION The results of this study show that five genes ("NRBP1", "SIRT1", "BDNF", "MAPK3", "CREB1".) and key biological pathways such as NFkB, PI3K/AKT activation, and MAPK are the keys to the occurrence and development of PSD biomarkers, which can also be therapeutically intervened by acupuncture.
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Affiliation(s)
- Menghan Li
- Acupuncture-Moxibustion Clinical Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, People's Republic of China.,Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, People's Republic of China
| | - Ran Ding
- School of Medical Informatics Engineering, Anhui University of Chinese Medicine, Hefei, 230012, People's Republic of China
| | - Xinming Yang
- Acupuncture-Moxibustion Clinical Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, People's Republic of China.,Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, People's Republic of China
| | - Dawei Ran
- Acupuncture-Moxibustion Clinical Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, People's Republic of China.,Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, People's Republic of China
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