Two Distinct Neural Mechanisms Underlying Acupuncture Analgesia

Research trends on acupuncture for neuropathic pain: A bibliometric analysis from 1979 to 2023

BACKGROUND

Acupuncture has drawn increasing attention as a complementary and alternative therapy for neuropathic pain (NP). The present study aimed to summarize the current status and research trends on acupuncture for NP over the past several decades.

METHODS

The publications on acupuncture for NP in the database of Web of Science Core Collection from 1979 to 2023 were searched. VOSviewer (1.6.15) and CiteSpace software (5.5.R2) were applied to identify active authors, journals, countries and institutions, co-cited references and hot keywords.

RESULTS

A total of 642 publications were finally included, and the quantitative trend of annual publications on acupuncture for NP have shown overall upward from 1979 to 2023. Peoples R China was the most productive and influential country, while Kyung Hee University from South Korea was both the first in publications and citations. Fang JQ ranked the first productive author and Han JS was the first 1 among the co-cited authors. The first productive journal was Evidence-based Complementary and Alternative Medicine, while the first co-cited journal was Pain. The high-frequency keywords were divided into 9 clusters, and the frontier topic focused on "Chronic pain".

CONCLUSION

This present study visually showed the research status and trends of acupuncture for NP from 1979 to 2023 on the basis of bibliometric analysis, which may in some way help researcher discovery and explore some new research directions and ideas in the future.

Dorsal brain activity reflects the severity of menopausal symptoms

OBJECTIVE

The severity of menopausal symptoms, despite being triggered by hormonal imbalance, does not directly correspond to hormone levels in the blood; thus, the level of unpleasantness is assessed using subjective questionnaires in clinical practice. To provide better treatments, alternative objective assessments have been anticipated to support medical interviews and subjective assessments. This study aimed to develop a new objective measurement for assessing unpleasantness.

METHODS

Fourteen participants with menopausal symptoms and two age-matched participants who visited our outpatient section were enrolled. Resting-state brain activity was measured using magnetoencephalography. The level of unpleasantness of menopausal symptoms was measured using the Kupperman Kohnenki Shogai Index. The blood level of follicle-stimulating hormone and luteinizing hormone were also measured. Correlation analyses were performed between the oscillatory power of brain activity, index score, and hormone levels.

RESULTS

The level of unpleasantness of menopausal symptoms was positively correlated with high-frequency oscillatory powers in the parietal and bordering cortices (alpha; P = 0.016, beta; P = 0.015, low gamma; P = 0.010). The follicle-stimulating hormone blood level was correlated with high-frequency oscillatory powers in the dorsal part of the cortex (beta; P = 0.008, beta; P = 0.005, low gamma; P = 0.017), whereas luteinizing hormone blood level was not correlated.

CONCLUSION

Resting-state brain activity can serve as an objective measurement of unpleasantness associated with menopausal symptoms, which aids the selection of appropriate treatment and monitors its outcome.

Anatomical Exploration of the KI1 Acupoint: Implications for Medial and Lateral Plantar Nerve Stimulation

Background and Objectives: This study aims to identify the precise anatomical location and therapeutic mechanisms of the KI1 acupoint (Yongquan) in relation to foot muscles and nerves, known for treating neurological disorders and pain. Materials and Methods: Dissection of six cadavers at Chungnam National University College of Medicine examined KI1's relation to the foot's four-layer structure. Results: The KI1 acupoint was located in the superficial and deep layers of the plantar foot, adjacent to significant nerves like the medial and lateral plantar nerves. Differences in the acupoint's exact location between genders were noted, reflecting variances in foot morphology. KI1 acupuncture was found to stimulate the muscle spindles and nerve fibers essential for balance and bipedal locomotion. This stimulation may enhance sensory feedback, potentially improving cognitive functions and balance control. Conclusions: This anatomical insight into KI1 acupuncture underpins its potential in neurological therapies and pain management.

Resting-state brain activity distinguishes patients with generalised epilepsy from others

PURPOSE

Epilepsy is a prevalent neurological disorder characterised by repetitive seizures. It is categorised into three types: generalised epilepsy (GE), focal epilepsy (FE), and combined generalised and focal epilepsy. Correctly subtyping the epilepsy is important to select appropriate treatments. The types are mainly determined (i.e., diagnosed) by their semiologies supported by clinical examinations, such as electroencephalography and magnetoencephalography (MEG). Although these examinations are traditionally based on visual inspections of interictal epileptic discharges (IEDs), which are not always visible, alternative analyses have been anticipated. We examined if resting-state brain activities can distinguish patients with GE, which would help us to diagnose the type of epilepsy.

METHODS

The 5 min resting-state brain activities acquired using MEG were obtained retrospectively from 15 patients with GE. The cortical source of the activities was estimated at each frequency band from delta to high-frequency oscillation (HFO). These estimated activities were compared with reference datasets from 133 healthy individuals and control data from 29 patients with FE.

RESULTS

Patients with GE showed larger theta in the occipital, alpha in the left temporal, HFO in the rostral deep regions, and smaller HFO in the caudal ventral regions. Their area under the curves of the receiver operating characteristic curves was around 0.8-0.9. The distinctive pattern was not found for data from FE.

CONCLUSION

Patients with GE show distinctive resting-state brain activity, which could be a potential biomarker and used complementarily to classical analysis based on the visual inspection of IEDs.

Decreased beta-band activity in left supramarginal gyrus reflects cognitive decline: Evidence from a large clinical dataset in patients with dementia

Cognitive impairment is a major concern in clinical medicine. It is usually evaluated with neuropsychological assessments, which have inherent limitations. To compensate for them, magnetoencephalography has already come into clinical use to evaluate the level of cognitive impairment. It evaluates global changes in the frequency of resting-state brain activity, which are associated with cognitive status. However, it remains unclear what neural mechanism causes the frequency changes. To understand this, it is important to identify cortical regions that mainly contribute to these changes. We retrospectively analysed the clinical records from 310 individuals with cognitive impairment who visited the outpatient department at our hospital. The analysis included resting-state magnetoencephalography, neuropsychological assessment, and clinical diagnosis data. Regional oscillatory intensities were estimated from the magnetoencephalography data, which were statistically analysed, along with neuropsychological assessment scores, and the severity of cognitive impairment associated with clinical diagnosis. The regional oscillatory intensity covering a wide range of regions and frequencies was significantly associated with neuropsychological assessment scores and differed between healthy individuals and patients with cognitive impairment. However, these associations and differences in all conditions were overlapped by a single change in beta frequency in the left supramarginal gyrus. High frequency oscillatory intensity in the left supramarginal gyrus is associated with cognitive impairment levels among patients who were concerned about dementia. It provides new insights into cognitive status measurements using magnetoencephalography, which is expected to develop as an objective index to be used alongside traditional neuropsychological assessments.