Efficacy of transcutaneous electrical acupoint stimulation for patients with first-episode schizophrenia: An 8-week, preliminary, randomized controlled trial.

Combination therapy with antipsychotics has been investigated for treating schizophrenia, and has shown clear advantages among non-invasive therapies. Transcutaneous electrical acupoint stimulation (TEAS) is a novel non-invasive treatment with definite efficacy in treating mental disorders. The current study aimed to investigate the efficacy of TEAS in further improving the psychotic symptoms in patients with first-episode schizophrenia (FES) being treated with pharmacological drugs. This 8-week, preliminary, sham-controlled, randomized clinical trial was conducted in patients with FES to compare the efficacy of TEAS and sham TEAS in combination with aripiprazole treatment. The primary outcome was a change in the Positive and Negative Syndrome Scale (PANSS) score after ending the intervention (Week 8). A total of 49 participants completed the whole treatment cycle. The linear mixed-effects regression for PANSS indicated a significant time × group interaction (F(2, 116)=9.79, p <0.001). The PANSS score differed by 8.77 points (95% CI, -2.07 to -15.47 points; p=.01) between the TEAS group and the sham TEAS group after 8 weeks of treatment; this difference was significant. This study indicates that 8 weeks of TEAS combined with aripiprazole treatment can effectively treat FES. Thus, TEAS is an effective combination therapy to improve the psychiatric symptoms of FES.

Reassessment of the Effect of Transcutaneous Auricular Vagus Nerve Stimulation Using a Novel Burst Paradigm on Cardiac Autonomic Function in Healthy Young Adults.

BACKGROUND: Transcutaneous auricular vagus nerve stimulation (taVNS) may modulate cardiac autonomic function. However, the response rate of the traditional tonic paradigm is low, and the results remain inconsistent. A recent pilot study presented a novel burst paradigm to activate the cardiac parasympathetic system, which might offer a new approach to treat cardiac autonomic function. The present study reassessed the effect of burst taVNS on modulating heart rate variability and explored the difference between burst and traditional tonic paradigms. MATERIALS AND METHODS: Forty-two young adults were recruited for this study. Each participant underwent three types of taVNS with sham (30 sec of stimulation), tonic (25 Hz, 500 µsec), and burst (five pulses at 500 Hz every 200 msec) paradigms, respectively, with simultaneous electrocardiogram recording. One-way analysis of variance, multivariate analysis of variance, and linear regression were used for analysis. Multiple testing was performed using Bonferroni correction. RESULTS: Both burst and tonic paradigms induced a significant decrease in heart rate, which continued until poststimulation, and increased cardiac parasympathetic activity. Moreover, two parasympathetic system indicators showed significant increase only in burst taVNS. The response rates during burst (35.7%) and tonic (38.1%) stimulations were both higher than that during sham stimulation (11.9%). The response to taVNS showed parameter specificity with few nonresponders to the tonic paradigm responding to the burst paradigm. The overall response rate increased from 38.1% in tonic taVNS to 54.8% in taVNS using both burst and tonic paradigms. For both burst and tonic responders, baseline cardiac parasympathetic activity was found to be significantly negatively correlated with changes during stimulation. CONCLUSION: The burst parameter could be used as an alternative strategy for regulating cardiac parasympathetic function by taVNS, which has the potential to be used as a complementary paradigm to traditional tonic taVNS for promoting clinical treatment efficacy.

Biobased Epoxies Derived from Myrcene and Plant Oil: Design and Properties of Their Cured Products.

Two biobased epoxy resin monomers derived from myrcene and plant oil are synthesized without using petroleum-based bisphenol A. To obtain material with balanced strength and toughness, the two epoxy monomers are cured together in different weight proportions. Properties of cured epoxy resin are tested by different techniques. Tensile and impact tests indicate that when the content of myrcene-based epoxy is 50-75 wt %, the cured sample has a high strain of 32.30-161.47%, and a moderate tensile strength of 9.57-15.96 MPa. Dynamic mechanical analysis suggests that the glass transition temperature (T g) of cured samples increases from 17 to 71 °C with the increasing content of myrcene-based epoxy. Morphology of fracture surface indicates that the cured sample containing plant oil-based epoxy resin shows obvious plastic deformation. The curing kinetics of the two epoxies resin is studied by differential scanning calorimetry. Also, the calculated activation energy is 70.49 kJ/mol for myrcene-based epoxy and 64.02 kJ/mol for poly-fatty acid-derived epoxy resin. The thermogravimetric analysis indicates that the main degradation temperature of all cured samples is above 300 °C. The sustainable biobased epoxy has some potential in preparing flexible epoxy materials and can be used to toughen conventional petroleum-based epoxy.

Baseline Brain Gray Matter Volume as a Predictor of Acupuncture Outcome in Treating Migraine.

Background: The present study aimed to investigate the use of imaging biomarkers to predict the outcome of acupuncture in patients with migraine without aura (MwoA). Methods: Forty-one patients with MwoA received 4 weeks of acupuncture treatment and two brain imaging sessions at the Beijing Traditional Chinese Medicine Hospital affiliated with Capital Medical University. Patients kept a headache diary for 4 weeks before treatment and during acupuncture treatment. Responders were defined as those with at least a 50% reduction in the number of migraine days. The machine learning method was used to distinguish responders from non-responders based on pre-treatment brain gray matter (GM) volume. Longitudinal changes in GM predictive regions were also analyzed. Results: After 4 weeks of acupuncture, 19 patients were classified as responders. Based on 10-fold cross-validation for the selection of GM features, the linear support vector machine produced a classification model with 73% sensitivity, 85% specificity, and 83% accuracy. The area under the receiver operating characteristic curve was 0.7871. This classification model included 10 GM areas that were mainly distributed in the frontal, temporal, parietal, precuneus, and cuneus gyri. The reduction in the number of migraine days was correlated with baseline GM volume in the cuneus, parietal, and frontal gyri in all patients. Moreover, the left cuneus showed a longitudinal increase in GM volume in responders. Conclusion: The results suggest that pre-treatment brain structure could be a novel predictor of the outcome of acupuncture in the treatment of MwoA. Imaging features could be a useful tool for the prediction of acupuncture efficacy, which would enable the development of a personalized medicine strategy.

Intersubject synchronisation analysis of brain activity associated with the instant effects of acupuncture: an fMRI study.

OBJECTIVE: To use a promising analytical method, namely intersubject synchronisation (ISS), to evaluate the brain activity associated with the instant effects of acupuncture and compare the findings with traditional general linear model (GLM) methods. METHODS: 30 healthy volunteers were recruited for this study. Block-designed manual acupuncture stimuli were delivered at SP6, and de qi sensations were measured after acupuncture stimulation. All subjects underwent functional MRI (fMRI) scanning during the acupuncture stimuli. The fMRI data were separately analysed by ISS and traditional GLM methods. RESULTS: All subjects experienced de qi sensations. ISS analysis showed that the regions activated during acupuncture stimulation at SP6 were mainly divided into five clusters based on the time courses. The time courses of clusters 1 and 2 were in line with the acupuncture stimulation pattern, and the active regions were mainly involved in the sensorimotor system and salience network. Clusters 3, 4 and 5 displayed an almost contrary time course relative to the stimulation pattern. The brain regions activated included the default mode network, descending pain modulation pathway and visual cortices. GLM analysis indicated that the brain responses associated with the instant effects of acupuncture were largely implicated in sensory and motor processing and sensory integration. CONCLUSION: The ISS analysis considered the sustained effect of acupuncture and uncovered additional information not shown by GLM analysis. We suggest that ISS may be a suitable approach to investigate the brain responses associated with the instant effects of acupuncture.

Effect of catechol-O-methyltransferase Val158Met polymorphism on resting-state brain default mode network after acupuncture stimulation.

The effects of acupuncture can be characterized by clear individual differences. Several revealing studies suggest an underlying role of inherited genetic factor in interindividual variability in response to acupuncture treatment. It remains unclear, however, if the modulation of acupuncture on resting brain function is influenced by genetic factors. Catechol-o-methyltransferase (COMT) Val158Met polymorphism has been shown to regulate the resting brain network, especially in the default mode network (DMN), which is a target area that responds to acupuncture stimulation. Therefore, the present study investigated the effect of COMT Val158Met polymorphism on the modulation of acupuncture in DMN connectivity in healthy Chinese young adults. Using mixed-design ANOVA analysis, we found a significant interactive effect between acupuncture and the COMT gene. For subjects carrying the Val/Met genotype, acupuncture induced decreased DMN connectivity with the left middle frontal gyrus during the post-acupuncture stage compared with the pre-acupuncture stage, which was not observed in Val/Val homozygous subjects. These results demonstrated that during sustained periods after acupuncture stimulation, the brain network is likely under genetic control, and COMT might be a candidate gene that regulates the resting DMN response to acupuncture stimulation.

Alterations in regional homogeneity of resting-state cerebral activity in patients with chronic prostatitis/chronic pelvic pain syndrome.

The purpose of this study was to explore the neural mechanism in Chronic prostatitis/Chronic pelvic pain syndrome (CP/CPPS) using resting-state functional magnetic resonance imaging. The functional magnetic resonance imaging was performed on 31 male CP/CPPS-patients and 31 age and education matched male healthy controls on a 3-T magnetic resonance imaging unit. A two-sample t-test was adopted to reveal the regional homogeneity between the patients and healthy controls. The mean regional homogeneity values in the alerted brain regions of patients were correlated with the clinical measurements by using Pearson's correlation analyses. The CP/CPPS-patients had significantly decreased regional homogeneity in the bilateral anterior cingulate cortices, insular cortices and right medial prefrontal cortex, while significantly increased regional homogeneity in the brainstem and right thalamus compared with the healthy controls. In the CP/CPPS-patients, the mean regional homogeneity value in the left anterior cingulate cortex, bilateral insular cortices and brainstem were respectively correlated with the National Institutes of Health Chronic Prostatitis Symptom Index total score and pain subscale. These brain regions are important in the pain modulation process. Therefore, an impaired pain modulatory system, either by decreased descending pain inhibition or enhanced pain facilitation, may explain the pain symptoms in CP/CPPS.

Preparation and characterization of acorn starch/poly(lactic acid) composites modified with functionalized vegetable oil derivates.

Composites of acorn starch (AS) and poly(1actic acid) (PLA) modified with dimer fatty acid (DFA) or dimer fatty acid polyamide (DFAPA) were produced by a hot-melt extrusion method. The effects of DFA and DFAPA contents on the mechanical, hydrophobic, thermal properties and melt fluidity of the composites were studied under an invariable AS-to-PLA mass ratio of 40/60. SEM and DMA research results show that the compatibility of AS/PLA composites are determined by the dosage of DFA or DFAPA. The hydrophobicity and melt fluidity of composites are improved with the addition of DFA and DFAPA. The glass transition temperatures of the composites are all reduced remarkably by additives DFA and DFAPA. However, DFA and DFAPA exert different effects on the mechanical properties of AS/PLA composites. In the DFAPA-modified system, the tensile and flexural strength first increase and then decrease with the increase of DFAPA dosage; the mechanical strength is maximized when the dosage of DFAPA is 2 wt% of total weight. In the DFA-modified system, the tensile and flexural strength decrease with the increase of DFA dosage.

Expertise modulates local regional homogeneity of spontaneous brain activity in the resting brain: an fMRI study using the model of skilled acupuncturists.

Studies on training/expertise-related effects on human brain in context of neuroplasticity have revealed that plastic changes modulate not only task activations but also patterns and strength of internetworks and intranetworks functional connectivity in the resting state. Much has known about plastic changes in resting state on global level; however, how training/expertise-related effect affects patterns of local spontaneous activity in resting brain remains elusive. We investigated the homogeneity of local blood oxygen level-dependent fluctuations in the resting state using a regional homogeneity (ReHo) analysis among 16 acupuncturists and 16 matched nonacupuncturists (NA). To prove acupuncturists' expertise, we used a series of psychophysical tests. Our results demonstrated that, acupuncturists significantly outperformed NA in tactile-motor and emotional regulation domain and the acupuncturist group showed increased coherence in local BOLD signal fluctuations in the left primary motor cortex (MI), the left primary somatosensory cortex (SI) and the left ventral medial prefrontal cortex/orbitofrontal cortex (VMPFC/OFC). Regression analysis displayed that, in the acupuncturists group, ReHo of VMPFC/OFC could predict behavioral outcomes, evidenced by negative correlation between unpleasantness ratings and ReHo of VMPFC/OFC and ReHo of SI and MI positively correlated with the duration of acupuncture practice. We suggest that expertise could modulate patterns of local resting state activity by increasing regional clustering strength, which is likely to contribute to advanced local information processing efficiency. Our study completes the understanding of neuroplasticity changes by adding the evidence of local resting state activity alterations, which is helpful for elucidating in what manner training effect extends beyond resting state.

Involvement of brain ANG II in acute sodium depletion induced salty taste changes.

Many investigations have been devoted to determining the role of angiotensin II (ANG II) and aldosterone (ALD) in sodium-depletion-induced sodium appetite, but few were focused on the mechanisms mediating the salty taste changes accompanied with sodium depletion. To further elucidate the mechanism of renin-angiotensin-aldosterone system (RAAS) action in mediating sodium intake behavior and accompanied salty taste changes, the present study examined the salty taste function changes accompanied with sodium depletion induced by furosemide (Furo) combined with different doses of angiotensin converting enzyme (ACE) inhibitor, captopril (Cap). Both the peripheral and central RAAS activity and the nuclei Fos immunoreactivity (Fos-ir) expression in the forebrain area were investigated. Results showed that sodium depletion induced by Furo+low-Cap increased taste preference for hypertonic NaCl solution with amplified brain action of ANG II but without peripheral action, while Furosemide combined with a high dose of captopril can partially inhibit the formation of brain ANG II, with parallel decreased effects on salty taste changes. And the resulting elevating forebrain ANG II may activate a variety of brain areas including SFO, PVN, SON and OVLT in sodium depleted rats injected with Furo+low-Cap, which underlines salty taste function and sodium intake behavioral changes. Neurons in SFO and OVLT may be activated mainly by brain ANG II, while PVN and SON activation may not be completely ANG II dependent. These findings suggested that forebrain derived ANG II may play a critical role in the salty taste function changes accompanied with acute sodium depletion.

Impact of global normalization in FMRI acupuncture studies.

Global normalization is often used as a preprocessing step for dispelling the "nuisance effects." However, it has been shown in cognitive and emotion tasks that this preprocessing step might greatly distort statistical results when the orthogonality assumption of global normalization is violated. The present study examines this issue in fMRI acupuncture studies. Thirty healthy subjects were recruited to evaluate the impacts of the global normalization on the BOLD responses evoked by acupuncture stimulation during De-qi sensation and tactile stimulation during nonpainful sensations. To this end, we compared results by conducting global normalization (PSGS) and not conducting global normalization (NO PSGS) based on a proportional scaling model. The orthogonality assumption of global normalization was violated, and significant changes between BOLD responses for NO PSGS and PSGS were shown in most subjects. Extensive deactivations of acupuncture in fMRI were the non-specifically pernicious consequences of global normalization. The central responses of acupuncture during De-qi are non-specifically activation-dominant at the somatosensory-related brain network, whose statistical power is specifically enhanced by PSGS. In conclusion, PSGS should be unjustified for acupuncture studies in fMRI. The differences including the global normalization or not may partly contribute to conflicting results and interpretations in previous fMRI acupuncture studies.

[Molluscicidal effect of Phytolacca americana linn leaf against Oncomelania hupensis and its acute toxicity].

OBJECTIVE: To study the molluscicidal activity, the influence on glycogen content of Oncomelania hupensis and the acute toxicity to zebra fish of the extract from Phytolacca americana Linn leaf. METHODS: The different polar factions of the extract of Phytolacca americana Linn leaf were separated by using the systemic solvent segregation method, and then the molluscicidal activity of the fractions was detected according to the Laboratory Final Milluscicides Screening Method issued by WHO. The glycogen content of soft tissues of Oncomelania hupensis treated by the ethyl acetate polar fraction was determined by the anthrone method. Finally, the acute toxicity of the ethyl acetate polar fraction to non-targets was studied with zebra fish. RESULTS: The ethyl acetate polar fraction was the best active components against the snails. Its 48 h LC50 and LC90 were 6.0 mg/100 ml and 26.1 mg/ 100 ml, respectively. The glycogen content of soft tissues of the snails decreased by 20% after treated with the fraction. The fish treated by the concentration of LC50 (48 h) of the ethyl acetate polar fraction survived for 12 h. CONCLUSION: The Phytolacca americana Linn leaf possesses an adequate molluscicidal activity and a significant acute toxicity to the zebra fish.

Power estimation predicts specific function action of acupuncture: an fMRI study.

PURPOSE: The purpose was to investigate the distinct pattern of brain response induced by electroacupuncture stimulation (EAS) related to sustained acupuncture effects. MATERIAL AND METHODS: Twenty-eight healthy volunteers were enrolled and randomized into two groups. According to grouping, volunteers were separately treated by EAS at GB37 (Guangming) or KI8 (Jiaoxin) during functional magnetic resonance imaging. Differences in acupuncture effects between the groups were tested by the power estimation approach. RESULTS: Spatial patterns of the whole brain power were different in the periaqueductal gray, occipital cortex (OC) and temporal cortex when induced by EAS at GB37 and KI8. Moreover, the differences in the sustained effects between these two acupoints were also identified and associated with the OC, dorsolateral prefrontal cortex, medial prefrontal cortex, anterior cingulate cortex and insula. CONCLUSION: Electroacupuncture stimulation induced different power fluctuation patterns related to GB37 and KI8. We suggest that these findings might be attributed to the specific function action of these acupoints.

Role of the lateral hypothalamus in modulating responses of parabrachial gustatory neurons in the rat.

The lateral hypothalamus (LH) receives projections from the parabrachial nucleus (PBN) gustatory neurons and sends efferent projections to the PBN. To examine if the LH is involved in modulating activity of gustatory neurons in the PBN, we examined the effects of electrical stimulation and electrolytic lesions of the LH on the response of PBN gustatory neurons, using extracellular recording techniques. Among 45 PBN taste neurons recorded, 60% were affected by LH stimulation and 73% were affected by LH lesions. During LH stimulation, the responses of most affected PBN neurons were inhibited with the magnitude significantly lower than that obtained before stimulation (P<0.05). In contrast, LH lesions facilitated the response. Based on the best-stimulus category, the responses of the NaCl-best neurons to NaCl and HCl and the QHCl-best neurons to HCl and QHCl were significantly suppressed during LH stimulation (P<0.05). After lesions of the LH, however, the response to HCl in NaCl-best PBN neurons was significantly increased (P<0.05). Analysis of across-unit patterns indicated that LH stimulation decreased the correlations between NaCl and other stimuli, and increased those between QHCl and other stimuli. After LH lesions, the correlations between NaCl and other tastants were higher than those before lesions. These findings suggest that the LH mediates feeding and taste via modulating the activity and chemical selectivity of PBN gustatory neurons.