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OBJECTIVES: To observe the changes in the regional homogeneity (ReHo) and functional brain network in treatment of chronic fatigue syndrome (CFS) with anxiety and depression comorbidity with the mind-regulation electroacupuncture (EA), using resting-state functional magnetic resonance imaging (rs-fMRI). METHODS: Thirty CFS patients with anxiety and depression comorbidity were enrolled from medical staffs as the observation group. The other 30 healthy subjects were recruited from medical university students as the control group, matching gender, age and education years with the observation group. No any acupuncture intervention was delivered in the control group, and EA for regulating the mind was operated in the observation group. Main points were the emotional area of Sun's scalp acupuncture, the regions 1 and 8 of Sun's abdominal acupuncture. Supplementary acupoints included Baihui (GV 20), Guanyuan (CV 4) and bilateral. RESULTS: The scores of the five domains in MFI-20 (i.e. general fatigue, physical fatigue, mental fatigue, reduced motivation and reduced activity), the total score of MFI-20, and the scores of SDS, SAS and PSQI in the observation group before treatment were higher than those of the control group (P<0.05). Except the score of reduced motivation in MFI-20, the scores of the other domains and the total score of MFI-20, as well as the scores of SDS, SAS and PSQI after treatment were lower than those before treatment in the observation group (P<0.05). Compared with the values before treatment, ReHo value was increased in the the right precuneus and decreased in the left inferior temporal gyrus and the left angular gyrus of the brain in the observation group after treatment. In the observation group, when compared with the control group, ReHo values were increased in the left inferior cerebral lobe, the interhemispheric region, the right occipital lobe and the thalamus; and it was reduced in the left middle temporal gyrus, the right posterior central gyrus, the right middle temporal gyrus, the right orbital middle frontal gyrus, the paracentral lobule and the right fusiform gyrus before treatment. In the observation group, the functional connectivity was decreased between the right thalamus and the left posterior central gyrus, the right hippocampus and the right fusiform gyrus before treatment, respectively; it was re-constructed after treatment between the right thalamus and the left posterior central gyrus, and the right fusiform gyrus. Compared with the control group, the functional connectivity between the right thalamus and the left posterior central gyrus, the right hippocampus, and the right fusiform gyrus was reduced before treatment; while after treatment, the functional connectivity was reduced between the right thalamus and the hippocampus in the observation group. With Spearman correlation analysis between the differential brain regions and the scores of MFI-20, SAS, SDS and PSQI, it was found that the left middle temporal gyrus, the paracentral lobule, the right precuneus, and the left inferior temporal gyrus had a partial positive correlation with the above clinical scales; and the interhemispheric region, the thalamus, the right fusiform gyrus, and the right middle temporal gyrus showed a partial negative correlation. CONCLUSIONS: There is the decrease of ReHo in many brain regions and the numbers of the local brain functional network connectivity in CFS patients with anxiety and depression comorbidity. The mind-regulation electroacupuncture therapy may relieve the clinical symptoms of the patients through adjusting the abnormal brain regions and activating emotion-related brain regions.
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Eletroacupuntura , Síndrome de Fadiga Crônica , Humanos , Síndrome de Fadiga Crônica/diagnóstico por imagem , Síndrome de Fadiga Crônica/terapia , Depressão/diagnóstico por imagem , Depressão/terapia , Ansiedade/diagnóstico por imagem , Ansiedade/terapia , Comorbidade , Imageamento por Ressonância MagnéticaRESUMO
Professor GAO Wei-bin's clinical experience of electric eye acupuncture and stagnant-moving needling for ophthalmopathy was introduced. The indications of electric eye acupuncture and stagnant-moving needling include external ophtalmoplegia and visual impairment. Professor GAO has proposed new acupoints at the ocular muscles attachment of eyeball, and put forward five experience points: Shangming point, Neiming point, Xiaming point, Waiming point and Tijian point. The points are selected according to different pathological changes of ocular muscles. In the treatment of ophthalmopathy, the tendons and vessels are often regulated at the same time. Neiming point, Shangming point, Xiaming point and Qiuhou point are the main points, with Fengchi (GB 20) and Gongxue (Extra) as the matching points. In addition, attention is paid to the application of stagnant-moving needling and electroacupuncture (continuous dense wave, frequency of 50 Hz).
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Terapia por Acupuntura , Acupuntura , Eletroacupuntura , Oftalmopatias , Pontos de Acupuntura , HumanosRESUMO
Background: Postherpetic neuralgia (PHN) is a common, complex, and refractory type of neuropathic pain. Several systematic reviews support the efficacy of acupuncture and related treatments for PHN. Nevertheless, the efficacy of various acupuncture-related treatments for PHN remains debatable. Objective: We aimed to assess the efficacy and safety of acupuncture-related treatments for PHN, identify the most effective acupuncture-related treatments, and expound on the current inadequacies and prospects in the applications of acupuncture-related therapies. Methods: We searched PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, Google Scholar, four Chinese databases (China National Knowledge Infrastructure, China Biomedical, Chongqing VIP, and Wan Fang databases), clinical research registration platform (World Health Organization International Clinical Trial Registration platform, China Clinical Trial Registration Center) for relevant studies. We also examined previous meta-analyses; gray literature; and reference lists of the selected studies. We then evaluated the risk of bias in the included studies and performed a Bayesian multiple network meta-analysis. Results: We included 29 randomized controlled trials comprising 1,973 patients, of which five studies showed a high risk of bias. The pairwise meta-analysis results revealed that the efficacy of all acupuncture-related treatments for pain relief related to PHN was significantly better than antiepileptics. The network meta-analysis results showed that pricking and cupping plus antiepileptics were the most effective treatment, followed by electroacupuncture (EA) plus antiepileptics for pain relief in patients with PHN. EA plus antiepileptics ranked the best regarding reduced Pittsburgh Sleep Quality Index (PSQI) and Self-Rating Depression Scale (SDS) scores in patients with PHN. No results were found regarding the total response rate or quality of life in this study. Acupuncture-related treatments showed a lower incidence of adverse events than that of antiepileptics. Conclusion: Acupuncture-related therapies are potential treatment options for PHN and are safe. Pricking and cupping plus antiepileptics, are the most effective acupuncture-related techniques for pain relief, while EA plus antiepileptics is the best acupuncture-related technique for improving PHN-related insomnia and depression symptoms. However, owing to the limitations of this study, these conclusions should be cautiously interpreted, and future high-quality studies are needed. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021226422, identifier CRD42021226422.
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This study aimed to explore the feasible gender differences and similarities in cerebral activity response to the acupuncture at local acupoints around knee.Fifteen male and 15 female healthy adults were recruited and included in this study. Functional magnetic resonance imaging (fMRI) was applied to measure cerebral activity response to acupuncture at Liangqiu (ST34), Xuehai (SP-10), Neixiyan (EX-LE4), and Dubi (ST-35).Acupuncture activated the postcentral gyrus, precuneus, temporal, posterior lobe, and occipital lobe in both males and females. When compared with females, males showed brain activation in the right middle frontal gyrus, inferior frontal gyrus, right precuneus, right superior parietal lobule, left cerebellum anterior lobe; and brain deactivation in the right frontal. When compared with males, females were observed brain activation in the right frontal lobe, right parietal lobe, and right middle temporal gyrus; and brain deactivation in the left and right medial frontal gyrus.The results of this study demonstrated that the neural effects of local acupoints around knee might be different between male and female subjects. Further clinical trials should take this gender effect into account in their design of studies.
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Terapia por Acupuntura/métodos , Acupuntura/métodos , Encéfalo/diagnóstico por imagem , Joelho/inervação , Pontos de Acupuntura , Terapia por Acupuntura/efeitos adversos , Adulto , Encéfalo/anatomia & histologia , Encéfalo/fisiologia , Feminino , Humanos , Joelho/patologia , Joelho/fisiopatologia , Imageamento por Ressonância Magnética/métodos , Masculino , Ensaios Clínicos Controlados não Aleatórios como Assunto/métodos , Dor , Fatores SexuaisRESUMO
Brain plasticity is referred to the ability of the brain to change in structure and functional activities from microscopic aspects (synapses) in individual neurons to larger-scale aspects such as cortical remapping, neuronal remodeling, etc. in response to injury. Acupuncture has a positive effect in the treatment of cerebral diseases, thus leading to an increasing research on its underlying mechanisms in regulating brain plasticity. The present paper reviewed recent development of studies on acupuncture treatment of Alzheimer's disease, vascular dementia, cerebral ischemia, bone cancer pain, autism, etc. from 1) regulating synaptic plasticity (up-regulating the proportion of hippocampal synapses, increasing synaptic curvature, post-synaptic density, and numerical density, areal density, and lowering synaptic cleft); 2) increasing hippocampal post-synaptic potential slop, peak and peak area of population spikes to evoke long-term potentiation (LTP) by regulating the expression of glutamate N-methyl-D-aspartate (NMDA) and alpha amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA) receptors, and growth associated protein (GAP-43); 3) down-regulating the expression of glial fibrillary acidic protein (GFAP) to suppress the activity of astrocytes in the ischemic cerebral area and hippocampus in cerebral ischemia rats, and in the spinal cord dorsal horns of bone cancer rats, etc. and promoting vimentin and connexin 43 expression; and 4) promoting neuronal remodeling, and repair and regeneration of the injured nerve in the central nervous system via regulating neuron-glia network, expression of nerve growth factor, brain derived neurotrophic factor, etc. The future studies should pay more attention to 1) the contribution of acupuncture intervention to the correlation between the initiation of the endogenous protective effect and the brain plasticity during the onset of nerve injury and repair of the injured nerve, and 2) standarization of stimulating quantity, manipulation and duration of acupuncture treatment, as well as the relationship between the stimulating quantity and efficacy.
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Terapia por Acupuntura , Sinapses , Animais , Encéfalo , Hipocampo , Humanos , Plasticidade Neuronal , Receptores de AMPA , Receptores de N-Metil-D-AspartatoRESUMO
BACKGROUND: This study aims to investigate the efficacy and safety of acupuncture for patients with chronic neck pain. METHODS: The MEDLINE, EMBASE, CENTRAL, CINAHL, and the Chinese Biomedical Literature Database, the China National Knowledge Infrastructure, VIP Information, and Wanfang Data databases will be searched from their inception to present. Randomised controlled trials (RCTs) of acupuncture (assessed as the sole treatment or as an adjunct treatment) for chronic neck pain will be included. The primary outcome is chronic neck pain measured by the visual analogue scale (VAS), McGill Pain Questionnaire, or short-form McGill Pain Questionnaire. The secondary outcomes will include the functional recovery, health-related quality of life, psychological improvements related to the reduction of pain, and adverse events. Two authors will perform the study selection, data extraction, and quality assessment independently. Any disagreements will be resolved through discussion with a third author. Methodological quality of the included trials will be evaluated by the Cochrane risk-of-bias criteria, and the Standards for Reporting Interventions in Controlled Trials of Acupuncture checklist will be used to assess completeness of reporting. DISCUSSION: The results of this systematic review will provide the latest evidence of the efficacy of acupuncture in treating chronic neck pain, which will benefit both practitioners and policymakers. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42015017178.