Abnormal Cerebrovascular Activity, Perfusion, and Glymphatic Clearance in Lewy Body Diseases.

Cerebrovascular activity is not only crucial to optimal cerebral perfusion, but also plays an important role in the glymphatic clearance of interstitial waste, including α-synuclein. This highlights a need to evaluate how cerebrovascular activity is altered in Lewy body diseases. This review begins by discussing how vascular risk factors and cardiovascular autonomic dysfunction may serve as upstream or direct influences on cerebrovascular activity. We then discuss how patients with Lewy body disease exhibit reduced and delayed cerebrovascular activity, hypoperfusion, and reductions in measures used to capture cerebrospinal fluid flow, suggestive of a reduced capacity for glymphatic clearance. Given the lack of an existing framework, we propose a model by which these processes may foster α-synuclein aggregation and neuroinflammation. Importantly, this review highlights several avenues for future research that may lead to treatments early in the disease course, prior to neurodegeneration. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Scientific Basis of Auriculotherapy: State of the Art.

Background: Using a modern scientific basis, this article examines clinical findings and experimentally reproducible data that demonstrate reliably the objective reality of the auriculotherapy procedures initiated by Paul Nogier, MD, of Lyon, France. Objective: The aims of this review are to: (1) identify the Chinese acupoints and all relevant related subjects; (2) offer a critical analysis of different auricle cartographies or ear maps; and (3) evaluate evidence for auriculotherapy with respect to the constant progress of our knowledge of nervous-system organization. Discussion: Acupuncture points have lower electrical impedance than nonacupoints. This was demonstrated by Niboyet and Terral, utilizing a sinusoidal current with the technical arrangements of different equivalent circuits made at Unit 103 of the French National Institute of Health and Medical Research (INSERM), Montpellier, France. This work demonstrated that physical behavior associated with acupuncture corresponds to a specific histologic structure located within the dermis termed the neurovascular complex (NVC). The concept of using sham points for testing acupuncture needs to be criticized. A reproducible experimental model of analgesia has been produced using the hind limb of a rabbit; this model is a proven demonstration of the positive action of acupuncture on pain. Acupuncture analgesia is a technique that has been used effectively by Chinese researchers in the 1970s for surgical applications. The different ear maps may have to be significantly modified because of the paucity of scientific validation of most of the localizations of organs or functions and, particularly, of nervous structures. Increased knowledge about complex nervous interactions should facilitate formulation of some scientifically acceptable hypothesis to explain the action of auriculotherapy. Conclusions: More scientific research should be performed to improve the scientific credibility of auriculotherapy.