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BACKGROUND: Transcutaneous electrical cranial-auricular acupoint stimulation (TECAS) is a novel non-invasive therapy for major depressive disorder (MDD) that stimulates acupoints innervated by the trigeminal and auricular vagus nerves. However, there are few neuroimaging studies involving the TECAS for the treatment of MDD. Therefore, this study aimed to investigate the treatment response and neurological effects of TECAS using resting-state functional magnetic resonance imaging (rs-fMRI). METHOD: A total of 34 patients with mild-to-moderate MDD and 34 demographically matched healthy controls (HCs) were recruited. After an eight-week treatment the primary outcome was clinical response, defined as a baseline-to-endpoint ≥ 50 % reduction in the 17-item Hamilton Depression Rating Scale (HAMD-17). The low-frequency fluctuations (ALFF) method were used to investigate the brain abnormalities of MDD patients and HCs, and altered brain networks were analyzed between pre- and post-treatment using seed-based functional connectivity (FC) analysis. RESULTS: We found no significant differences in terms of gender, age, and years of education between the two groups. After treatment, the response rate was 58.82 %. Compared to HCs, MDD patients showed lower ALFF values in the left insula(t = -4.298,P < 0.005), the insula-based FC revealed in the right middle frontal gyrus (MFG)/ right superior frontal gyrus, orbital part (ORBsupmed) (t = -5.29,P < 0.005) and the right anterior cingulate gyrus (ACC)were decreased (t = -6.08,P < 0.005). Furthermore, Compared to pre-treatment, abnormal FC values in the ACC /orbital superior frontal gyrus (SFG) (t = 3.42,P < 0.005) and left superior frontal gyrus (SFG)/ supplement motor area (SMA) were enhanced (t = 3.34,P < 0.005). CONCLUSION: TECAS exhibits antidepressant efficacy, particularly influencing the insula-based functional connections within the Default Mode Network (DMN) related to emotion processing in individuals with MDD.
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Depressive Disorder, Major , Humans , Depressive Disorder, Major/diagnostic imaging , Depressive Disorder, Major/drug therapy , Acupuncture Points , Default Mode Network , Brain/diagnostic imaging , Antidepressive AgentsABSTRACT
OBJECTIVE To clarify whether the thera-peutic effect of escitalopram on depression patients is cor-related with traditional Chinese medicine syndrome types,and to provide a basis for more accurate drug applica-tion.METHODS A total of 235 depression patients were recruited and classified according to traditional Chinese medicine syndrome differentiation into 5 types:liver and qi stagnation(45),liver stagnation and fire transformation(43),liver qi stagnation and spleen deficiency(79),heart and spleen deficiency(20),and liver and kidney deficiency(38).All patients were treated with escitalopram(10 mg·d-1)for eight weeks.The Montgomery Depression Rating Scale(MADRS)and the 17 Hamilton Depression Rating Scale(HAMD-17)were used to score before treatment and 2,4,and 8 weeks after treatment,respectively.RESULTS Compared with before treatment,the MADRS and HAMD-17 scores and remission rates of each syn-drome type significantly improved with increasing medica-tion duration.The MADRS score relief rate of liver and kidney deficiency type was the most significant(69.3%),significantly higher than the other four syndrome types(47.5%-52.6%,P<0.05);The remission rate of HAMD-17 score was significantly higher than that of heart and spleen deficiency(50.7%vs.28.5%,P<0.05).The remis-sion rate of HAMD-17 score in liver and qi stagnation type(52.2%)was significantly higher than that in liver stagnation and spleen deficiency type(37.0%,P<0.01)and heart spleen deficiency type(28.5%,P<0.05).CON-CLUSION Escitalopram may have a more significant therapeutic effect on patients with liver and kidney defi-ciency and liver stagnation depression.This study pro-vides a new approach for the more effective and accu-rate application of traditional Chinese medicine syndrome differentiation in the selection of clinical antidepressants.
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With the increasing number of Chinese medical aid and the overseas development of Chinese medicine, acupuncture has spreaded to and the Republic of Guinea and saw develoment. At present, only China Guinea Friendship Hospital and Astatin Hospital have set up Acupuncture Department, which have equipped with basic acupuncture instruments and acupuncture is used as the main treatment method, and acupuncture is a self funded project. There is no acupuncture major in the local education system, neither laws and regulations on acupuncture and moxibustion. Language barrier also makes it difficult for doctors in the two countries to communicate. Thus, it is recommended to consider geographic, diet, and medical factors when formulating acupuncture treatment plans which are suitable for local conditions, and launching new projects such as laser acupuncture treatment and ear concha electroacupuncture treatment, while improving the language level of foreign aid physicians, designing suitable teaching materials, and using multimedia technology for teaching. Besides, we should promote legislation, conduct academic and cultural exchanges, so as to better promote the development of acupuncture and moxibustion in Guinea.
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OBJECTIVE@#To compare the effect difference between acupuncture combined with western medication and simple western medication for Meniere's disease.@*METHODS@#Ninety-six patients with Meniere's disease were randomly assigned into a combination group (48 cases, 12 cases dropping) and a medication group (48 cases, 9 cases dropping). Betastatin mesylate tablets (once 12 mg, 3 times a day) and mecobalamin tablets (once 0.5 mg, 3 times a day) were prescribed orally in the two groups. Acupuncture was used in the combination group, twice a week, 20 min a time, and the acupoints were Baihui (GV 20), Fengchi (GB 20), Tinggong (SI 19), Hegu (LI 4), Quchi (LI 11), Zusanli (ST 36), Fenglong (ST 40), Taichong (LR 3), Taixi (KI 3) and Tianshu (ST 25). All the treatment was given for continuous 12 weeks. The symptoms were observed by dizziness handicap inventory (DHI), tinnitus handicap inventory (THI), pure tone audiometry score and stuffy ear visual analogue scale (VAS). The effects were compared in the aspects of dizziness, hearing and activity.@*RESULTS@#The scores of DHI, THI, pure tone audiometry and VAS scores after treatment were lower than those before treatment in the two groups (all <0.05), with lower scores of the above 4 indexes in the combination group after treatment (all <0.05). The difference values before and after treatment of the 4 indexes in the combination group were higher than those in the medication group (all <0.05). The effective rates of dizziness, hearing and activity in the combination group were 97.2% (35/36), 91.7% (33/36), 88.9% (32/36), which were better than 71.8% (28/39), 74.4% (29/39) and 69.2% (27/39) in the medication group (all <0.05).@*CONCLUSION@#Acupuncture combined with conventional medication achieve better effect than simple conventional medication.
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Humans , Acupuncture Therapy , Meniere Disease , Therapeutics , Tinnitus , Treatment OutcomeABSTRACT
OBJECTIVE@#To observe the effect of acupoint injection of bone mesenchymal stem cells (BMSCs) combined with Chinese herbs of benefiting for activating blood circulation for capillary density and arterioles density in skeletal muscle in ischemic hind limb of diabetes mellitus (DM) rats.@*METHODS@#A total of 80 rats were randomized into a normal sham operation group (10 rats) and a model group (70 rats). Disposable intraperitoneal injection of streptozotocin (STZ, 50.0 mg/kg) was used to establish DM model, and the rats in the model group were randomized into 7 subgroups, 10 rats in each one. The subgroups were the DM sham operation group, DM ischemic group, Chinese herb group (intragastric herbs of benefiting for activating blood circulation), local injection group (BMSCs local injection), local injection + Chinese herb group (BMSCs local injection combined with intragastric herbs of benefiting for activating blood circulation), acupoint injection group (BMSCs acupoint injection), acupoint injection + Chinese herb group (BMSCs acupoint injection combined with intragastric herbs of benefiting for activating blood circulation). The local injection was phosphate buffer (PBS) injection at the equidistant 5 points along the line between the ischemic tissue and the normal tissue a time. The acupoints were "Sanyinjiao" (SP 6), "Zhaohai" (KI 6), "Huantiao" (GB 30), "Housanli" (ST 36) and "Yanglingquan" (GB 34). 100 μL BMSCs with 1×10/mL was totally injected at the above acupoints for one rat, 20 μL an acupoint. 1.5 kg/L Chinese herbs were applied by intragastric administration, including 120 g Radix Astragali, 120 g Codonopsis, 48 g Radix Glycyrrhiza, 120 g Angelica sinensis, 120 g Blood Rattan, 48 g Achyranthes bidentata. Intragastric distilled water was used in the other non-Chinese herb groups. The expressions of α-smooth muscle actin (α-actin), latelet endothelial cell adhesion molecule (CD31) and von willebrand factor (vWF) in the skeletal muscle were detected with immunohistochemical SP two-step method.@*RESULTS@#Twenty-one days after intervention, the expressions of α-actin and CD31 on the operation hind limb were higher than those on the healthy hind limb in all the groups, except the Chinese herb group (<0.05<0.01). The vWF expressions on the operation side were lower than those on the healthy side in the Chinese herb group, the local injection group, the local injection + Chinese herb group and the acupoint injection + Chinese herb group (<0.05, <0.01). The α-actin expression on the operation side in the acupoint injection + Chinese herb group was higher than those in the normal sham operation group, DM sham operation group, the DM ischemic group and the local injection group (<0.05, <0.01). The CD31 expressions in the acupoint injection group, the acupoint injection + Chinese herb group, local injection + Chinese herb group were higher than those in the normal sham operation group, DM sham operation group and DM ischemic group (<0.05, <0.01). The CD31 expression in the acupoint injection + Chinese herb group was higher than those in the Chinese herb group and the local injection group (both <0.05). The vWF expressions in the local injection + Chinese herb group, the acupoint injection group and the acupoint injection + Chinese herb group lower than those in the DM sham operation group and the DM ischemic group (<0.05, <0.01).@*CONCLUSION@#schemia increases the expressions of the vascular density related factors of α-actin and CD31. It is more obvious for the increasing expressions of α-actin and CD31, and decreasing expression of vWF with the interventions of simple BMSCs injection and simple Chinese herbs of benefiting for activating blood circulation, especially with the combination of the above tow methods. It is indicated that acupoint injection of BMSCs combined with Chinese herbs of benefiting for activating blood circulation can improve the angiogenesis of ischemic tissue.
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Animals , Rats , Acupuncture Points , Diabetes Mellitus , Ischemia , Lower Extremity , Mesenchymal Stem Cells , Rats, Sprague-DawleyABSTRACT
Objective To explore the feasibility of needle-embedding therapy in the treatment of chronic myocardial ischemia using a miniature pig model established by placement of an Ameroid constrictor at the left anterior descending branch (LAD) of coronary artery in Bama miniature pigs during surgery. Methods The miniature pig model of chronic myocardial ischemia was established by placement of an Ameroid constrictor at the left anterior descending branch of the left coronary artery in Bama miniature pigs. The pig models were randomly divided into the treatment group (the"Neiguan " group) and the control group (the "Zusanli " group), and were treated with needle- embedding electroacupuncture at the"Neiguan" (PC6) and "Zusanli" (ST36) acupoints, respectively. Myocardial samples were taken at 6 weeks after surgery for light and electron microscopic examinations. Results Gross pathology showed that ischemic area in the myocardium appeared in both experimental groups. The ischemic area in the "Zusanli "group was larger than that of the"Neiguan"group. Histopathology showed that the acupuncture treatment at the"Neiguan"acupoint reduced the ischemic injury in the pig myocardial tissues. Ultrastructural observation of the myocardium showed mitochondrial vacuolization in cardiomyocytes and myocardial fibrosis in both groups. Conclusions Acupuncture therapy at the"Neiguan"acupoint of pericardial channel may exert protective effect on the myocardial ischemia by reducing the ischemia-injury of cardiomyocytes, but can not inhibit the already existed ischemia-induced cardiomyocytic injuries. Our findings suggest that the establishment of miniature pig model of chronic myocardial ischemia by surgically placing an Ameroid constrictor on the left anterior descending branch of left coronary artery and the needle-embedding in acupoints is feasible for the treatment of chronic myocardial ischemia in this pig model.
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Syndromes of coronary heart disease with angina pectoris were analyzed to provide guidance for clinical practice and to improve accuracy of traditional Chinese medicine (TCM) diagnoses and efficacy of TCM treatment. A total of 860 cases with coronary heart disease with angina pectoris were selected from TCM Clinical Research Information Sharing System for TCM clinics and research. Syndromes were automatically extracted with the cluster method and were analyzed to provide objective evidence for clinical studies. Final syndrome classifications were recognized and confirmed by clinical experts. Popular syndromes included Qi and blood deficiency, blood stasis and obstruction collaterals, liver depression and spleen deficiency, and Qi stagnation and blood stasis. Syndromes Qi and blood deficiency and blood stasis and obstruction collaterals accounted for 28.61% of total syndromes, whereas liver depression and spleen deficiency and Qi stagnation and blood stasis accounted for 26.44%. The main syndrome elements comprised Qi deficiency, blood deficiency, blood stasis, and Qi stagnation.
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Aged , Female , Humans , Male , Middle Aged , Angina Pectoris , Diagnosis , Therapeutics , Cluster Analysis , Coronary Disease , Diagnosis , Therapeutics , Diagnosis, Differential , Hemostasis , Medicine, Chinese Traditional , SyndromeABSTRACT
The transcutaneous auricular vagus nerve stimulation (taVNS) was researched and developed based on traditional Chinese medicine (TCM) auricular acupuncture (AA),vagus nerve stimulation (VNS) and anatomy.It is a typical representative of TCM modernization.Meanwhile,taVNS does not require surgery,with low cost,and has almost no side effects.Most importantly,it ensures a comparable efficiency as the classic VNS.The taVNS regulates the autonomic neural function as its core,opens up a new principle of peripheral nerve-brain network-body function,and has made breakthroughs in the treatment of epilepsy and depression.Other indications of taVNS contain disorders of consciousness (DOC),autism spectrum disorder (ASD),Alzheimer's disease (AD),and etc.The further improvement of taVNS technique will definitely benefit a wider range of patients.
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<p><b>OBJECTIVE</b>To observe and evaluate the clinical efficacy of transcutaneous vagus nerve stimulation (taVNS) at auricular concha for primary insomnia (PI) and affective disorder.</p><p><b>METHODS</b>A total of 35 patients who met the diagnosis standard of PI in(5th edition) were included. The self-developed auricular vagus nerve stimulator (TENS-200A) was applied at auricular concha, 30 min per treatment, twice a day, 5 days a week for consecutive 4 weeks. The follow-up visit was conducted at the end of 6th week. The Pittsburg sleep quality index scale (PSQI), 17-items Hamilton depression scale (17HAMD) and Hamilton anxiety scale (HAMA) were applied for evaluation. The PSQI, HAMA and 17HAMD were observed before and after treatment; the safety was also observed.</p><p><b>RESULTS</b>Compared before treatment, the PSQI was significantly decreased to (13.20±3.61) at the end of 2nd week (<0.05); compared before treatment, the 17HAMD and HAMA were significantly decreased at the end of 4th week and 6th week (all<0.05). No adverse reaction was observed.</p><p><b>CONCLUSIONS</b>The taVNS could not only relieve PI symptoms, but also improve the depressive and anxiety symptoms, in addition, it may have positive long-term efficacy and safety.</p>
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The physiological mechanism underlying the acupoint sensitization was evaluated systemically by using the method of electric physiology at spinal cord, medulla, and thalamus levels; the dynamic change of acupoint from the relative "silence" to the relative "activation" function was explained through the study on the dynamic process of acupoint sensitization; the biological process of the therapeutic effect of acupoint stimulation was illuminated through the research of the central mechanism underlining the dose effect relationship between the sensitive acupoint and the related brain area, thus scientific evidence for the functional link between the acupoint and internal organs as well as the nature of the acupoint were provided.
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Animals , Humans , Acupuncture Points , Acupuncture Therapy , Moxibustion , Nociceptors , Physiology , Sensation , Viscera , Physiology , Visceral Afferents , PhysiologyABSTRACT
This study was aimed to compare the effects of acupuncture stimulation on different acupoints, which included LR14-Qimen, ST25-Tianshu, GB34-Yanglingquanand CO11-pancreas and gallbladder (auricular vagus nerve intensively distributed areas) on gallbladder pressure and Oddi sphincter function of guinea pig, in order to discuss acupuncture effect on different acupoints in the regulation of motor function of extrahepatic biliary system. A total of 20 adult guinea pigs of both sexes were randomly divided into two groups, with 10 in each group. The detection was made on changes of Oddi sphincter electromyography and gallbladder pressure before and after acupuncture. A double-hook electrode was implanted into the Oddi sphincter for the detection of Oddi sphincter electromyography. And one small artificial balloon was put into the gallbladder to measure the intrabiliary pressure. After the guinea pig was anesthetized, changes of gallbladder pressure as well as the electromyography frequency and amplitude index of Oddi sphincter of the normal guinea pig were recorded. When the guinea pig was stabilized, acupuncture was given on LR14, ST25, GB34 and CO11 for 1 min. Observations were made on acupuncture effects of gallbladder pressure and Oddi sphincter function of guinea pig. The results showed that after acupuncture on LR14 and ST25, the electromyography frequency of Oddi sphincter was obviously increased compared with before acupuncture (frequency:P < 0.01, amplitude:P < 0.05); the gallbladder pressure was obviously decreased (P < 0.05). After acupuncture on CO11 and GB34, the electromyography frequency and amplitude index of Oddi sphincter were obviously decreased compared with before acupuncture (P < 0.05); the gallbladder pressure was obviously increased (P < 0.01). It was concluded that acupuncture on LR14 and ST25 can obviously inhibit the movement of gallbladder and promote the myoelectricity release of Oddi sphincter. Acupuncturing on CO11 and GB34 can apparently promote the shrinking movement of gallbladder and inhibit the myoelectricity release of Oddi sphincter.
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Epilepsy is a group of chronic diseases characterized by recurrent and transient brain dysfunction induced by abrupt and intermittent abnormal discharge of neurons in the brain, which is difficult to be cured. Thee auricular concha are is he zone of visera in TCM auricular points, but also the innervating area of the auricular brach of the vagus nerve. Auricular acupuncture, as a special treatment, has superior therapeutic effect for epilepsy. In recent years, remarkable progress has been made in the theoretical basis and clinic application of auricular acupuncture for epilepsy, and the ear-vagus percutaneous electrical stimulation apparatus (auricular acupuncture apparatus) is developed for clinical trial researches. From the basic study to clinical research of auricular acupuncture for epilepsy, the epilepsy pathogenesis as well as the intervention pathway and clinical efficacy of auricular: experimental support and rich clinical experience for auricular acupuncture apparatus.
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Humans , Acupuncture Points , Acupuncture, Ear , Methods , Ear , Epilepsy , TherapeuticsABSTRACT
<p><b>BACKGROUND</b>Previous studies demonstrated that vagus nerve stimulation (VNS) is an effective therapy for drug-resistant epilepsy. Acupuncture is also used to treat epilepsy. This study was designed to examine the safety and effectiveness of transcutaneous auricular vagus nerve stimulation (ta-VNS) for patients with drug-resistant epilepsy.</p><p><b>METHODS</b>A total of 50 volunteer patients with drug-resistant epilepsy were selected for a random clinical trial to observe the therapeutic effect of ta-VNS. The seizure frequency, quality of life, and severity were assessed in weeks 8, 16, and 24 of the treatment according to the percentage of seizure frequency reduction.</p><p><b>RESULTS</b>In the pilot study, 47 of the 50 epilepsy patients completed the 24-week treatment; three dropped off. After 8-week treatment, six of the 47 patients (12%) were seizure free and 12 (24%) had a reduction in seizure frequency. In week 16 of the continuous treatment, six of the 47 patients (12%) were seizure free; 17 (34%) had a reduction in seizure frequency. After 24 weeks' treatment, eight patients (16%) were seizure free; 19 (38%) had reduced seizure frequency.</p><p><b>CONCLUSION</b>Similar to the therapeutic effect of VNS, ta-VNS can suppress epileptic seizures and is a safe, effective, economical, and widely applicable treatment option for drug-resistant epilepsy. (ChiCTR-TRC-10001023).</p>
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Adolescent , Adult , Female , Humans , Male , Young Adult , Epilepsy , Therapeutics , Transcutaneous Electric Nerve Stimulation , Methods , Treatment Outcome , Vagus Nerve Stimulation , MethodsABSTRACT
Acupoints are surface reaction and treatment spots under the pathological conditions which have functions of diagnosis and treatment. For the study of acupoints, we can carry it out from the aspects of structure and function. The two aspects have a close relationship. Structure is the material basis of function, while function is the manifesta-tion of structure. Therefore, the study of acupoints is not only significant to reveal the essence of acupoint, but also has enormous value in the guidance of acu-moxibustion for clinical practice. Staring from the normality of structure and variability of function, we explored the essence of acupoints, and further revealed ordered regulation rule and its biological basis, so that the essence of acupuncture points will be illustrated with scientific evidences.
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This study was aimed to choose the best fixing method of electrocardiogram (ECG) measurement in mice by comparison of ECG index in three different fixing ways. Changes of ST amplitude and heart rate in ECG were measured in the self-made mouse sets, tape bundling or breathing anesthesia state. The amplitudes of the ST seg-ment in C57BL6 mice and β1/β2-AR double knockout mice were elevated in tape bundling or breathing anesthesia state in comparison with that in the self-made mouse sets (all P < 0.01). The heart rate under the tape bundling state in C57BL6 mice was significantly faster than that in the self-made mouse sets (P< 0.05 or P< 0.01). And the heart rate under anesthesia in β1/β2-AR double knockout mice was significantly slower than that in tape bundling state or the self-made mouse sets (both P < 0.01). It was concluded that relative to the binding and anesthesia method, fixing mouse in the self-made mouse sets, which can more truly reflect the physiological or pathological states, is a relatively good fixing method of ECG measurement in experimental study.
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This study was aimed to examine whether transcutaneous auricular vagus nerve electrical stimulation (ta-VNS) at auricular concha area was an effective approach for patients with refractory seizures. Double-blind transcu-taneous nerve electrical stimulation was applied in this study. A pilot study was conducted firstly on 50 patients with refractory seizures to preliminarily observe the therapeutic effect of ta-VNS. Then, a randomized controlled trial (RCT) was conducted on another 144 epilepsy patients who were randomly assigned to the ta-VNS group (n = 98), and the transcutaneous non-auricular vagus nerve electrical stimulation (tn-VNS) control group (n = 46). The treat-ment was performed twice a day for 24 weeks. Patients who were neither in the ta-VNS group nor the tn-VNS group accepted medication at the same time. The seizure frequency and severity were assessed in the 8-week, 16-week and 24-week of the treatment according to the modified Engel scale. The results showed that in the pilot study, after 8-week treatment, 6 out of 50 epilepsy patients were seizure free; and 12 cases had a 50%-89% reduction in seizure frequency. After 24-week treatment, 8 cases were seizure free; 2 cases had a more than 90% reduction in seizure frequency; and 9 cases had a 50%-89% reduction in seizure frequency. In the RCT study of 144 epilepsy patients, after 8-week treatment, 10 out of 98 patients in the ta-VNS group were seizure free; 6 cases had a more than 90% reduction in seizure frequency; and 25 cases had a 50%-89% reduction in seizure frequency. After 24-week treatment, 15 cases were seizure free; 6 cases had a more than 90% reduction in seizure frequency; and 26 cases had a 50%-89% reduction in seizure frequency. After 8-week treatment, in the tn-VNS control group, only 3 out of 46 patients were seizure free; 2 cases had a more than 90% reduction in seizure frequency; and 9 cases had a 50%-89% reduction in seizure frequency. After an additional 16-week treatment of ta-VNS, 7 out of 46 patients were seizure free; 14 had a 50%-89% reduction in seizure frequency. There were significant differences in seizure frequency reduction among groups (P< 0.05). It was concluded that ta-VNS, which had similar therapeutic effect as VNS, was able to suppress epileptic seizures. It is a safe, effective, economic, and applicable treatment option for the treatment of refractory epilepsy.
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Objective To investigate the effect of the time factor on acupuncture effects by observing the changes of nitric oxide (NO) content at the acupuncture points in different times. Method The experimental study was done on 20 cases of healthy volunteers who provide informed consent. Among 10 cases of acupuncture group, 5 cases were male, 5 cases were female. Among 10 cases of non-acupuncture group, 5 cases were male, 5 cases were female. The age was around 25 to 45 years. Jianshi on Pericardium Meridian of Hand Jueyin and Weizhong on Bladder Meridian of Foot Taiyang was acupunctured. "Active"/"silent" time of points were projected with Ziwuliuzhu Najia method. Acupuncture was done at the points "active"/"silent" respectively. The changes of NO content at the body points were detected. The difference of acupuncture in different time at the body points was compared. Result NO content in acupuncture group was higher at the "active" than at the "silent", while there was no significant difference at non-acupuncture group. NO content was higher in acupuncture group than that in non-acupuncture group. Conclusion NO content at the points can be increased by acupuncture. Effect of acupuncture at acupoints "active" was more significant than at acupoints "silent". It was proved that the therapeutic effect of acupuncture can be increased by using time acupuncture.
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Classical description of central pathways has been that there are segregated routes for visceral and somatic inputs, for pain and tactile processing. Ample evidence in recent studies however calls for a revision of this traditional view. It has been demonstrated that visceral nociceptive inputs may travel in the dorsal column-medial lemnicus system along with skin tactile inputs, and convergence and interactions between the two distinct modalities have been demonstrated in route to the high brain centers. In the spinal cord and thalamus, skin inputs may inhibit noxious colorectal inputs; on the other hand pre-existing visceral nociception may cause abnormally high discharge of single neurons. These recent findings shine light on mechanisms of central processing of visceral nociception and its associated allodynia and referred pain, as well as for the effects of some traditional therapies such as acupuncture and massage.
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AIM: To study the interactions between skin tactile and visceral nociceptive inputs in the ventroposterior lateral (VPL) nucleus of the rat thalamus. METHODS: Visceral nociceptive inputs were generated by colorectal distension (CRD). Skin tactile inputs were generated by 10 Hz skin puff. They were delivered in sequence to investigate the changes in reaction to the test stimulus after the conditioning stimulation. RESULTS: Among the isolated 78 single VPL neurons that had response to both CRD and skin tactile stimuli, 44% (31/70) had their response to CRD reduced by the preceding conditioning tactile stimulation, and 54% (38/70) had their tactile response enhanced by the preceding CRD. The skin receptive fields of the majority of the cells were located along the caudal part of the Meridians of Stomach and Gallbladder of Chinese medicine. CONCLUSIONS: (1) Conditioning tactile inputs may inhibit noxious colorectal inputs, but this effect was short-lasting and limited at single neuron level. (2) On the other hand, pre-existing visceral nociception may cause abnormally high discharge of thalamic neurons, a phenomenon that may be related to the clinically seen allodynia on the body surface in visceral lesions.