Effect of transcutaneous auricular vagus nerve stimulation on functional connectivity in the related brain regions of patients with depression based on the resting-state fMRI / 中国针灸

OBJECTIVE@#To explore the brain effect mechanism and the correlation between brain functional imaging and cognitive function in treatment of depressive disorder (DD) with transcutaneous auricular vagus nerve stimulation (taVNS) based on the resting-state functional magenetic reasonance imaging (rs-fMRI).@*METHODS@#Thirty-two DD patients were included in a depression group and 32 subjects of healthy condition were enrolled in a normal group. In the depression group, the taVNS was applied to bilateral Xin (CO15) and Shen (CO10), at disperse-dense wave, 4 Hz/20 Hz in frequency and current intensity ≤20 mA depending on patient's tolerance, 30 min each time, twice daily. The duration of treatment consisted of 8 weeks. The patients of two groups were undertaken rs-fMRI scanning. The scores of Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA) and Wisconsin card sorting test (WCST) were observed in the normal group at baseline and the depression group before and after treatment separately. The differential brain regions were observed before and after treatment in the two groups and the value of degree centrality (DC) of fMRI was obtained. Their correlation was analyzed in terms of HAMD, HAMA and WCST scores.@*RESULTS@#The scores of HAMD and HAMA in the depression group were all higher than those in the normal group (P<0.05). After treatment, the scores of HAMD and HAMA were lower than those before treatment in the depression group; the scores of total responses, response errors and perseverative errors of WCST were all lower than those before treatment (P<0.05). The brain regions with significant differences included the left inferior temporal gyrus, the left cerebellar peduncles region 1, the left insula, the right putamen, the bilateral supplementary motor area and the right middle frontal gyrus. After treatment, the value of DC in left supplementary motor area was negatively correlated to HAMD and HAMA scores respectively (r=-0.324, P=0.012; r=-0.310, P=0.015); the value of DC in left cerebellar peduncles region 1 was negatively correlated to the total responses of WCST (r=-0.322, P=0.013), and the left insula was positively correlated to the total responses of WCST (r=0.271, P=0.036).@*CONCLUSION@#The taVNS can modulate the intensity of the functional activities of some brain regions so as to relieve depressive symptoms and improve cognitive function.

Effect of electroacupuncture at "Zusanli" (ST 36) on duodenal mast cells, NGF and NTRK1 in rats with functional dyspepsia / 中国针灸

OBJECTIVE@#To observe the effect of electroacupuncture (EA) at "Zusanli" (ST 36) on duodenal mast cells, nerve growth factor (NGF) and neurotrophic tyrosine kinase receptor type 1 (NTRK1), and to explore the mechanism of electroacupuncture at Zusanli (ST 36) on functional dyspepsia (FD).@*METHODS@#Sixty SPF-grade 10-day-old SD rats were randomly divided into a normal group, a model group, a ketotifen group and an EA group, 15 rats in each group. The FD model was prepared by iodoacetamide combined with rat tail clamping method in the model group, the ketotifen group and the EA group. The rats in the ketotifen group were injected intraperitoneally with ketotifen (1 mg•kg-1•d-1) for 7 days; the rats in the EA group were treated with EA at bilateral "Zusanli" (ST 36), with disperse-dense wave, frequency of 2 Hz/50 Hz and intensity of 0.5 mA, 20 min each time, once a day for 14 days. The gastric emptying rate and small intestinal propulsion rate in each group were observed; the morphology of duodenal mucosa was observed by HE staining; the toluidine blue staining was used to observe the number and degranulation of mast cells in duodenal mucosa; the protein and mRNA expressions of NGF, NTRK1 in duodenum were detected by Western blot and real-time PCR; the level of interleukin-1β (IL-1β) in duodenum was measured by ELISA.@*RESULTS@#Compared with the normal group, the gastric emptying rate and small intestinal propulsion rate in the model group were decreased (P<0.01); compared with the model group, the gastric emptying rate and small intestinal propulsion rate in the ketotifen group and the EA group were increased (P<0.01); the small intestinal propulsion rate in the EA group was higher than that in the ketotifen group (P<0.01). In the model group, local defects in duodenal mucosa were observed with a small amount of inflammatory cell infiltration; no obvious abnormality was found in duodenal mucosa of the other groups. Compared with the normal group, the mast cells of duodenal mucosa in the model group were increased significantly with significant degranulation; compared with the model group, the mast cells of duodenal mucosa in the ketotifen group and the EA group were decreased significantly, and the degranulation was not obvious. Compared with the normal group, the protein and mRNA expressions of NGF, NTRK1 as well as the level of IL-1β in duodenum in the model group were increased (P<0.01); compared with the model group, the protein and mRNA expressions of NGF, NTRK1 as well as the levels of IL-1β in duodenum in the ketotifen group and the EA group were decreased (P<0.01, P<0.05); compared with the ketotifen group, the mRNA expression of NGF, as well as the protein and mRNA expressions of NTRK1 in duodenum in the EA group were decreased (P<0.05, P<0.01).@*CONCLUSION@#EA at "Zusanli" (ST 36) could inhibit the activation of duodenal mast cells and regulate the expressions of NGF and its receptor to improve the low-grade inflammatory response of duodenum, resulting in treatment effect on FD.

Effect of transcutaneous auricular vagus nerve stimulation on nocturnal autonomic nervous function in primary insomnia patients / 中国针灸

OBJECTIVE@#To observe the effect of transcutaneous auricular vagus nerve stimulation (taVNS) on the sleep quality and nocturnal heart rate variability (HRV) in patients with primary insomnia.@*METHODS@#Twenty-one patients with primary insomnia were included. Using SDZ-ⅡB electric acupuncture apparatus, Xin (CO15) and Shen (CO10) were stimulated with disperse-dense wave, 4 Hz/ 20 Hz in frequency, (0.2±30%) ms of pulse width and tolerable intensity. Electric stimulation was given once every morning and evening of a day, 30 min each time, for 4 weeks totally. Before and after treatment, the score of Pittsburgh sleep quality index (PSQI), objective sleep structure (total sleep time [TST], sleep latency [SL], wake after sleep onset [WASO], sleep efficiency [SE], the percentages of non-rapid eye movement period 1, 2, 3, and the percentage of rapid eye movement period to TST [N1%, N2%, N3%, REM%] ) and nocturnal HRV (high frequency [HF], low frequency [LF], the ratio of LF to HF [LF/HF], standard deviation for the normal RR intervals [SDNN], squared root of the mean sum of squares of differences between adjacent intervals RR [RMSSD], the percentage of adjacent RR intervals with differences larger than 50 ms in the entire recording [PNN50%], the mean of sinus RR intervals [NNMean] ) were compared in the patients separately.@*RESULTS@#After treatment, the score of each item and the total score of PSQI and SL were all reduced as compared with those before treatment (P<0.01, P<0.001); SE, N3%, LF, HF, LF/HF, SDNN, NNMean and RMSSD were all increased compared with those before treatment (P<0.001, P<0.01).@*CONCLUSION@#The taVNS improves the sleep quality and objective sleep structure in patients with primary insomnia, which is probably related to the regulation of autonomic nervous functions.

Modulation of transcutaneous auricular vagus nerve stimulation on default mode network in patients with primary insomnia / 中国针灸

OBJECTIVE@#To explore the modulation of transcutaneous auricular vagus nerve stimulation (taVNS) on default mode network (DMN) in patients with primary insomnia (PI).@*METHODS@#A total of 22 PI patients (one patient dropped off and two patients were excluded) were included and treated with taVNS. The bilateral auricular points of Xin (CO15) and Shen (CO10) were selected and treated with disperse-dense wave at frequency of 4 Hz/20 Hz, the intensity was based on the patient's tolerance. taVNS was given once in the morning and once in the evening for 30 minutes each time. The treatment lasted for at least 5 days a week for 4 weeks. At the same time, 16 healthy subjects matched with gender and age were recruited. The Pittsburgh sleep quality index (PSQI) score was evaluated before and after treatment in PI patients. The resting-state functional magnetic resonance imaging (rs-fMRI) data of PI patients before and after treatment and healthy subjects at baseline period were collected to observe the effect of taVNS on the functional connection (FC) between posterior cingulate cortex (PCC) and whole brain.@*RESULTS@#After treatment, the total score of PSQI in PI patients was lower than that before treatment (P<0.01). Compared with healthy subjects, the FC of the left PCC was increased either with the left orbital superior frontal gyrus or with left middle frontal gyrus (P<0.001), and the FC between right PCC and left middle frontal gyrus was increased in PI patients before treatment (P<0.001). Compared before treatment, the FC between left PCC and left middle frontal gyrus was decreased (P<0.05), and the FC of the right PCC was decreased either with the right medial prefrontal cortex or with the left middle frontal gyrus in PI patients after treatment (P<0.001, P<0.01).@*CONCLUSION@#taVNS can modulate the FC between anterior and posterior DMN, and between DMN and cognitive control network of PI patients, which may be one of the brain effect mechanisms of taVNS in the treatment of PI patients.

Application prospect of common viral tracers in study on brain effect of acupuncture / 中国针灸

The feasibility and prospect of viral tracers and mediating functional components are explored in study on brain effect of acupuncture. In the paper, proceeding with viral tracers, the viral tracers used to analyze the structure of specific neural circuits are introduced, as well as their mediated probes, optical/chemical genetics techniques, Cre-LoxP systems, etc. The viral tracers and their functional components can not only mark specifically nerve cells or neural circuits, but also interfere with the function of specific types of neurons or nuclei. They solve some disadvantage of traditional nerve tracing method that only describes the morphology of neurons of one brain region and the simple projection among brain regions, and the indirect and non-specific absorption. The viral tracers and their functional components play the important approach to decoding the mechanism on brain effect of acupuncture when introduced in experimental acupuncture so as to provide an in vivo, real-time and intuitive novel method for a further analysis of neurobiological mechanism on brain effect of acupuncture.

Transcutaneous Auricular Vagus Nerve Stimulation: From Concept to Application / 神经科学通报·英文版

Whether in the West or the East, the connection between the ear and the rest of the body has been explored for a long time. Especially in the past century or more, the relevant theoretical and applied research on the ear has greatly promoted the development of ear therapy, and finally the concept of transcutaneous auricular vagus nerve stimulation (taVNS) has been proposed. The purpose of taVNS is to treat a disease non-invasively by applying electrical current to the cutaneous receptive field formed by the auricular branch of the vagus nerve in the outer ear. In the past two decades, taVNS has been a topic of basic, clinical, and transformation research. It has been applied as an alternative to drug treatment for a variety of diseases. Based on the rapid understanding of the application of taVNS to human health and disease, some limitations in the development of this field have also been gradually exposed. Here, we comprehensively review the origin and research status of the field.

Brain science promotes the development of acupuncture in treating brain diseases / 针刺研究

Brain science is the "ultimate territory" for human beings to understand the nature. In the present paper, the authors introduce the current state of brain science research projects in the USA, European countries, Japan and China. In recent years, with the continuous innovations of technologies in brain imaging, biosensors, human-computer interaction and big data, the brain science has become an important frontier field with interdisciplinarity and a focus of science and technology strategies in various countries. As a scientific and technological resource with original advantages in China, traditional Chinese medicine (TCM) is abundant in knowledge of brain, almost covering all kinds of encephalopathy in modern medicine. At present, TCM is increasingly becoming an effective tool to conquer mental and nervous diseases. With the intersection and penetration of multi-disciplines, an increasing close association between the traditional theory of TCM about prevention and treatment of encephalopathy and modern basic biological research appears, and new ideas, new technologies and new achievements have constantly been coming out, particularly in the field of acupuncture medicine. In the present historical juncture when the development of science and technology in China is changing from the "follower" to the "parallel runner", even the "top runner" in some fields, the progress of brain science research in TCM will make enormous contributions to explore brain disease and exploit cutting-edge technologies of TCM, as well as accelerate the modernization of TCM.

Somato stimulation and acupuncture therapy / 中国结合医学杂志

Acupuncture is an oldest somato stimulus medical technique. As the most representative peripheral nerve stimulation therapy, it has a complete system of theory and application and is applicable to a large population. This paper expounds the bionic origins of acupuncture and analyzes the physiological mechanism by which acupuncture works. For living creatures, functionally sound viscera and effective endurance of pain are essential for survival. This paper discusses the way in which acupuncture increases the pain threshold of living creatures and the underlying mechanism from the perspective of bionics. Acupuncture can also help to adjust visceral functions and works most effectively in facilitating the process of digestion and restraining visceral pain. This paper makes an in-depth overview of peripheral nerve stimulation therapy represented by acupuncture. We look forward to the revival of acupuncture, a long-standing somato stimulus medicine, in the modern medical systems.

Auricular acupuncture and biomedical research--A promising Sino-Austrian research cooperation / 中国结合医学杂志

Treatment by auricular acupuncture has a long history. Ear-acupoint research has been advancing step by step in China and also in Europe. Auricles are rich in nerves, therefore a close relationship with different functions of the human body has been proved by the research teams of the two main authors of this article from China and Austria. In recent years, great progress has been made in the research of regulating human body functions through electroacupuncture at the auricular branch of the vagus nerve, which is part of auricular acupuncture therapy. It is well known that the auricular branch of the vagus nerve is the only peripheral pathway to the cerebral cortex. Studies of the Chinese team on hypertension, diabetes, epilepsy and depression have shown that the mechanism of auricular vagus nerve stimulation (VNS) may be comparable with cervical VNS in terms of pathways. Auricular VNS has a broad clinical application prospect.

Progress of research on specificity of meridian acupoint efficacy / 中国结合医学杂志

Acupuncture point specificity is the theoretical basis for meridian and acupuncture theory. Also it is the key factor for the efficacy of acupuncture treatment. Studies on acupoint specifificity have aroused wide interest in scholars both at home and abroad. Some researchers abroad do not support acupoint specifificity. Chinese scholars have, after years of research, preliminarily confifirmed the existence of acupoint specifificity. However, there is still no conclusive evidence to support acupoint specificity in terms of its specific physiological foundation, underlying mechanism and laws. This paper summarizes and analyzes basic and clinical researches on acupoint specificity in biological structure, physiology and acupoint effect, provides clues for further studies and develops the theoretical basis for acupont specifificity.

Bibliometrics study of the development trend of acupuncture-moxibustion clinical trials in foreign countries / 中国针灸

On the basis of MEDLINE and EMBASE database, through bibliometrics, the quantitative research was conducted on the published literatures on the acupuncture-moxibustion clinical trial abroad. The situation of published articles in each continent, country and institution was analyzed statistically. It was found that the number of published articles was higher in Germany, America, England, Sweden, Austria, Japan, South Korea, etc. In Europe, the clinical trial of acupuncture and moxibustion was in the tendency of more country participants, wider distribution and larger amount of research. In North America, America was the main country for the study. In Asia, Japan and South Korea played the leading role. Of those countries, some institutions in Germany America, and South Korea were on the top of the list. In future, the above-mentioned countries and institutions should be monitored specifically so as to launch the active cooperation and strategic project.

Observation on therapeutic effect of Hwato never and muscle stimulator on peripheral facial paralysis / 中国针灸

<p><b>OBJECTIVE</b>To observe the therapeutic effect of Hwato never and muscle stimulator on peripheral facial paralysis.</p><p><b>METHODS</b>Eighty-seven cases of peripheral facial paralysis were randomly divided into a Hwato never and muscle stimulator observation group (n=44) and a G 6805 electronic stimulator control group (n=43). The same acupoints, Hegu (LI 4), Sanyinjiao (SP 6), Taichong (LR 3) and local acupoints on the affected side were selected in the two groups. The therapeutic effects were compared between the two groups.</p><p><b>RESULTS</b>Although the total effective rates were both 100.0% in the two groups, the cured rate was 90.9% in the observation group and 62.8% in the control group with a significant difference between the two groups (P < 0.05). There were no adverse effects in the two groups.</p><p><b>CONCLUSION</b>The cured rate of Hwato never and muscle stimulator on peripheral facial paralysis is superior to that of G 6805 electronic stimulator.</p>

Responses of glucose-sensitive neurons and insulin-sensitive neurons in nucleus tractus solitarius to electroacupuncture at auricular concha in rats / 中国针灸

<p><b>OBJECTIVE</b>To investigate the central mechanism of hypoglycemic effect induced by ear acupuncture.</p><p><b>METHODS</b>Extracellular single-unit recordings were carried out in nucleus tractus solitarius (NTS) of rats after infusion of glucose, insulin via jugular venous and electroacupuncture at auricular concha, observing responses of glucose-sensitive neurons and insulin-sensitive neurons in NTS to electroacupuncture stimulation at auricular concha.</p><p><b>RESULTS</b>There existed glucose-sensitive neurons and insulin-sensitive neurons in NTS. Among glucose-sensitive neurons, inhibitory ones accounted for 37.3%, and excitable ones accounted for 10.9%. Among the insulin-sensitive neurons, excitable ones accounted for 33.3%, and inhibitory ones accounted for 4.9%. When electroacupuncture was given at auricular concha, 49.3% (34/69) of total neurons recorded in NTS showed increase in firing rate, while 4.3% (3/69) showed decrease in firing rate. Among the 34 exciting-responsive neurons, there were 18 neurons responding to glucose infusion with a discharge decreased in frequency, and there were 8 neurons responding to insulin infusion with a discharge increased in firing rate.</p><p><b>CONCLUSION</b>Acupuncture stimulation at auricular concha can irritate the neurons in NTS, which show largely inhibitory and excitable response to glucose and insulin infusion, respectively. The hypoglycemic effect induced by auricular acupuncture possibly results from regulating these neurons' firing activities.</p>

Acupuncture inhibiting responses of spinal dorsal dorsal horn neurons induced by noxious dilation rectum and colon / 中国针灸

<p><b>OBJECTIVE</b>To study on mechanisms of acupuncture in relieving visceral pain.</p><p><b>METHODS</b>In SD rats CRD was used as noxious visceral stimuli. Activities of spinal dorsal horn wide dynamic (WDR) neurons of L1-L13 were recorded by extracellular microelectrode technique. Acupuncture was given at ipsi-lateral and contra-lateral Zusanli (ST 36) of the same segmental innervation of rectum and colon.</p><p><b>RESULTS</b>Visceral noxious afferent could significantly activate spinal dorsal horn convergent neurons, and mechanical stimulation of contra-lateral body surface and hand acupuncture at Zusanli (ST 36) could inhibit this noxious response. When the spinal cord was acutely blocked, the inhibiting CRD effect of needling CRD effect of needling contra-lateral Zusanli (ST 36) completely disappeared.</p><p><b>CONCLUSION</b>Acupuncture and visceral noxious afferent signals converge and interact each other in spinal level, and acupuncture at acupoint can inhibit the spinal dorsal horn neuron respon se activated by visceral noxious afferent and this action needs the participation of the center above the spinal cord.</p>