Medical Acupuncture

Low-Frequency Electroacupuncture Improves Insulin Sensitivity in Obese Diabetic Mice through Activation of SIRT1/PGC-1α in Skeletal Muscle

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Figure 4: Schematic model of electroacupuncture on insulin resistance in skeletal muscle. SIRT1-mediated deacetylation of PGC1α is required to activate genes that are associated with mitochondrial fatty acid oxidation in response to energy demands. The resultant increase in expression of mitochondrial genes, including NRF1, could exert positive effects on insulin signaling. eNOS: endothelial nitric oxide synthase; PGC1α: peroxisome proliferator-activated receptor γ coactivator 1α; SIRT1: Sirtuin 1; NRF1: nuclear respiratory factor 1.

This study suggested a preliminary mechanism of electroacupuncture. Specifically, low-frequency EA improved insulin sensitivity in a mouse model of genetic insulin resistance and diabetes, at least in part, via stimulation of SIRT1/PGC-1α in the skeletal muscle. Events involved in this mechanism are presented in Figure 4. This effect leads to a net switch in the metabolic program of the organism to an adaptation that may be of benefit in the face of disorders characterized by insulin resistance. The study introduces an effective and safe activator (electroacupuncture) for SIRT1, offering a basis for applying acupuncture in clinical practice in the treatment of diseases related to insulin resistance.

Low-Frequency Electroacupuncture Improves Insulin Sensitivity in Obese Diabetic Mice through Activation of SIRT1/PGC-1α in Skeletal Muscle

Evidence-Based Complementary and Alternative Medicine
Volume 2011

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Medical Acupuncture

Rewiring the primary somatosensory cortex in carpal tunnel syndrome with acupuncture.

Figure 7

Figure 7
Schematic summarizing CTS response to acupuncture therapy. 
(A) While distal acupuncture at the leg can modulate median nerve function via indirect S1 interhemispheric neuroregulatory pathways, local acupuncture can modulate median nerve function at the wrist via both indirect (e.g. S1 influences on the central autonomic control of local vasa nervorum) and direct pathways (e.g. direct axon reflex mediated control of local vasa nervorum).
(B) Our results demonstrate that electro-acupuncture can produce improvement in symptoms, median nerve function, and S1 neuroplasticity, with objective changes following therapy (median nerve function, functional S1 neuroplasticity) directly predicting long-term symptom improvement.

Abstract

Carpal tunnel syndrome is the most common entrapment neuropathy, affecting the median nerve at the wrist. Acupuncture is a minimally-invasive and conservative therapeutic option, and while rooted in a complex practice ritual, acupuncture overlaps significantly with many conventional peripherally-focused neuromodulatory therapies. However, the neurophysiological mechanisms by which acupuncture impacts accepted subjective/psychological and objective/physiological outcomes are not well understood.

Eligible patients (n = 80, 65 female, age: 49.3 ± 8.6 years) were enrolled and randomized into three intervention arms: (i) verum electro-acupuncture ‘local’ to the more affected hand; (ii) verum electro-acupuncture at ‘distal’ body sites, near the ankle contralesional to the more affected hand; and (iii) local sham electro-acupuncture using non-penetrating placebo needles.

Acupuncture therapy was provided for 16 sessions over 8 weeks.

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Boston Carpal Tunnel Syndrome Questionnaire assessed pain and paraesthesia symptoms at baseline, following therapy and at 3-month follow-up.

Nerve conduction studies assessing median nerve sensory latency and brain imaging data were acquired at baseline and following therapy. Functional magnetic resonance imaging assessed somatotopy in the primary somatosensory cortex using vibrotactile stimulation over three digits (2, 3 and 5).

While all three acupuncture interventions reduced symptom severity, verum (local and distal) acupuncture was superior to sham in producing improvements in neurophysiological outcomes, both local to the wrist (i.e. median sensory nerve conduction latency) and in the brain (i.e. digit 2/3 cortical separation distance).

Moreover, greater improvement in second/third interdigit cortical separation distance following verum acupuncture predicted sustained improvements in symptom severity at 3-month follow-up. We further explored potential differential mechanisms of local versus distal acupuncture using diffusion tensor imaging of white matter microstructure adjacent to the primary somatosensory cortex. Compared to healthy adults (n = 34, 28 female, 49.7 ± 9.9 years old), patients with carpal tunnel syndrome demonstrated increased fractional anisotropy in several regions and, for these regions we found that improvement in median nerve latency was associated with reduction of fractional anisotropy near (i) contralesional hand area following verum, but not sham, acupuncture; (ii) ipsilesional hand area following local, but not distal or sham, acupuncture; and (iii) ipsilesional leg area following distal, but not local or sham, acupuncture.

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As these primary somatosensory cortex subregions are distinctly targeted by local versus distal acupuncture electrostimulation, acupuncture at local versus distal sites may improve median nerve function at the wrist by somatotopically distinct neuroplasticity in the primary somatosensory cortex following therapy.

Our study further suggests that improvements in primary somatosensory cortex somatotopy can predict long-term clinical outcomes for carpal tunnel syndrome.

 

Brain. 2017 Apr 1;140(4):914-927. doi: 10.1093/brain/awx015.

Rewiring the primary somatosensory cortex in carpal tunnel syndrome with acupuncture.

 

 

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Medical Acupuncture

Long-Lasting Reduction of Blood Pressure by Electroacupuncture in Patients with Hypertension

Results: After 8 weeks, 33 patients treated with EA at PC 5-6+ST 36-37 had decreased peak and average SBP and DBP, compared with 32 patients treated with EA at LI 6-7+GB 37-39 control acupoints. Changes in blood pressures significantly differed between the two patient groups. In 14 patients, a long-lasting blood pressure–lowering acupuncture effect was observed for an additional 4 weeks of EA at PC 5-6+ST 36-37. After treatment, the plasma concentration of norepinephrine, which was initially elevated, was decreased by 41%; likewise, renin was decreased by 67% and aldosterone by 22%.

Conclusions: EA at select acupoints reduces blood pressure. Sympathetic and renin-aldosterone systems were likely related to the long-lasting EA actions.

Hypertensive patients benefit from acupuncture treatments, UCI study finds

UCI researchers have found that electroacupuncture – a form of acupuncture that employs low-intensity electrical stimulation – can reduce high blood pressure in hypertensive patients for up to six weeks. Chris Nugent / UCI

Long-Lasting Reduction of Blood Pressure by Electroacupuncture in Patients with Hypertension: Randomized Controlled Trial

Medical AcupunctureVol. 27, No. 4

Hypertensive patients benefit from acupuncture treatments, UCI study finds

Ancient Chinese practice lowers blood pressure, may lessen stroke, heart disease risks

August 19, 2015

 

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Medical Acupuncture

Acupuncture Effect and Central Autonomic Regulation

“Acupuncture has clinical efficacy on various autonomic nerve-related disorders, such as cardiovascular diseases, epilepsy, anxiety and nervousness, circadian rhythm disorders, polycystic ovary syndrome (PCOS) and subfertility. An increasing number of studies have demonstrated that acupuncture can control autonomic nerve system (ANS) functions including blood pressure, pupil size, skin conductance, skin temperature, muscle sympathetic nerve activities, heart rate and/or pulse rate, and heart rate variability. Emerging evidence indicates that acupuncture treatment not only activates distinct brain regions in different kinds of diseases caused by imbalance between the sympathetic and parasympathetic activities, but also modulates adaptive neurotransmitter in related brain regions to alleviate autonomic response. This review focused on the central mechanism of acupuncture in modulating various autonomic responses, which might provide neurobiological foundations for acupuncture effects.”

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Figure 1
Acupuncture autonomic regulation mechanism. Blue indicates the area involved in acupuncture parasympathetic regulation. Orange indicates the area involved in acupuncture sympathetic regulation.

 

Acupuncture Effect and Central Autonomic Regulation

Published online 2013 May 26. doi:  10.1155/2013/267959

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Medical Acupuncture

Monitoring Acupuncture Effects on Human Brain by fMRI

“Our studies of several classical acupoints indicate that acupuncture modulates the limbic network, an important intrinsic regulatory system of the human brain. The network shows significant overlap with the default mode of the resting brain. These associated autonomic nervous function changes can be demonstrated by physiological monitoring.”

Monitoring Acupuncture Effects on Human Brain by fMRI

J Vis Exp. 2010; (38): 1190.
Published online 2010 Apr 8. doi:  10.3791/1190
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Medical Acupuncture

Randomized clinical trial of five ear acupuncture points for the treatment of overweight people

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Abstract

Objective To evaluate the efficacy of the five ear acupuncture points (Shen-men, Spleen, Stomach, Hunger, Endocrine), generally used in Korean clinics for treating obesity, and compare them with the Hunger acupuncture point.

Methods A randomized controlled clinical trial was conducted in 91 Koreans (16 male and 75 female, body mass index (BMI)≥23), who had not received any other weight control treatment within the past 6 months. Subjects were divided randomly into treatment I, treatment II or sham control groups and received unilateral auricular acupuncture with indwelling needles replaced weekly for 8 weeks. Treatment I group received acupuncture at the five ear acupuncture points, treatment II group at the Hunger acupuncture point only and the sham control group received acupuncture at the five ear acupuncture points used in treatment I, but the needles were removed immediately after insertion. BMI, waist circumference, weight, body fat mass (BFM), percentage body fat and blood pressure were measured at baseline and at 4 and 8 weeks after treatment.

Results For the 58 participants who provided data at 8 weeks, significant differences in BMI, weight and BFM were found between the treatment and control groups. Treatment groups I and II showed 6.1% and 5.7% reduction in BMI, respectively (p<0.004). There were no significant differences between the two treatment groups.

Conclusions This finding suggests that the five ear acupuncture points, generally used in Korean clinics, and the Hunger point alone treatment are both effective for treating overweight people.

https://aim.bmj.com/content/32/2/132.long

https://www.kmcric.com/database/ebm_result_detail?cat=RCT&access=R201312045

 

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Medical Acupuncture

Neurophysiological Basis of Acupuncture-induced Analgesia—An Updated Review

This article presents an up-to-date review of the various neurophysiologic mechanisms that have been proposed to produce acupuncture-induced analgesia.

Figure 4. Schematic diagram of the best explanation of the physiologic basis of acupuncture-induced analgesia.

Blue arrows = activation; red arrows = inhibition. 5-HT = 5-hydroxytryptamine; DNIC = diffuse noxious inhibitory control; LTD = long-term depression; LTP = long-term potentiation.

 

Neurophysiological Basis of Acupuncture-induced Analgesia—An Updated Review

Journal of Acupuncture and Meridian Studies

Volume 5, Issue 6, December 2012, Pages 261-270

 

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