The discovery of adult neurogenesis was a turning point in the field of neuroscience. Adult neurogenesis offers an enormous possibility to open a new therapeutic paradigm of neurodegenerative diseases and stroke. Recently, several studies suggested that acupuncture may enhance adult neurogenesis. Acupuncture has long been an important treatment for brain diseases in the East Asia. The scientific mechanisms of acupuncture treatment for the diseases, such as Alzheimer’s disease, Parkinson’s disease, and stroke, have not been clarified yet; however, the neurogenic effect of acupuncture can be a possible reason. Here, we have reviewed the studies on the effect of stimulation at various acupoints for neurogenesis, such as ST36 and GV20. The suggested mechanisms are also discussed including upregulation of brain-derived neurotrophic factor, glial cell line-derived neurotrophic factor, basic fibroblast growth factor and neuropeptide Y, and activation of the function of primo vascular system.

Book: Neurobiology of Acupuncture  2013
© 2013 Elsevier Inc. All rights reserved.

OBJECTIVE:

To explore the possible mechanism of scalp acupuncture (SA) in relieving cerebral ischemia reperfusion (CI-R) injury.

METHODS:

Seventy male SD rats were randomized into sham-operation (sham, n = 10), model (n = 30) and SA (n = 30) groups. The later 2 groups were further divided into 24 h, 48 h and 72 h subgroups respectively, with 10 cases in each. CI-R model was established by middle cerebral artery occlusion (MCAO) and reperfusion. Electroacupuncture (2 mA, 2 Hz/100 Hz) was applied to “Dingnie Houxiexian” (MS 7) and “Dingnie Qianxiexian” (MS 6) for 30 min, once every 24 h. Changes of the animal behavior were observed by using neurological severity score (NSS), nuclear factor-kappa B (NF-kappaB) and cyclooxygenase (COX-2) contents and their mRNA expression were detected with enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) techniques respectively.

RESULTS:

Following modeling, the NSS at 24 h, 48 h and 72 h after MCAO increased significantly, while compared with model group, NSS of SA group at the 3 time-points decreased considerably (P < 0.05, P < 0.01), suggesting an improvement of the neurological functions after SA treatment. In comparison with sham group, NF-kappaB mRNA and COX-2 mRNA, and NF-kappaB and COX-2 protein expression of model group in the infarcted cerebral tissue were significantly upregulated at the 3 time-points (P < 0.01) except NF-KB mRNA at 72 h (no significant change), while compared with the 3 time-points of model group, NF-kappaB mRNA and COX-2 mRNA, and NF-KB and COX-2 protein expression of SA group were downregulated obviously (P < 0.01) except COX-2 mRNA at 72 h.

CONCLUSION:

Scalp acupuncture can suppress cerebral ischemia-induced upregulation of NF-kappaB mRNA and COX-2 mRNA, and NF-kappaB and COX-2 protein expression, which may contribute to its effect in promoting neurofunctional rehabilitation of CI-R rats by reducing cytokines-mediated inflammatory reaction.

OBJECTIVE:

To explore the underlying mechanism of scalp-acupuncture therapy in the treatment of acute cerebral ischemia (ACI) in the rat.

METHODS:

A total of 140 SD female rats were randomly assigned to sham-operation (n=20), model (n=60), scalp-acupuncture (SA, n=60) groups, and the later two groups were further divided into 24 h, 48 h and 72 h subgroups separately, with 20 cases in each. Among them, 70 rats were used for cerebral tissue section, and the other 70 cases for homogenating cerebral tissue. ACI model was established by occlusion of the middle cerebral artery (MCAO) for 1 h and reperfusion. EA (2/100 Hz, 2 mA) was applied to bilateral “Dingnie Houxiexian” (MS 7) and “Dingnie Qianxiexian” (MS 6) for 20 min, once daily for 1 d, 2 d and 3 d respectively. The rat’s neurological severity score (NSS) was assessed before and after EA. Blood and brain tissue were sampled for detecting TNF-alpha and IL-1beta contents respectively with enzyme-linked immunosorbent assay. Haematoxylin-eosine (H&E) staining method was used for displaying the inflammatory cells in the ischemic brain tissue.

RESULTS:

(1) After ACI, NSS at each time-point increased significantly, while compared with model group, NSS of SA group decreased apparently 72 h after ACI (P<0.01). Compared with the corresponding time-points of sham-operation group, the number of inflammatory cells, plasma and cerebral TNF-alpha and IL-1beta contents at 24 h, 48 h and 72 h in model group increased considerably (P<0.01, 0.05). In comparison with the corresponding time-points of model group, the number of inflammatory cells at 48 h and 72 h, plasma and cerebral TNF-alpha and IL-1beta contents at 72 h in SA group declined significantly (P<0.01).

CONCLUSION:

Scalp-acupuncture can relieve inflammatory cell infiltration, and reduce plasma and cerebral TNF-alpha and IL-1beta contents in ACI rats, which may contribute to its effect in promoting neurofunctional recovery.

OBJECTIVE:

Acupuncture is beneficial in treating stroke neuropsychiatric symptoms. The present study aimed to identify functional brain response to active acupuncture in patients with unilateral ischaemic stroke using functional MRI (fMRI).

METHODS:

A total of 10 patients aged 47-65 years with left hemispheric ischaemic stroke received single-session manual acupuncture at the TE5 point of the affected (right) forearm. A 6-min tactile control procedure in which an acupuncture needle tip was alternately touched and removed from the skin at the acupuncture point for 30 s each was performed first, followed by active acupuncture in a blocking paradigm consisting of six 30-s twist blocks of rotation interspersed between six 30-s blocks of rest. A whole brain scan was simultaneously conducted on a 3.0-T imager. Activated and deactivated brain regions during tactile stimulation and active acupuncture relative to rest were obtained via group analysis.

RESULTS:

Compared to tactile stimulation, needling with twist manipulation modulated many more widespread brain areas. All the brain areas activated and deactivated by active acupuncture relative to tactile stimulation were distributed in the primary sensorimotor and medial frontal cortex of the unaffected, but not the affected hemisphere.

CONCLUSIONS:

Active acupuncture results in lateralisation of functional cerebral response to the contralateral unaffected hemisphere in patients with unilateral stroke. This lateralisation may represent an effect of acupuncture in enhancing a compensatory process by redistributing functions into the intact cortex, particularly in the unaffected hemisphere.

This pilot study obtained preliminary data on the effects of acupuncture treatment combined with a standard inpatient stroke rehabilitation program on poststroke motor recovery and physical function. Thirty-two patients with acute stroke were recruited and randomized to 1 of 2 treatment arms: standard rehabilitation (control group) or a combination of acupuncture and standard rehabilitation (acupuncture group). Baseline and discharge assessments were obtained on motor recovery as measured by the Fugl-Meyer (FM) Assessment and on physical function as measured by the Functional Independence Measure (FIM). Comparisons were made between the acupuncture and control group in total FM and FIM as well as for each subscale of the FM and FIM. No differences between treatment groups were found in the total FM or the total FIM. However, statistically significant benefit due to acupuncture was observed for the FM lower extremity motor function subscale (P = 0.01) and the tub/shower transfer mobility subscale of the FIM (P = 0.03). Marginally significant benefit due to acupuncture was noted for the toilet transfer mobility subscale of the FIM (P = 0.09). The effectiveness of acupuncture as an adjunct to standard poststroke rehabilitation programs may be demonstrated when more specific measures of stroke motor recovery and physical function are used.

To evaluate the therapeutic effect of comprehensive therapeutic protocol of electroacupuncture combined with active-blood-and-dissolve-stasis herbs and rehabilitation training for cerebral infarction.