The Cumulative Therapeutic Effect of Acupuncture Treatment in Patients with Migraine without Aura: Evidence from Dynamic Alterations of Intrinsic Brain Activity and Effective Connectivity Analysis

We explored the dynamic alterations of intrinsic brain activity and effective connectivity after acupuncture treatment to investigate the underlying neurological mechanism of acupuncture treatment in patients with migraine without aura (MwoA). The fMRI scans were separately obtained at baseline, after the first and after the 12th acupuncture sessions in 40 patients with MwoA. Compared with HCs, patients with MwoA showed mostly decreased dynamic amplitude of low-frequency fluctuation (dALFF) variability in regions with differences. After acupuncture treatment, the decreased dALFF variability of the rostral ventromedial medulla (RVM), the superior lobe of left cerebellum (Cerebelum_Crus1_L), and the right precuneus (PCUN.R) progressively recovered. The RVM revealed gradually increased dynamic effective connectivity (DEC) variability outflow to the right middle frontal gyrus, the left insula, the right precentral gyrus, and the right supramarginal gyrus, and enhanced DEC variability from the right fusiform gyrus inflow to RVM. Furthermore, the increased DEC variability were found from Cerebelum_Crus1_L outflow to the left middle occipital gyrus and the left precentral gyrus, from PCUN.R outflow to the right thalamus. These dALFF variabilities were positive correlated with frequency of migraine attack and negative correlated with disease duration, dynamic GCA coefficients were positive correlated with Migraine-Specific Quality of Life Questionnaire score, negative correlated with frequency of migraine attack and visual analog scale score postacupuncture treatment. Our results provide insight into dynamic alterations from the perspective of dynamic local brain activity and effective connectivity for the understanding mechanisms of cumulative therapeutic effect of acupuncture in patients with MwoA.

Tandem mass tag-based proteomics analysis of type 2 diabetes mellitus with non-alcoholic fatty liver disease in mice treated with acupuncture

Objective: To explore the proteomics profiles of hepatocytes of mice treated with acupuncture for type 2 diabetes mellitus (T2DM) with non-alcoholic fatty liver disease (NAFLD). Methods: We used a Tandem mass tag (TMT)-based quantitative proteomics approach to identify proteins with potential molecular mechanisms associated with acupuncture interventions for T2DM with NAFLD. Results: Acupuncture effectively improved body weight, blood glucose, and insulin levels in T2DM with NAFLD mouse models and reversed steatosis within hepatocytes. Quantitative TMT- based proteomics analysis identified a total of 4710 quantifiable proteins and 1226 differentially expressed proteins (DEPs) in the model control group (MCG) compared to the normal control group (NCG). The Acupuncture Treatment Group (ATG) presented in 122 DEPs compared to the MCG group. We performed a bioinformatics analysis, which revealed that DEPs enriched in the KEGG pathway after acupuncture treatment were mainly involved in the PPAR signalling pathway, fatty acid biosynthesis, fatty acid metabolism, fatty acid elongation, fat digestion, and absorption. We used parallel reaction monitoring (PRM) technology to explore the association of aldehyde oxidase 1 (Aox1), acyl-coenzyme A thioesterase 2 (Acot2), perilipin-2 (Plin2), acetyl-CoA carboxylase 1 (Acc), NADP-dependent malic enzyme (Me1), fatty acid synthase (Fasn), ATP-citrate synthase (Acly), fatty acid binding protein (Fabp2) with lipid synthesis, fatty acid oxidation and hepatocyte steatosis. Conclusions: Our results show that acupuncture can regulate the protein expression of T2DM in the NAFLD mice model, and can effectively improve hepatocyte steatosis, and has potential benefits for the clinical treatment of this disease.

Metabolomics analysis revealed acupuncture treatment target the upstream for dry eye disease

AIM: To find out the pathogenesis of dry eye disease (DED) and the possible mechanisms of available effective treatments. METHODS: A non-targeted technology, ultra-high performance liquid chromatography coupled with quadrupole-time-of-flight mass spectrometry (UHPLC-Q-TOF-MS), to investigate metabolic characterizations for tear samples from 18 patients with DED upon drug or acupuncture treatment. RESULTS: A total of 190 named metabolites were identified, which presented so far the broadest tear metabolome. Further analysis indicated a significantly distinct metabolomics profile among all patients, but very subtle metabolic differences upon drug or acupuncture treatment. On one hand, only six significantly changed metabolites were determined after drug treatment, five of which including inosine, monopalmitin, urate, propionylcarnitine, and nicotinamide were all increased and involved in inflammatory responses. On the other hand, merely four metabolites including alanine, serine, and homoserine were found to be significantly different. Further pathway analysis of those six and four significantly changed metabolites revealed that only one pathway, aminoacyl-tRNA biosynthesis was significantly influenced in acupuncture-treated patients, which were highly associated with the cause of the disease. The results here indicated acupuncture treatment may address the cause rather than the symptoms for dry eye disease, displaying partially better compared with drug treatment. CONCLUSION: Collectively, this work extended our understanding on the key regulatory elements or pathways involved in the potential mechanisms of available effective treatments, and would be useful for providing novel potential targets and therapeutic strategies for DED.

Effects of Acupuncture on Cardiac Remodeling in Patients with Persistent Atrial Fibrillation: Results of a Randomized, Placebo-Controlled, Patient- and Assessor-Blinded Pilot Trial and Its Implications for Future Research

Background and Objectives: In this study, we attempted to determine the effects of acupuncture on cardiac remodeling and atrial fibrillation (AF) recurrence rates in patients with AF after electrical cardioversion (EC). Materials and Methods: We randomly assigned 44 patients with persistent AF to an acupuncture group or a sham acupuncture group. An electroacupuncture treatment session was administered once weekly for 12 weeks at four acupuncture points (left PC5, PC6, ST36, and ST37). Results: Among the 44 recruited participants, 16 (treatment group) and 15 (control group) completed the trial. The three-month AF recurrence rate (primary outcome) was not significantly different between the two groups. Following the completion of treatment, patients who had been treated with acupuncture had a significant reduction in left atrial volume index (42.2 ± 13.9 to 36.1 ± 9.7 mL/m2; p = 0.028), whereas no change in atrial size was observed in the sham acupuncture group. No serious adverse events were observed. The AF recurrence rate and cardiac function did not differ significantly between the two groups. At three months, the acupuncture treatment group showed more favorable atrial structural remodeling compared to the sham acupuncture group. Conclusion: In future research on acupuncture in AF management, it is recommended that the inclusion criteria be amended to include only symptomatic AF, that an appropriate control group is designed, and that the acupuncture treatment frequency is increased to several times per week.

Effect of Specific Acupuncture Therapy Combined with Rehabilitation Training on Incomplete Spinal Cord Injury: A Randomized Clinical Trial

Acupuncture therapies were used to treat spinal cord injury (SCI) and its complications. To assess the effect of a specific acupuncture therapy combined with rehabilitation training for inpatients with incomplete SCI, we conducted an assessor-blinded, randomized controlled clinical trial in the Department of Rehabilitation Medicine Center in West China Hospital, Sichuan University. Seventy-two participants diagnosed with incomplete SCI were randomly assigned into 3 groups of 24 patients each, with data collection completed in December, 2019. Participants were randomly assigned (1 : 1 : 1) to 3 groups to receive treatment for 4 weeks, 5 times/week of acupuncture for Continuous Acupuncture Treatment (CAT) group, 3 times/week for Intermittent Acupuncture Treatment (IAT) group, and no acupuncture for Control group; all 3 groups received routine rehabilitation training. The primary outcome was the change of American Spinal Injury Association (ASIA) motor score from baseline to week 4. Secondary outcomes included sensory score, Modified Barthel Index (MBI). At week 4, CAT group had a higher motor score and MBI score increase than the control group (mean difference 10.52, 17.36; p < 0.001, p < 0.01, respectively). CAT group had more increase in motor score and MBI than IAT group (mean difference 5.55, 14.77; p < 0.05, p < 0.05, respectively). But the difference among groups in the increase of sensory score was not statistically significant. Acupuncture resulted in a higher motor score and MBI after 4 weeks. And the dosage of 5/week led to more improvement in motor score and MBI than that of 3/week. The results suggested that a dosage of 5/week of acupuncture is safe and more effective for SCI than 3/week. But further research is needed to determine the best intervention dosage, long-term efficacy, and underlying mechanism. This trial is registered with ChiCTR1900021530.

Special Issue: State of the Art in Research on Acupuncture Treatment

Acupuncture is a medical treatment that involves inserting a needle into the body [...]

Higher Expectancy of Acupuncture Treatment is Associated with Significant Higher Ovulation, Less Bruising and Lower Dropout in Infertile Women with PCOS Receiving Acupuncture

Object: To study the expectancy of acupuncture treatment on fertility outcomes and adverse events in infertile women with polycystic ovary syndrome (PCOS) receiving acupuncture. Method: This analysis including 1000 infertile women with PCOS. Women with available expectancy of acupuncture treatment were included in analysis, of whom were subdivided into low and high expectancy groups. The anthropometric and endocrinal parameters, fertility outcomes as well as adverse events and dropout were compared. The risk of low expectancy of acupuncture treatment on ovulation and correspondent 95% confidence interval was computed by multivariable logistic regression model. The Kaplan Meier survival curve was employed to plot the time to ovulation and Cox regression model was used to compare the difference of time to ovulation between groups, adjusting by interventions. Results: 827 women were included in analysis, of whom 373 and 454 women were identified as low and high expectancy, respectively. Compared with low expectancy, women with high expectancy had higher BMI (24.56 vs 23.77 kg/m2, p = 0.03), shorter time to attempt to conception (22.97 vs. 25.00 months, p = 0.03), earlier menarche (13.61vs.13.68 years, p = 0.03) and lower estradiol (256.68 vs. 284.13 pmol/L, p = 0.03). There was not interaction between acupuncture treatment and expectancy of acupuncture treatment regarding ovulation (p = 0.07). High expectancy was associated with significant higher ovulation (adjusted odds ratio (OR) 2.33, 95% CI 1.31 to 4.16, p = 0.004) and lower dropout (adjusted OR 0.13, 95%CI 0.03 to 0.57) in women receiving control acupuncture, even after adjustment by BMI, estradiol, and clomiphene, while it was associated with significant less bruising (adjusted OR 0.28, 95%CI 0.13-0.61) and lower dropout (adjusted OR 0.42, 95%CI 0.18-0.96) in those receiving active acupuncture. High expectancy was associated with significant shorter time to ovulation (median 28 vs 49 days, P < 0.001) in women received control acupuncture, yet it was no longer significant after adjustment for clomiphene. Conclusion: High expectancy of acupuncture treatment was associated with significant higher ovulation, less bruising and lower dropout, but not other fertility outcome in infertile women with PCOS receiving acupuncture. Trial Registration:ClinicalTrial.gov number: NCT01573858 and chictr.org.cn number: ChiCTR-TRC-12002081.

Timing of Acupuncture Treatment in Peripheral Facial Paralysis: A Systematic Review and Meta-Analysis

Objective. Investigate the optimum time of acupuncture treatment in peripheral facial paralysis in order to provide evidence for clinical treatment. Methods. CNKI, Wanfang, PubMed, Cochrane Library, and EMBASE databases were systematically searched from the inception dates to February 20, 2020. Studies limited to participants with acute peripheral facial paralysis treated with acupuncture and patients without information of the stage were excluded. The primary outcomes were effective rate and cure rate (based on facial nerve function scores). This meta-analysis is registered with PROSPERO, number CRD42020169870. Results. 15 randomized controlled trials that enrolled 2847 participants met the selection criteria. There was no significant differences in the effective rate (RR, 1.22; 95% CI, 0.70-2.11) when comparing acupuncture to prednisone therapy in acute facial paralysis. Acupuncture treatment in the acute stage increased both the effective rate (RR, 1.03; 95% CI, 1.00-1.07) and the cure rate (RR, 1.34; 95% CI, 1.14-1.58) compared to that in the nonacute stage. Conclusions. In this meta-analysis, acupuncture showed a better effect in the acute stage than the nonacute stage for participants with peripheral facial paralysis. There was no statistical difference in the effective rate no matter the choice of acupuncture or prednisone therapies in the acute stage. These findings encourage early acupuncture treatment in peripheral facial paralysis.