How does acupuncture help improve motor function after spinal cord injury?

Spinal cord injury often leads to the severe dysfunction below the injury site. Regeneration and functional recovery after spinal cord injury are very limited due to irreversible pathophysiological processes, although slow recovery of injured spinal cord neurons and limited neurite outgrowth might be achieved.

Electroacupuncture has been used to treat patients with spinal cord injury and is effective in promoting functional recovery. However, the mechanisms of electroacupuncture action are not fully understood. Recently many studies of spinal cord injury models reported very interesting results. The following is the summary of some studies.

JH Yang and colleagues reported, in a SCI model by compressing the T8–9 segments using a modified Nystrom method, that electroacupuncture stimulation of ST36, GB39, ST32 and SP6 for 2-6 weeks increased GDNF mRNA expression and increased AChE activity at the injury site of medium and large neurons in the spinal cord anterior horn, and increased motor neuron activities compared with control group.

DX Jiang and colleagues reported, a model of intervertebral disc extrusion by inserting a silica gel pad into the left ventral surface of T13, electroacupuncture stimulation at the bilateral ST36 and ST44 for 14 days increased blood flow in the first lumbar vertebra (L1). Microvessel density in the T13 segment of the spinal cord was increased significantly as well. The number of normal neurons was higher in the ventral horn of the spinal cord compared with control group.

The results of those studies are quite encouraging and shed some light on the action of electroacupuncture. However, more studies both preclinical and clinical are needed to provide more information about mechanism of acupuncture.

References:

Jiang DX et al., Electroacupuncture improves microcirculation and neuronal morphology in the spinal cord of a rat model of intervertebral disc extrusion. Neural Regen Res. 2015 Feb;10(2):237-43.  http://www.ncbi.nlm.nih.gov/pubmed/25883622

Yang JH, et al., Electroacupuncture promotes the recovery of motor neuron function in the anterior horn of the injured spinal cord. Neural Regen Res. 2015 Dec;10(12):2033-9.    http://www.ncbi.nlm.nih.gov/pubmed/26889195 

Early acupuncture treatment protects neurons from traumatic damage in spinal cord

Traumatic spinal cord injury results in devastating consequence to individuals, their families and communities.  Early acupuncture treatment can rescue neurones in spinal cord from damage in a spinal cord injury model, suggests in a study published in journal Evidence based complementary and alternative medicine.

Traumatic spinal cord injury induces immediate severe pathophysiologic changes in spinal cord such as edema, inflammation, tissue compression, blood vessel damage, leading to cellular impairments e.g. oxidative damage, mitochondria dysfunction and initiation of apoptosis, then cell death. How to protect neurons in spinal cord from damage is vital for recovery and is an unmet challenge.

Researchers in China carried out a study to investigate the effects of early acupuncture treatment on neuronal survival after traumatic damage in a spinal cord injury model. The rats with a spinal injury at the level of the tenth thoracic vertebra were given acupuncture at 2 hours and 8 hours after spinal cord injury at acupoints DU16 and DU26 with either manual or electro acupuncture. Both acupoints are on Governor Vessel meridian which runs posterior along the interior spinal column and closely relates the function of spinal cord according to the theory of traditional Chinese medicine.

Results are quite interesting. Observation from histological sections of spinal cord from acupuncture treated groups showed normal cell morphology with reduced edema and haemorrhage compared with control group. Biomarkers for inflammation, oxidative damage and apoptosis were all significantly decreased in acupuncture groups compare to control.

The data showed that early acupuncture treatment protects neurons in spinal cord against traumatic injury by exerting anti-inflammatory and anti-apoptotic effects and act as antioxidant. This suggests that the earlier acupuncture treatment applied in spinal cord injury, the better neuroprotection, and then better functional recovery.

Reference:

Jiang S et al., Neuroprotective effects of different modalities of acupuncture on traumatic spinal cord injury in rats. Evid Based Complement Alternat Med. 2014; 2014:431580.   http://www.ncbi.nlm.nih.gov/pubmed/24803946

Acupuncture treatment improves spinal cord injury complications

Spinal cord injury, resulting from trauma or neurodegeneration, is a devastating and life-altering injury. It often affects young and healthy individuals who are suffering from severe sensory and motor dysfunction. This debilitating condition not only creates enormous physical and emotional costs to individuals but also a significant financial burden to society.

While care and treatment options such as spinal surgery, pharmacological interventions and rehabilitation continue to improve, many patients with spinal cord injury still experience substantial disabilities and complications including bladder and bowel dysfunctions. These severely impact the quality of life of patients.

A recent study showed that acupuncture treatment can improve bladder and bowel functions in patients with spinal cord injury. After acupuncture treatment once a day five times a week for the first four week, then once every other day three times a week for a further four weeks, patients were then followed up for six months. Following acupuncture treatment, 29% of patients resumed normal bowel and bladder functions, 40% of patients showed significant improvement in both bladder and bowel functions. These effects persisted during the follow-up. The rest of patients did show little improvement.

The study concluded that acupuncture can provide an alternative modality in improving the complications in patients with spinal cord injury with little side effect.

Reference:

Liu Z et al., Electroacupuncture improves bladder and bowel function in patients with traumatic spinal cord injury: results from a prospective observational study. Evid Based Complement Alternat Med. 2013; 2013:543174. doi: 10.1155/2013/543174.  http://www.ncbi.nlm.nih.gov/pubmed/24382977