Acupuncture improved the symptoms and quality of life in patients with lumbar spinal stenosis

Acupuncture treatment showed that it could relieve pain and improve quality of life in patients with lumbar spinal stenosis (LLS). The report was published in Journal of Acupuncture and Meridian Studies.

Lumbar spinal stenosis is a narrowing of the spinal canal in the lower back, known as lumbar area. This usually happens when bone or tissue-or both-grow in the opening of the spinal canal, caused commonly by spondylosis or degenerative arthritis. Neurogenic pain of LLS is normally exacerbated by walking, standing and/or maintaining certain postures and relieved with sitting or lying. Other symptoms of LLS include sensory loss and weakness of legs, reflecting involvement of spinal nerve roots within lumbar spinal canal. Although medication is effective in relieving symptoms temporarily and surgical procedures will improve the conditions in some cases, none of the treatments is curative.

Dr. MJ Hadianfard and colleagues in Iran conducted a clinical study to assess the effectiveness of acupuncture on patients with LLS. Twenty-four patients with LLS were recruited for the study and were given acupuncture on following acupoints: bilateral BL-23, BL-25, BL-26, BL-37, BL-40, BL-54, BL-57, LI-4, BL-60, DU-3, DU-4, and DU-20 for 30 minutes per session, three sessions a week and 10 sessions in total. The visual analogue scale (VAS) and Short Form-36 Health Survey (SF-36) were monitored for pain and quality of life before treatment, immediate after final treatment and 6-week follow-up. Patients did not receive other treatments during the course of acupuncture treatment.

It was shown that acupuncture treatment significantly improved pain and quality of life such as emotions, vitality, general health, bodily pain, and physical well-being not only immediate after final treatment and but maintained 6-week after treatment. There was no adverse effect reported.

The study demonstrated that acupuncture was able to relieve pain and improve the quality of life of patients with LLS.

Reference:

Hadianfard MJ et al., Effect of Acupuncture on Pain and Quality of Life in Patients with Lumbar Spinal Stenosis: A Case Series Study. J Acupunct Meridian Stud. 2016 Aug;9(4):178-82.    https://www.ncbi.nlm.nih.gov/pubmed/27555222

Dihuang Yinzi, a Chinese herbal formula improved amyotrophic lateral sclerosis – A case report of 12-year follow-up study

A woman patient with amyotrophic lateral sclerosis (ALS) was treated with Dihuang Yinzi, a Chinese herbal formula for 12-year still does not require permanent continuous ventilator and showed improvement in chocking on liquids and muscle twitching of limbs. The study was published in journal of Medicine.

A 41-year-old Chinese woman patient with complaints of weakened bilateral grip, slurred speech, stumbling, and muscle twitching for 3 years, and neurogenic injury in bilateral upper limbs and tongue shown by subsequent electromyography, was diagnosed with ALS. She was treated with Riluzole 100 mg daily for 10 months and stopped. Then, she was administered with Dihuang Yigzi (DHYZ) for the period of 12-year. During the 12 years, DHYZ was modified according to the changes in accompanied syndrome or symptoms. The patient survived with ALS up to now, and does not require permanent continuous ventilator support. The symptoms of choking on liquids were improved and the utility of 30 mL water swallow test was improved with grade 2. The symptoms of muscle twitching of limbs were also reduced. No obvious adverse effect was observed during 12-year treatment and follow-up. However, muscle strength worsened slowly.

Authors suggested that DHYZ can be a potential candidate for treating patients with ALS because it exerts multi-targeted neuroprotection and is a general safe herbal formula. Further rigorous randomized controlled trials are needed to confirm the results of the study.

Reference

Qiu H et al., Dihuang Yinzi, a Classical Chinese Herbal Prescription, for Amyotrophic Lateral Sclerosis: A 12-Year Follow-up Case Report. Medicine (Baltimore). 2016 Apr;95(14):e3324.
https://www.ncbi.nlm.nih.gov/pubmed/27057909

Acupuncture improved conditions of a patient with chronic schizophrenia and sleep disorders – a case report

This report described the use of acupuncture treatment for a patient with chronic schizophrenia and sleep disorder. It was published in journal of Case Reports in Psychiatry.

The 63-year-old woman suffered from long-term schizophrenia (length of illness: 16 years) and (subjective) sleep disorders. The patient received 12 weekly acupuncture treatments. A clinical diagnostic interview and psychological tests such as the Positive and Negative Syndrome Scale (PANSS), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI) and many more were conducted before, immediately after and 3 months after the acupuncture treatment.

The patient experienced improved daily functioning and markedly improved cognitive functioning (working memory). In addition, the results showed that the overall score of the positive and negative symptoms did not change immediately; however, a decrease in symptoms occurred 3 months after acupuncture treatment. Moreover, the patient described an immediate improvement in sleep; this was confirmed by a daytime sleepiness questionnaire. The patient was not able to complete a (longer) test on sleep quality beforehand but did so after the treatment period. Finally, a delayed improvement in the depression scale was found.

This case study indicated that acupuncture may be beneficial treatment tool in patients with schizophrenia and sleep disorder.

Reference

Bosch P, et al., Acupuncture in the Treatment of a Female Patient Suffering from Chronic Schizophrenia and Sleep Disorders. Case Rep Psychiatry. 2016;2016:6745618.     https://www.ncbi.nlm.nih.gov/pubmed/28101392

Unanticipated ripple effect of acupuncture research

Since the report of acupuncture by James Restone in the United States in early 1970s, acupuncture as a modality has been significantly increased its popularity in the Western countries. Effectiveness of acupuncture for many conditions such as pain has been widely recognized. However, for acupuncture research the major impetus in the United States occurred in 1998, when the National Centre for Complementary and Alternative Medicine (now the National Centre for Complementary and Integrative Health) was established within the National Institutes of Health. Since then development of acupuncture research made good progress regarding to effectiveness of acupuncture and understanding of mechanisms of action of acupuncture.

Recently, Professor Hugh MacPherson and colleagues summarised some unexpected and broad-reaching discoveries that materialize when biomedicine and acupuncture encounter in the context of objective and systematic scientific exploration.

1.    Acupuncture stimulation increased release of endorphins leading to wider range of analgesia research.

2.    Increased interesting in connective tissue research in health and disease because insertion of acupuncture needle into connective tissue produce many local changes lead to mechanotransduction study.

3.    Toward better understanding of placebo effect. The use of the sham acupuncture needle as a unique placebo device has assisted researchers in identifying key components of treatment that may enhance the effect of placebo.

4.    Acupuncture-related devices that have beneficial effect on biomedicine, such as transcutaneous electrical nerve stimulation units for analgesia and acupressure bands for relief of nausea.

5.    Pragmatic clinical trials. Acupuncture research in pain helped the evolution of clinical research towards more pragmatic randomized controlled trials, as a part of comparative effectiveness research.

Those unexpected ripple effect of acupuncture research identified by authors not only are the clearest examples of this scientific cross-fertilization, but provide additional rationale for continued support of research evaluating acupuncture therapy.

Reference

MacPherson H, et al., Unanticipated Insights into Biomedicine from the Study of Acupuncture. J Altern Complement Med. 2016 Feb;22(2):101-7.    https://www.ncbi.nlm.nih.gov/pubmed/26745452

Acupuncture is very effective in treating trigger finger

Trigger finger, also known as stenosing tenosynovitis, is a painful condition in which one of your fingers gets stuck as it bents towards the palm. Recently it was reported that acupuncture could significantly improve symptoms of trigger finger after a few sessions of treatment. The clinical study was published in the journal of Acupuncture in Medicine.

Trigger finger occurs when the affected finger's tendon sheath becomes irritated and inflamed that narrows the space within the sheath that surrounds the tendon in the affected finger. This interferes with the normal gliding motion of the tendon through the sheath, leading your finger become locked in a bent position. People whose work or hobbies require repetitive gripping actions are at higher risk of developing trigger finger. Treatment of trigger finger varies depending on the severity and includes avoiding activities that causes pain, a small splint to hold the finger at the night, local steroid injection and surgery. However, results of therapies are not all satisfactory.

Recently Dr. Inour and colleagues in Japan conducted a small clinical study to assess the effect of acupuncture performed at the synovial and ligamentous tendon sheath (A1 pulley site) on pain during snapping and the severity of the snapping phenomenon in patients with trigger finger. Acupuncture was performed on 19 fingers of 15 patients. Acupuncture needles were inserted into the radial and ulnar sides of the flexor tendon at the A1 pulley of the affected finger. Treatment was performed daily up to a maximum of five times. Before and after each treatment, pain during snapping and the severity of snapping were evaluated using a visual analogue scale (VAS).

It was found that VAS scores for pain and snapping severity were significantly improved immediately after the first treatment and reached statistical significance from the second treatment onwards. Similarly, a significant improvement in the severity of snapping was observed from the second treatment. Patients with clinically significant improvements had a significantly shortened duration of the disorder.

Authors proposed that acupuncture may reduce inflammation/swelling of the synovial membrane of the tendon sheath and could be effective alternative treatment for patients with trigger finger.

Reference

M Inour et al., Acupuncture for the treatment of trigger finger in adults: a prospective case series. Acupunct Med doi:10.1136/acupmed-2016-011068.   https://www.ncbi.nlm.nih.gov/pubmed/27401746  

Acupuncture promoted activity of hippocampal neural stem cells in Alzheimer’s model.

Acupuncture stimulation at specific acupoints improved cerebral microenvironment and promoted the proliferation and differentiation of transplanted hippocampal neural stem cells (NSCs) and improved cognitive function of Alzheimer’s model. It has been reported in journal of Molecular Neurobiology.

NSCs, with the potential for neural regeneration, represent a promising clinical strategy for Alzheimer’s. However, under the influence of the host microenvironment, only few grafted NSCs survive, proliferate, and differentiate into functional neural cells, which eventually results in decreased anti-dementia efficacy.

Recently, Dr. Lan Zhao and colleagues in China conducted a study to evaluate whether acupuncture will improve host microenvironment grated with NSCs in Alzheimer’s model. Acupuncture stimulation was applied, 24 hrs after hippocampal NSCs transplantation, at CV17, CV12, CV6, and bilateral ST36 acupoints for 30 s daily for 15 days. Five days after acupuncture, behavioural tests showed that acupuncture significantly improved cognitive functions compared with control group. Biochemical studies revealed that acupuncture markedly increased expression of neurotrophic factors, such as basic fibroblast growth factor, epidermal growth factor and brain derived neurotrophic factor in the hippocampal tissues compared with control group, indicating that acupuncture improved hippocampal microenvironment leading to better survival, proliferation and differentiation of hippocampal NSCs, resulting in improved cognitive function.

Reference

Zhao L, et al., Acupuncture Improves Cerebral Microenvironment in Mice with Alzheimer's Disease Treated with Hippocampal Neural Stem Cells. Mol Neurobiol. 2016 Aug 24. [Epub ahead of print]      https://www.ncbi.nlm.nih.gov/pubmed/27558235

Mechanisms underlying effect of GB34 acupoint in Parkinson’s disease

Although both clinical observation and model studies showed that stimulation of GB34 acupoint improved motor function in Parkinson’s, its mechanism behind is unclear. Very recently two reports of PD model studies shed the light on the question.

Dr. Tian and colleagues in China investigated the effect and mechanism of stimulating GB34 in PD model. They observed first that there was an aggregation of toxic protein, alpha-synuclein closely linked to PD, in the dopamine cells in the brain of PD model. Stimulation at GB34 promoted the autophagic clearance of alpha-synuclein, in a manner different from mammalian target of rapamycin (mTOR)-dependent pathway. Further improvement in the motor function at the behavior level of model was observed. Authors suggested that connection between acupuncture and autophagy not only provides a new route to understanding the molecular mechanism of acupuncture treatment in Parkinson’s.

Later, Dr. Park and colleagues in Korea conducted a series of in vitro and in vivo studies of Parkinson’s. Firstly they found that melanin-concentrating hormone (MCH) in hypothalamus of brain is a neuroprotective agent, then that MCH protected dopamine cells in both vitro and vivo studies. Further stimulation at GB34 activated hypothalamic MCH biosynthesis which can be blocked by MCH-R1 antagonist, then releasing MCH-activated MCH receptors (MCH-Rs) in the dopamine terminals, and showed dopaminergic neuroprotection. MCH is an important metabolic hormone that reportedly influences sleep control and affects learning and memory. About 80 % of patients with PD experienced sleep disturbances, and they showed substantial losses of MCH neurons in the hypothalamus. Moreover, this loss of MCH neurons has been significantly correlated with the clinical stages of PD and regarded as hypothalamic dysfunction in PD. This study suggested that acupuncture stimulation at GB34 activated MCH may play an important role in neuroprotection of Parkinson’s.

References

Tian T et al., Acupuncture promotes mTOR-independent autophagic clearance

of aggregation-prone proteins in mouse brain. Sci Rep. 2016 Jan 21;6:19714.    http://www.nature.com/articles/srep19714

Park JY et al., Novel Neuroprotective Effects of Melanin-Concentrating Hormone in Parkinson’s Disease. Mol Neurobiol. 2016 Nov 14.  https://www.ncbi.nlm.nih.gov/pubmed/27844281