Acupuncture and neuroregeneration in ischemic stroke

Chang, Qwang Yuen; Lin, Yi Wen; Hsieh, Ching-Liang

doi:10.4103/1673-5374.230272

Cited by 59 publications

(36 citation statements)

References 99 publications

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“…This technique has been widely used to treat post-stroke symptoms, and the mechanism of its effect has been described in a number of studies. [ 11 , 12 ] EA can be used to treat PSD: several clinical trials have been conducted, but there is still insufficient evidence regarding the efficacy and safety of EA for this condition. The present review aims to assess the efficacy and safety of EA in the treatment of dysphagia after stroke, in order to provide reliable evidence regarding the use of EA to practitioners and patients with PSD.…”

Section: Discussionmentioning

confidence: 99%

Electroacupuncture for post-stroke dysphagia

Han

Kim

et al. 2020

Medicine

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Background: Post-stroke dysphagia (PSD) requires effective treatment as it may cause aspiration pneumonia, dehydration, or malnutritution, which can increase the length of hospital stay as well as mortality. In the field of stroke, electroacupuncture (EA) has been widely used, and a number of clinical research papers have been published regarding its effects. This systematic review aims to evaluate the effectiveness of EA for the treatment of PSD. Methods: Randomized controlled trials evaluating the use of EA in PSD will be included in this meta-analysis. The following electronic databases will be searched from inception to July 31, 2020, using terms relating to EA and PSD: PubMed, the Cochrane Library, the Excerpta Medica Database, China National Knowledge Infrastructure, the Korean Medical Database, KoreaMed, the National Digital Science Library, and the Oriental Medicine Advanced Searching Integrated System. Two reviewers will independently search these databases, select studies for inclusion, and evaluate the quality of the studies. Methodological quality will be assessed using the Cochrane Handbook for Systematic Reviews of Interventions (version 6.0). The primary outcome will be the total effective rate; secondary outcomes will include results of other assessments of dysphagia such as the water drinking test scale and videofluoroscopic swallowing study. We will also investigate the number and severity of adverse events. The Cochrane Review Manager (RevMan) software (version 5.3.5) will be employed to assess bias risk, data integration risk, and meta-analysis risk. Mean difference and standardized mean difference will be used to represent continuous data, while risk ratios will be used for pooled binary data. Results: This study will provide a comprehensive review and evaluation of the available evidence regarding the efficacy and safety of EA as a treatment for PSD. Conclusion: This study will clarify whether EA could be an effective and safe treatment for PSD.

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Section: Discussionmentioning

confidence: 99%

Electroacupuncture for post-stroke dysphagia

Han

Kim

et al. 2020

Medicine

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“…Those studies demonstrated the therapeutic effect of acupuncture in stroke rehabilitation. [ 11 , 14 , 27 , 28 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 4 ] Previous studies have indicated that acupuncture therapy is effective in improving balance function. [ 8 , 11 , 13 , 28 , 29 ] In some cases, the effectiveness can occur immediately after acupuncture. It also can affects the sensory perceptions.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic effects of acupuncture on sensory ataxia after a cerebral hemorrhage

Yuen²,

Luo

et al. 2020

Medicine

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Introduction: Sensory ataxia is a dysfunction of dynamic balance due to impairment of sensory input into the control of movement. The sequelae of stroke, such as hemiplegia, somatosensory impairment, and impaired balance may cause significant disability and may affect patients’ quality of life. In addition to rehabilitation programs, acupuncture therapy has been applied to stroke patients and is recommended as a complementary therapy in stroke rehabilitation. Patient concerns: A 70-year-old male had a sudden onset of conscious loss. The brain computed tomography showed intracerebral hemorrhage with subdural hemorrhage and subarachnoid hemorrhage. Diagnosis: Intracerebral hemorrhagic stroke was diagnosed. Interventions: He received craniotomy with hematoma evacuation immediately and waked up 3 weeks with bilateral hemiparesis (right side weaker than left), impaired position sensation and tactile perception in the right lower limb. He then began to receive rehabilitation therapy and had significant improvement in muscle strength and static balance, but no improvement in tactile perception of position sense in the right lower limbs and reached plateau. Then he received acupuncture therapies to Yongquan (KI1), Tongtien (BL7) and Houxi (SI3). Outcomes: The patient's walking ability recovered after receiving rehabilitation programs for 3 years, but the impairment in proprioception and dynamic balance persisted. The perception and dynamic balance had significantly improved after patient received acupuncture therapy, especially the acupuncture point of Yongquan (KI1). Conclusion: The clinical effect of acupuncture in combination with conventional rehabilitation therapy for neurological impairment recovery, improving activity of daily living performance and improving post-stroke imbalance was explored. We hope that this report can facilitate further well controlled quantitative objective studies on a big size of samples.

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“…Another neuroprotective mechanism of EA involves the downregulation of astrocytic S100B, which in turn deactivates p38 MAPK and its downstream substrate NF-κB. These effects subsequently reduce oxidative/nitrative stress and inhibit the TNF-α/tumor necrosis factor receptor type 1-associated DEATH domain protein (TRADD)/ Fas-associated protein with death domain (FADD)/cleaved caspase-8/cleaved caspase-3 apoptotic pathway in the ischemic cortical penumbra after reperfusion [ 89 , 201 , 202 , 203 , 204 , 205 , 206 , 207 ]. Both 5- and 25-Hz EA at acupoints GV20 and GV16 effectively downregulated reactive astrocytosis to exert neuroprotective effects against cerebral infarction-induced neuronal apoptosis, probably by activating the p38 MAPK/CREB signaling pathway [ 203 ].…”

Section: Cerebral Ischemiamentioning

confidence: 99%

“…Heat shock proteins (Hsp) significantly contribute to cellular regenerative processes in injured tissues because Hsp is upregulated during stem cell differentiation; however, the depletion or inhibition of Hsp70/Hsc70 impairs this process [ 206 ]. Hsp27 and Hsp70 reportedly contribute to intracellular protein repair after acute CI [ 206 , 207 , 208 , 209 , 210 , 211 ]. The dual phosphorylation of p38 MAPK was increased through early ischemia in an in vitro study wherein Hsp27 served as a terminal substrate of the p38 MAPK cascade.…”

Section: Cerebral Ischemiamentioning

confidence: 99%

Effect of Acupuncture on the p38 Signaling Pathway in Several Nervous System Diseases: A Systematic Review

Wei

Hsieh

2020

IJMS

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Acupuncture is clinically used to treat various diseases and exerts positive local and systemic effects in several nervous system diseases. Advanced molecular and clinical studies have continually attempted to decipher the mechanisms underlying these effects of acupuncture. While a growing understanding of the pathophysiology underlying several nervous system diseases shows it to be related to inflammation and impair cell regeneration after ischemic events, the relationship between the therapeutic mechanism of acupuncture and the p38 MAPK signal pathway has yet to be elucidated. This review discusses the latest advancements in the identification of the effect of acupuncture on the p38 signaling pathway in several nervous system diseases. We electronically searched databases including PubMed, Embase, and the Cochrane Library from their inception to April 2020, using the following keywords alone or in various combinations: “acupuncture”, “p38 MAPK pathway”, “signaling”, “stress response”, “inflammation”, “immune”, “pain”, “analgesic”, “cerebral ischemic injury”, “epilepsy”, “Alzheimer’s disease”, “Parkinson’s disease”, “dementia”, “degenerative”, and “homeostasis”. Manual acupuncture and electroacupuncture confer positive therapeutic effects by regulating proinflammatory cytokines, ion channels, scaffold proteins, and transcription factors including TRPV1/4, Nav, BDNF, and NADMR1; consequently, p38 regulates various phenomena including cell communication, remodeling, regeneration, and gene expression. In this review article, we found the most common acupoints for the relief of nervous system disorders including GV20, GV14, ST36, ST37, and LI4. Acupuncture exhibits dual regulatory functions of activating or inhibiting different p38 MAPK pathways, contributing to an overall improvement of clinical symptoms and function in several nervous system diseases.

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Acupuncture and neuroregeneration in ischemic stroke

Cited by 59 publications

References 99 publications

Electroacupuncture for post-stroke dysphagia

Electroacupuncture for post-stroke dysphagia

Therapeutic effects of acupuncture on sensory ataxia after a cerebral hemorrhage

Effect of Acupuncture on the p38 Signaling Pathway in Several Nervous System Diseases: A Systematic Review

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