The autonomic nervous system: A potential link to the efficacy of acupuncture

Abstract

The autonomic nervous system (ANS) is a diffuse network that regulates physiological systems to maintain body homeostasis by integrating inputs from the internal and external environment, including the sympathetic, parasympathetic, and enteric nervous systems (ENS). Recent evidence suggests that ANS is one of the key neural pathways for acupuncture signal transduction, which has attracted worldwide attention in the acupuncture field. Here, we reviewed the basic and clinical research published in PubMed over the past 20 years on the effects of acupuncture on ANS regulation and homeostasis maintenance. It was found that acupuncture effectively alleviates ANS dysfunction-associated symptoms in its indications, such as migraine, depression, insomnia, functional dyspepsia, functional constipation. Acupuncture stimulation on some specific acupoints activates sensory nerve fibers, the spinal cord, and the brain. Using information integration and efferents from a complex network of autonomic nuclei of the brain, such as the insular cortex (IC), prefrontal cortex, anterior cingulate cortex (ACC), amygdala (AMG), hypothalamus, periaqueductal gray (PAG), nucleus tractus solitarius (NTS), ventrolateral medulla (VLM), nucleus ambiguus (AMB), acupuncture alleviates visceral dysfunction, inflammation via efferent autonomic nerves, and relieves pain and pain affect. The modulating pattern of sympathetic and parasympathetic nerves is associated with acupuncture stimulation on specific acupoints, intervention parameters, and disease models, and the relationships among them require further exploration. In conclusion, ANS is one of the therapeutic targets for acupuncture and mediates acupuncture’s actions, which restores homeostasis. A systemic study is needed to determine the rules and mechanisms underlying the effects of acupoint stimulation on corresponding organs mediated by specific central nervous networks and the efferent ANS.

Association between vitamin B12 status and heart rate variability in patients with ischemic stroke

“…[ 25 ] Alterations in the central autonomic network or destruction of autonomic system pathways from the hypothalamus to the brain stem may lead to ANS dysfunction. [ 26 ]…”

The immunomodulatory mechanisms for acupuncture practice

“…The autonomous nervous system (ANS) is essential in maintaining the stability of the organism. It is composed mainly of the sympathetic and parasympathetic nerves and plays a significant role in acupuncture’s therapeutic effects on gastrointestinal motility, inflammation, analgesic anesthesia,and more ( 84 ). However, recent studies have demonstrated that acupuncture’s autonomic regulation is not as straightforward as that of the sympathetic or parasympathetic pathways.…”

Acupuncture for neuropathic pain: focusing on the sympathetic nerve system

“…Limbic systems such as the IC and ACC are essential for the regulation of painful emotions. These autonomic cortical regions form a complex pain regulatory network with autonomic nuclei related to descending inhibition systems, such as the PAG, NTS, RVLM, and dorsal reticular nucleus, to participate in acupuncture analgesia and alleviate pain-related emotions [104] . Several studies have shown that EA can reduce sympathoexcitatory responses, in part, through its effect on multiple brain regions, such as the arcuate nucleus in the hypothalamus, PAG, and RVLM and raphe nuclei in the brainstem, among others [105][106][107] .…”