Ultrasound-Guided Percutaneous Neuromodulation in Multiple Sclerosis: A Case Report

Javier-Ormazábal, Alberto; Herrero, Pablo; González-Platas, Montserrat

doi:10.2147/dnnd.s395082

Cited by 4 publications

(11 citation statements)

References 22 publications

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“…The treatment was terminated due to side effects and no information about the pain score was provided at the end of the treatment. Pain assessed with VAS by Del Pilar Pérez-Trujillo et al [24] decreased significantly (P = 0.009) in all participants after treatment. One month after the end of treatment, the decrease in pain score was not statistically significant, although it was maintained.…”

Section: Painmentioning

confidence: 82%

“…In total, 33 individuals were included in this review, 22 of whom were women. Four studies specified the MS type of the patients [24][25][26][27], while the other studies did not specify MS type. The results of the studies are summarized in Table 1 (study purpose, design and subjects) and Table 2…”

Section: Resultsmentioning

confidence: 99%

“…The dry needling techniques applied in the studies varied. Two studies used the "fast in-fast out" technique [26,29,30], one study used the "sparrow pecking" technique [28], one study used the intramuscular electrical stimulation technique [27], one study used the neuromodulation technique [25], and in one study no detailed information was given about the dry needling technique [24].…”

Section: Dry Needling Techniquementioning

confidence: 99%

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Effectiveness of dry needling on the treatment of patients with multiple sclerosis: systematic review

Mutlu,

Kaya,

Büyükturan

et al. 2023

Explor Neuroprot Ther

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Aim: The aim of this study is to review the effectiveness of dry needling in patients with multiple sclerosis (MS). Methods: PubMed, Physiotherapy Evidence Database (PEDro), Web of Science, Scopus, and Cochrane Library databases were searched from its inception until July 2023 and the reference lists of the articles obtained were manually searched. Studies examining the effectiveness of dry needling treatment alone or in combination with a different protocol in individuals diagnosed with MS, regardless of type, were included. The systematic review included quasi-experimental studies and case reports. Studies involving traditional Chinese medicine acupuncture applications, conference abstracts, and protocol records were excluded. Methodological quality assessments were carried out independently by two authors using tools developed by the Joanna Briggs Institute (JBI). Results: A total of 130 studies were found in the searches. Some studies were excluded due to duplication, protocol registration, conference abstract, and content outside the scope of the study and 7 studies were included in the review. In total, 33 individuals were included in this review, 22 of whom were women. Four studies specified the MS type of the patients, while the other studies did not specify MS type. Conclusions: Despite some limitations, this is, to our knowledge, the first review summarizing studies evaluating the effectiveness of dry needling in MS patients. The dry needling technique alone or in a combination of treatments was effective in improving pain, spasticity, range of motion, dexterity, mobility, limb function, and quality of life in MS patients. However, these results should be treated with caution due to the small number of included studies and the lack of randomized controlled trials. Although it is too early to talk about the positive effects of the dry needling technique in MS patients, the study results are promising. More randomized controlled trials should be conducted on this topic.

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Section: Painmentioning

confidence: 82%

Section: Resultsmentioning

confidence: 99%

Section: Dry Needling Techniquementioning

confidence: 99%

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Effectiveness of dry needling on the treatment of patients with multiple sclerosis: systematic review

Mutlu,

Kaya,

Büyükturan

et al. 2023

Explor Neuroprot Ther

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“…These findings unveil potential molecular alterations underlying the pathogenesis of IIH, shedding light on the nuanced differences between IIH and MS. Notably, biological processes (BP) related to various cellular functions, such as response to ultrasound [9], CXCL12-activated CXCR4 signaling pathway [10], and telencephalon cell migration, are markedly downregulated in both blood and CSF samples. These changes suggest potential disruptions in cellular signaling cascades, migration dynamics, and developmental processes in IIH.…”

Section: Discussionmentioning

confidence: 99%

Comparing Single-Cell Transcriptomes of Blood and Cerebrospinal Fluid Leukocytes in Multiple Sclerosis

Sayad,

Hiatt,

Mustafa

2024

Preprint

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Background. Multiple sclerosis (MS) is a chronic autoimmune disorder of the central nervous system, marked by inflammation, demyelination, and neurodegeneration. Diagnosis is complex due to overlapping symptoms with other neurological conditions, typically relying on clinical evaluation, neurological exams, and tests like magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) analysis. Recent advances in technology, particularly single-cell analysis of blood and CSF leukocytes, hold promise for enhancing MS diagnosis by providing insights into immune cell involvement at a molecular level, potentially enabling more precise diagnostics and personalized treatments. Method. We acquired single-cell RNA Sequence (RNA-Seq) data (GSE138266) from the website of the National Institutes of Health of the United States (NIH), comprising blood and CSF samples from patients diagnosed with idiopathic intracranial hypertension (IIH) and MS. Our analysis focused on identifying genes, pathways and gene ontology terms with distinct expression patterns in MS compared to IIH. Results. We identified clear differences in gene expression profiles between blood and CSF samples in MS, contrasting with single-cell leukocyte samples from IIH. The increased expression of genes in MS suggests a boost in immune activity and regulation of cellular proliferation, while decreased expression points to disruptions across various functional categories. Gene ontology analysis identifies upregulated terms associated with cellular differentiation, apoptotic regulation, and immune responses in MS, while downregulated terms suggest disruptions in cellular signaling cascades and myelination processes. Similarly, Reactome pathway analysis unveils upregulated pathways in MS related to cell cycle regulation and immune mechanisms, contrasting with downregulated pathways indicative of disruptions in oxygen transport and cellular metabolism. Conclusion. Our study offers a thorough examination of single-cell transcriptomic data, unveiling unique gene expression patterns, gene ontology terms, and Reactome pathways linked to MS pathophysiology. Notably, our findings identify CD69 and HNRNPK as potential key genes driving MS progression. By clarifying molecular differences between MS and IIH, our findings enhances our grasp of MS pathogenesis and unveils promising targets for diagnostic and therapeutic interventions.

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“…Future studies that address the same topic should include larger and more homogeneous samples, evaluating the effects of needling more muscles and more sessions, also with longer follow-up times to evaluate the effect of DN also in the long term. Moreover, other invasive techniques should be evaluated, as it is the case of percutaneous neuromodulation, which showed promising effects in the treatment of musculoskeletal disorders in pwMS [ 60 ], although cause–effect relationships cannot be established due to the fact that it is a case report. Furthermore, it would be interesting to carry out cost-effectiveness studies of DN in pwMS in comparison with other therapies or even with drugs such as fampridine in the same way that has been done in chronic stroke [ 61 ], as well as the value of adding DN to a program of neurorehabilitation, something already studied in the population with stroke [ 53 ].…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of a Single Dry Needling Session on Gait and Quality of Life in Multiple Sclerosis: A Double-Blind Randomized Sham-Controlled Pilot Trial

Javier-Ormazábal,

González-Platas,

Jiménez-Sosa

et al. 2023

Healthcare

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Introduction: Gait disorders are a major cause of disability and reduced health-related quality of life in people with multiple sclerosis (pwMS). Dry needling (DN) has demonstrated positive results to improve gait parameters in patients with stroke. The main aim of this study was to evaluate the effect of a single session of DN in the gait performance of pwMS. Methods: A double-blind parallel randomized sham-controlled pilot trial was conducted. Study participants received a single session of active DN or sham DN in the gastrocnemius medialis muscle. Pre-treatment and immediately post-treatment measurements were taken, as well as at one and four weeks after the intervention. Outcomes related to gait performance (Timed 25-Foot Walk), self-perceived walking capacity (Multiple Sclerosis Walking Scale), risk of falls (Timed Up and Go test), disability level (Expanded Disability Status Score) and quality of life (Multiple Sclerosis Quality of Life-54 questionnaire and Analogic Quality of Life scale) were evaluated. Results: 18 patients who had multiple sclerosis participated in the study. The group who received active DN showed within-group significant statistical differences immediately after treatment for gait performance (p = 0.008) and risk of falls (p = 0.008), as well as for self-perceived walking capacity at one week (p = 0.017) and four weeks (p = 0.011) and quality of life at four weeks (p = 0.014). Regarding the comparison between groups, only significant results were obtained in the physical domain of the quality of life at four weeks (p = 0.014). Conclusions: DN seems to be a promising therapeutic tool for the treatment of gait disorders in pwMS. However, when results were compared with sham DN, no differences were found.

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Ultrasound-Guided Percutaneous Neuromodulation in Multiple Sclerosis: A Case Report

Cited by 4 publications

References 22 publications

Effectiveness of dry needling on the treatment of patients with multiple sclerosis: systematic review

Effectiveness of dry needling on the treatment of patients with multiple sclerosis: systematic review

Comparing Single-Cell Transcriptomes of Blood and Cerebrospinal Fluid Leukocytes in Multiple Sclerosis

The Effectiveness of a Single Dry Needling Session on Gait and Quality of Life in Multiple Sclerosis: A Double-Blind Randomized Sham-Controlled Pilot Trial

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