GB20 Pharmacopuncture As a Potential Method for Brain Drug Delivery via the Perivascular Spaces

Oxana Semyachkina-Glushkovskaya^1,2,*, Inna Blokhina², Nikita Navolokin^2,3, Arina Evsukova², Georgy Karandin², Alexander Khorovodov², Andrey Terskov², Ivan Fedosov², Alexander Dubrovsky², Maria Tzoy², Vasily Ageev², Ilana Agranovich², Valeria Telnova², Anna Tsven², Jürgen Kurths^1,2,4

J Acupunct Meridian Stud 2022; 15(1): 43-49 https://doi.org/10.51507/j.jams.2022.15.1.43

Background: The development of new methods of drug brain delivery is a crucial step for the effective therapy of the brain diseases. Pharma- and acupuncture are the forms of alternative therapy of the brain pathology, including an increase in the permeability of blood-brain barrier. However, the mechanisms of pharma- and acupuncture-mediated effects on the brain physiology remain not fully understood. Results: This pilot study on healthy mice clearly demonstrates the Evans Blue spreading in the mouse head and in the brain via the perivascular spaces (PVSs) of the trigeminal structure and the cribriform plate after the dye injection into the Feng Chi point (Galbladder 20, GB20). Conclusion: These results suggest that pharmacopuncture at GB20 can be a perspective method for brain drug delivery via PVSs.

Effects of Joint Mobilization Versus Acupuncture on Pain and Functional Ability in People with Chronic Neck Pain: A Randomized Controlled Trial of Comparative Effectiveness

Petros Voulgarakis, Paris Iakovidis, Dimitrios Lytras*, Ioanna P. Chatziprodromidou, Anastasios Kottaras, Thomas Apostolou

J Acupunct Meridian Stud 2021; 14(6): 231-237 https://doi.org/10.51507/j.jams.2021.14.6.231

Background: Chronic Neck Pain (CNP) is one of the main contributing factors to disability in people of working age.Objectives: The aim of this randomized clinical trial was to compare the efficacy between acupuncture and joint mobilization on pain and disability in patients with CNP. Methods: The study involved 45 men and women with CNP, divided into three groups of 15 each. The first group followed a manual therapy protocol with joint mobilization for eight weeks three times per week. The second group followed an acupuncture protocol of equal duration and frequency, while the third group did not follow any treatment. Pain with the Visual Analog Scale (VAS) for pain and functional limitations with the Neck Disability Index (NDI) questionnaire were assessed before and after an 8-week intervention. Analysis of variance was applied while post-hoc comparisons were made to determine the differences among the groups at each time of measurement. Results: Both intervention groups showed statistically significant differences compared to the control group after the end of the intervention in both the VAS and the NDI scores (p< .001). Furthermore, the acupuncture group showed a statistically significant improvement compared to the joint mobilization team after the end of the intervention in the VAS score (p< .001) and the NDI score (p< .05). Conclusion: Both joint mobilization and acupuncture appear to be effective interventions in reducing pain and improving functional ability in people with CNP. However, acupuncture appears to have a greater analgesic effect than joint mobilization.

Effects of Dry Needling on Connectivity of Corticospinal Tract, Spasticity, and Function of Upper Extremity in People with Stroke: Study Protocol for a Randomized Controlled Trial

Masoome Ebrahimzadeh¹, Noureddin Nakhostin Ansari^2,3, Iraj Abdollahi^1,*, Behnam Akhbari¹, Saeideh Monjezi⁴

J Acupunct Meridian Stud 2021; 14(6): 238-243 https://doi.org/10.51507/j.jams.2021.14.6.238

Background: Spasticity is a common motor disorder in adult stroke patients. Injury to the corticospinal tract (CST) is associated with spasticity. Dry needling (DN) has positive impacts on spasticity reduction and improvement in the range of motion (ROM) in stroke patients. This study aims to investigate the effectiveness of DN on the connectivity of the CST and the level of spasticity in adult stroke patients. Methods: This double-blind randomized controlled trial will enroll and randomly assign stroke patients to either the experimental group, for receiving three sessions of DN for the spastic wrist flexors, or the control group, for sham needling. The primary outcome measures will be diffusion tensor imaging and the Modified Modified Ashworth Scale score to assess CST connectivity and wrist flexor spasticity, respectively. The Box and Block Test and standard goniometry are the secondary outcome measures to assess hand dexterity and active and passive wrist ROM, respectively. Measurements will be taken both before and after the intervention. Discussion: The results of this study will provide important evidence of the effects of DN on CST connectivity, spasticity, and arm function in adult stroke patients. Trial registration: This trial is registered in the Iranian Registry of Clinical Trials (IRCT) (https://www.irct.ir; IRCT20191208045649N1).

Short-Term Intraocular Pressure Response to the Combined Effect of Transcutaneous Electrical Nerve Stimulation over Acupoint (Acu-TENS) and Yoga Ocular Exercise in Type 2 Diabetic Patients with Primary Open-Angle Glaucoma: A Randomized Controlled trial

Ali Mohamed Ali Ismail^1,*, Alshaymaa Shaaban Abd El-Azeim²

J Acupunct Meridian Stud 2021; 14(5): 193-199 https://doi.org/10.51507/j.jams.2021.14.5.193

Background: Despite the adherence to medications, the control of the modifiable key risk factor—intraocular pressure (IOP)—for the progression of primary open-angle glaucoma (POAG) in diabetics is usually difficult; hence, many glaucoma patients try other alternative therapeutic options. Objectives: This randomized controlled study investigated the short-term IOP response to the combined effects of transcutaneous electrical nerve stimulation over acupoint (Acu-TENS) and yoga ocular exercise in type 2 diabetics with POAG. Methods: Eighty diabetics with bilateral POAG, ages ≥ 50 years, IOP > 21 mmHg in both eyes, and a body mass index below 30 kg/m² were included in this trial. The patients were randomly assigned to group A (n = 40; this group received 20 minutes of yoga ocular exercise followed by 20 minutes of active Acu-TENS over bilateral BL 61 and BL 62 acupoints) and group B (n = 40; this group received the same protocol as group A but with a placebo Acu-TENS). The repeated measurement of IOP were recorded before, immediately after, 30 minutes, and 60 minutes after the sessions. Results: The repeated measures analysis of variance revealed a greater significant decline of IOP in group A than group B in both eyes at the consecutive intervals of time measurements. Conclusion: According to this short-term observation, the addition of Acu-TENS to yoga ocular exercise could reduce the high IOP in diabetic patients with POAG, but further longterm trials are needed.

Mechanisms of Electroacupuncture Pretreatment in Alleviating Myocardial Ischemia Reperfusion Injury: Interactions between the Cerebellar Fastigial Nucleus and Lateral Hypothalamic Area

Qing Yu^1,2, Li-bin Wu¹, Fan Zhang¹, Xiao-tong Wei¹, Pian-pian Chen¹, Shuai-ya Wang¹, Mei-yi Cai¹, Qi Shu¹, Liao-yuan Li¹, Zi-jian Wu^2,3, Rong-lin Cai^2,3,*, Ling Hu^2,3,*

J Acupunct Meridian Stud 2021; 14(6): 207-218 https://doi.org/10.51507/j.jams.2021.14.6.207

Background: Myocardial ischemia reperfusion injury (MIRI) is an important mechanism of post-myocardial infarction injury and a main cause of death in patients with ischemic heart disease. Electroacupuncture (EA) pretreatment is effective for the prevention and treatment of MIRI, but mechanisms mediating the effects of cardiovascular disease EA treatments remain unclear.Objectives: To determine whether the lateral hypothalamus (LHA) and the cerebellar fastigial nucleus (FN) are involved in the protective effects of EA stimulation on MIRI. Methods: EA pretreatment was performed for 7 days before the establishment of the MIRI model. ST-segment changes on electrocardiograms were recorded and the Curtis–Walker arrhythmia score was used to evaluate changes in reperfusion injury. Hematoxylin–eosin staining was applied to evaluate the pathological and morphological changes in myocardial tissue. c-fos expression in the LHA and FN was determined by immunofluorescence staining. Glutamic (Glu) and γ-Aminobutyric acid (GABA) levels were measured using a high-performance liquid chromatography-electrochemical method. Results: EA pretreatment reduced ST-segment elevation, arrhythmia scores, and morphological changes in MIRI myocardial cells in rats, and decreased the c-fos protein expression in LHA/FN nuclei. MIRI was associated with an imbalance between GABA and Glu levels, whereas EA pretreatment increased GABA levels and decreased Glu levels in the LHA/FN. Conclusion: FN and LHA are involved in the EA-mediated attenuation of MIRI. Pretreatment with EA plays a protective role in the myocardium by regulating Glu and GABA release in the LHA and FN.

Effects of Acupuncture in the Treatment of Dogs with Neurological Sequels of Distemper Virus

Bianca P. C. R. Santos¹, Jean G. F. Joaquim², Renata Navarro Cassu^3,*, José C. F. Pantoja¹, Stelio Pacca Loureiro Luna¹

J Acupunct Meridian Stud 2022; 15(4): 238-246 https://doi.org/10.51507/j.jams.2022.15.4.238

Background: Acupuncture (AP) has been empirically used to relieve post-canine distemper virus (CDV) infection neurological signs in veterinary clinics.Objectives: This clinical study aimed to investigate the effects of AP combined with electroacupuncture (EA) on neurological function in dogs infected by CDV.Methods: Twenty-four CDV-infected dogs with neurological sequelae were recruited to receive weekly AP/EA sections for 24 weeks. Neurological improvements were assessed before each AP/EA session using a modified scoring system. Data were analyzed using the McNemar test, Friedman test, Fisher's exact test, and Kaplan-Meier curves (p < 0.05).Results: Neurological scores improved from seven to 24 weeks after AP/EA treatment compared with pretreatment scores (p < 0.001). Significant improvements were recorded over time for functional limb recovery, cranial nerve deficits, mental status (p = 0.025 – 0.014), and urinary function (p < 0.001). Myoclonus was improved and entirely reversed in 75% and 25% of the dogs, respectively. At the end of treatment, the proportion of dogs with normal proprioception, posture, hopping (p < 0.001), and superficial pain sensation responses (p = 0.004) was greater than pretreatment values.Conclusion: AP/EA therapy promoted significant neurological recovery in CDV-infected dogs and may be considered within the chronic phase of the disease to improve motor and sensory rehabilitation. However, these results are preliminary and must be confirmed by further investigations.