Anatomical and Clinical Characteristics of Scalp Acupuncture Systems: a Scoping Review and Synthesis

Svetlana Wise^1,*, Ava Lorenc²

J Acupunct Meridian Stud 2023; 16(5): 159-175 https://doi.org/10.51507/j.jams.2023.16.5.159

Scalp acupuncture is a therapeutic procedure that involves inserting needles into the scalp to treat various medical conditions, including pain and neurological and psychological disorders. The inter-system variability of scalp acupuncture limits secondary analysis and evidence synthesis, delaying its inclusion into evidence-based healthcare policies and establishment as a treatment intervention recognized by Western medicine. This scoping review aimed to identify the range of scalp acupuncture systems, systematically collect and summarize information on their general, anatomical, and clinical characteristics, and build a framework for understanding scalp acupuncture systems. This review included all English-language publications on scalp acupuncture applied to treat any health condition in humans. Extensive searches were conducted across bibliographic databases, journals, trial registries, and supplementary sources. The detailed general, anatomical, and clinical application characteristics of 19 scalp acupuncture systems were extracted. Data were collected and analyzed using charting and image manipulation software. Framework synthesis was performed using the Standard International Acupuncture Nomenclature Scalp Acupuncture as an a priori framework. The review revealed that the heterogeneity related to scalp acupuncture methods can be attributed to the high variability among the theoretical bases of different systems, intersystem mismatch in anatomical locations of treatment points and areas on the scalp, and inconsistencies in the methods used for locating them. These discrepancies in anatomical and clinical features have limited the synthesis and development of a framework for scalp acupuncture. Discussion and agreement on the anatomical locations of scalp stimulation areas, identification of methods for precise positioning of acupuncture areas on the scalp, and further exploration of theoretical bases will aid in the standardization of scalp acupuncture and improve the quality of research in this area.

Abdominal Acupuncture for Non-Responding TMD Patients: a Retrospective Observational Study in General Practice

Emanuela Serritella*, Gabriella Galluccio, Carlo Di Paolo

J Acupunct Meridian Stud 2023; 16(2): 56-64 https://doi.org/10.51507/j.jams.2023.16.2.56

Background: Pain related to Temporomandibular Disorders (TMD) is severe, negatively affecting patients' quality of life, and often resistant to conventional treatments. Abdominal Acupuncture (AA) is known to be particularly effective for pain, especially chronic and musculoskeletal pain, but it is still poorly studied and never investigated in TMD patients.Objectives: To analyze the efficacy of AA for the treatment of patients with subacute and chronic pain related to TMD and non-responding to previous conventional therapies (occlusal splint, medications, physical therapy).Methods: Twenty-eight patients, 24 F and four M (mean age 49.36 years), were recruited from January 2019-February 2021. All patients underwent AA treatment: two sessions per week for four weeks, for a total of eight sessions. At the beginning of therapy (T0) and at the end of the cycle (T1) the following data were evaluated: maximum mouth opening (MMO); cranio-facial pain related to TMD (verbal numeric scale, VNS); pain interference with normal activities and quality of life of patients (Brief Pain Inventory, BPI); oral functioning (Oral Behavior Checklist, OBC); impression of treatment effectiveness (Patients' Global Impression of Improvement, PGI-I Scale). Statistical comparison of data before and after the AA treatment was performed by Wilcoxon's signed-rank test (significance level p < 0.05).Results: The MMO values were significantly improved after one cycle of AA (p = 0.0002). In addition, TMD-related pain had a statistically significant decline following AA treatment (all p < 0.001). Patients’ general activity and quality of life (BPI) were described as improved following a course of AA, with statistically significant values for all aspects considered (all p < 0.05).Conclusion: Abdominal acupuncture resulted in effective treatment of subacute/chronic-resistant pain related to TMD, capable of improving mandibular function and facial pain, and reduced the interference of pain affecting patients' quality of life.

Add-on Effect and Safety of Pharmacopuncture Therapy in the Treatment of Patients with Lumbar Spinal Stenosis

Yoona Oh^1,†, Chang-Hyun Han^2,3,†, Yeonhak Kim¹, Jihun Kim¹, Changsop Yang², Young Eun Choi⁴, Byoung-Kab Kang², Gi Young Yang^1,5, Byung Ryul Lee^1,5, Eunseok Kim^1,5,*

J Acupunct Meridian Stud 2023; 16(1): 40-48 https://doi.org/10.51507/j.jams.2023.16.1.40

Background: Recently, Korean Medicine treatment with pharmacopuncture therapy (PPT) has been increasingly used in clinical practice to improve symptoms in patients with lumbar spinal stenosis (LSS). The aim of this study is to evaluate the effectiveness and safety of PPT in addition to conventional Korean Medicine treatment (CKMT) for the treatment of patients with LSS, compared with CKMT alone.Methods: This study is designed as a pragmatic, randomized, two-armed, parallel, stratified (by sex), controlled pilot trial. Forty patients diagnosed with LSS will be randomly allocated to the PPT + CKMT group or the CKMT group. Patients in the two groups will receive treatment two times weekly for 5 weeks. The primary outcome will be the mean change in the 100-mm visual analog scale score from the baseline to the end of treatment (week 5). The secondary outcomes will include the clinically important difference, Zurich Claudication Questionnaire score, self-reported walking capacity, Modified–Modified Schober test, EuroQol 5-dimension 5-level questionnaire, and Patients’ Global Impression of Change. Adverse events will be assessed at each visit.Discussion: The results of this study will provide meaningful data to evaluate the add-on effect and safety of PPT in the medical care of patients with LSS.

Application of Biophysical Properties of Meridians in the Visualization of Pericardium Meridian

Feng Xiong¹, Ruimin Xu², Tongju Li³, Jinyu Wang^1,4, Qingchuan Hu³, Xiaojing Song¹, Guangjun Wang¹, Huanhuan Su³, Shuyong Jia¹, Shuyou Wang¹, Zongxiang Zhu^2,5, Weibo Zhang^1,*

J Acupunct Meridian Stud 2023; 16(3): 101-108 https://doi.org/10.51507/j.jams.2023.16.3.101

Background: The biophysical properties of the meridian system, an important concept of traditional Chinese medicine, include low impedance, resounding voice, and high acoustic conductance, all of which are helpful for elucidating the essence of meridians.Objectives: To visualize the human pericardium meridian (PC) based on the resounding voice property of meridians.Methods: Visualization of the PC was performed by injection of fluorescein sodium at the PC6 acupoint (Neiguan) on the PC. Before injection, percussion active points (PAPs) were identified by the virtue of their resounding voice properties. After injection, the trajectories of fluorescein migration throughout the body surface were recorded and analyzed. The distribution of fluorescein in the tissue was further studied using cross-sections of hind limbs of mini-pigs, in which fluorescein was injected into low impedance points.Results: The identified PAP lines were colocalized with PC. Following intradermal fluorescein injection, 1-3 fluorescent lines, which were unrelated to the arm veins, were observed in 7 of 10 participants; 85.4% of fluorescent signals were coincident with PAPs and their intensity had a negative correlation with the body mass index (r = –0.56, p = 0.045). Cross-sections showed a Y-shaped fluorescence pattern where the two migration lines on the surface were the two vertices of the “Y.”Conclusion: The trajectories of fluorescein in the body are suggestive of the anatomical structure of meridians. The PC is related to the deep horizontal interstitial channels that connect to the body surface through vertical interstitial spaces. These biophysical properties and techniques for meridian visualization are valuable for revealing the anatomical structure of meridians.

Dry Needling for Arthrogenic Muscle Inhibition of Quadriceps Femoris in Patients after Reconstruction of Anterior Cruciate Ligament: a Protocol for a Randomized Controlled Trial

Milad Zarrin^1,2, Noureddin Nakhostin Ansari^1,3,*, Soofia Naghdi¹, Scott Hasson⁴, Bijan Forogh⁵, Mehdi Rezaee⁶

J Acupunct Meridian Stud 2023; 16(5): 193-202 https://doi.org/10.51507/j.jams.2023.16.5.193

Background: Dry needling (DN) is recommended as a therapeutic modality for various neuromusculoskeletal disorders. No study has been performed on the impact of DN on arthrogenic muscle inhibition (AMI) after anterior cruciate ligament reconstruction (ACLR). This study protocol is aimed to investigate the impacts of DN on AMI of quadriceps femoris, corticomotor, and spinal reflex excitability in patients with ACLR. Methods: A double-blind, between-subject, randomized, controlled trial will be conducted to measure changes in AMI after DN. Twenty-four subjects with ACLR will be recruited to receive a DN or a sham DN, providing that they met the inclusion criteria. Three sessions of DN on the quadriceps femoris will be applied during a one-week period. The primary outcome measures are the active motor threshold, motor evoked potential, and H_max – M_max ratio. The secondary outcomes are the International Knee Documentation Committee subjective knee form questionnaire score and maximum quadriceps isometric torque. Data will be collected at baseline, immediately after the first session, after the third session, and at the one-month follow-up visit. Discussion: The results of this study will provide preliminary evidence regarding the effects of DN on AMI of quadriceps femoris in patients with ACLR.

Effects of Preoperative Acupuncture on Prevention of Nausea and Vomiting and Plasma Serotonin Values in the Hysterectomy Postoperative Period: a Randomized Clinical Trial

Michelle Catarina Pires, Guilherme Antonio Moreira de Barros*, Lucas Guimarães Ferreira Fonseca, Murilo Moreira Thom, Paulo do Nascimento Junior, Norma Sueli Pinheiro Módolo

J Acupunct Meridian Stud 2022; 15(5): 300-306 https://doi.org/10.51507/j.jams.2022.15.5.300

Background: Nausea and vomiting are frequent complications of anesthesia in the postoperative period. Acupuncture at the pericardium point 6 (PC6) is known to be effective in preventing postoperative nausea and vomiting (PONV).Objectives: The objective of the present study is to investigate the effects of acupuncture performed at the PC6 point in the prevention of PONV in women undergoing elective open hysterectomy under general inhalational anesthesia and to assess its association with plasma serotonin levels.Methods: 97 patients undergoing elective open hysterectomy were randomly divided into two groups: acupuncture group (bilateral acupuncture at PC6, n = 49), and a control group (no acupuncture, n = 48). All patients prophylactically received ondansetron and dexamethasone and, as rescue medication, metoclopramide in case of occurrence of PONV. The primary outcome evaluated was occurrence of nausea and vomiting within 24 hours after surgery. Serotonin plasma levels were measured before and after acupuncture prior to anesthesia induction. For the control group, the repeat measurement was performed 30 minutes after admission to the preoperative unit.Results: Acupuncture at PC6 significantly reduced the incidence of nausea (29.2% vs. 6.1%; p > 0.003), and the need of rescue medication (metoclopramide) (33.3% vs. 10.2%; p > 0.006), but not vomiting (4.2 vs. 4.1; p > 0.98). The plasma serotonin levels between control and acupuncture groups did not differ.Conclusion: This study shows that acupuncture at PC6 resulted in a lower incidence of postoperative nausea in patients undergoing hysterectomy.