Central mechanisms of acupuncture in relieving visceral hypersensitivity in functional gastrointestinal disorders: A narrative review

Abstract

Abstract Visceral hypersensitivity (VH), one of the major symptoms of functional gastrointestinal disorders (FGIDs), impacts the social life and quality of life of the patients. Because of the complex pathological mechanism, the drug therapy for VH has unsatisfactory clinical efficacy and induces side effects. Alternative strategies acting on the central nervous system with few side effects are urgently needed. We summarize the central mechanisms of acupuncture in relieving VH to provide theoretical support for the clinical application of acupuncture in the treatment of VH in FGIDs. In this study, we retrieved the related articles from PubMed and Web of Science with the key words of “acupuncture,”“electroacupuncture,” and “visceral hypersensitivity.” According to the sensory conduction, perception, and emotion-related pathways involved in VH, we summarize the central mechanism of acupuncture in relieving VH from the perspectives of molecular biology and neuroimaging. The pathogenesis of VH in FGIDs involves the peripheral and central nervous systems, which are responsible for the transmission and perception of visceral sensations as well as the regulation of emotion. The widespread nature of VH indicates the involvement of the central nervous system. Acupuncture mediates the signaling pathways between the gastrointestinal tract and the brain to regulate gastrointestinal function and relieve VH. Acupuncture relieves VH by integrating multiple pathways and targets. The available studies in this field mainly focus on the regulation of a specific target or chemical transmitter by acupuncture, while the exact connection among these targets remains to be clarified by multilevel and multitarget studies.