Abstract
Acupuncture therapy has been used to treat several disorders in Asian countries and its use is increasing in Western countries as well. Current literature assessed the safety and efficacy of acupuncture in the acute management and rehabilitation of patients with neurologic disorders. In this paper, the role of acupuncture in the treatment of acute severe acquired brain injuries is described, acting on neuroinflammation, intracranial oedema, oxidative stress, and neuronal regeneration. Moreover, beneficial effects of acupuncture on subacute phase and chronic outcomes have been reported in controlling the imbalance of IGF-1 hormone and in decreasing spasticity, pain, and the incidence of neurovegetative crisis. Moreover, acupuncture may have a positive action on the arousal recovery. Further work is needed to understand the effects of specific acupoints on the brain. Allegedly concurrent neurophysiological measurements (e.g., EEG) may help in studying acupuncture-related changes in central nervous system activity and determining its potential as an add-on rehabilitative treatment for patients with consciousness disorders.
Highlights
Severe acquired brain injuries include a variety of acute brain lesions characterized by the occurrence of variably prolonged coma (24 hours), and simultaneous motor, sensory, cognitive, and/or behavioural impairment that causes a certain degree of disability
On the basis of the current taxonomy of disorders of consciousness (DOCs), a state of altered consciousness can be categorized into coma, vegetative state (VS), referred to as unresponsive wakefulness syndrome (UWS), and minimally conscious state (MCS) [1]
The aim of this review is to explore the potential role of acupuncture (1) in the acute treatment of sABIs, in containing secondary brain injury by acting on different pathophysiologic mechanisms, and (2) in the subacute/chronic management of sABI outcomes, through a limitation of spasticity, pain, dysautonomia, and a possible action on the arousal recovery
Summary
Severe acquired brain injuries (sABIs) include a variety of acute brain lesions characterized by the occurrence of variably prolonged coma (24 hours), and simultaneous motor, sensory, cognitive, and/or behavioural impairment that causes a certain degree of disability. A common consequence of sABIs is disorders of consciousness (DOCs), a prolonged cognitive impairment including the loss of awareness of oneself and environment. Two further causes of sABI are anoxic encephalopathy (AE), usually due to cardiocirculatory arrest (secondary to extensive myocardial injury and/or malignant arrhythmias), and ischemic or haemorrhagic stroke. These conditions mostly affect subjects from the fifth decade onwards and represent about 40% of the sABIs. The main involvement of neurons leads to a worse prognosis than TBI. (iv) ischemic injury (v) edema formation (vi) intracranial hypertension (vii) neuroinflammation (viii) blood-brain barrier disruption pharmacologic and neuromodulating strategies have been proposed, results on functional recovery of DOCs are still scarce
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