Auricular Acupuncture Research Articles

Traditional Chinese Medicine and Headache Disorders-A Review of Categorization and Selected Therapeutic Approaches.

Headaches have emerged as a prevailing global health concern, impacting millions of individuals and posing challenges to public health care systems. With an escalating number of patients seeking complementary therapies to attain a more holistic approach for headaches, Traditional Chinese Medicine has gained significant popularity. It plays a pivotal role in advancing the safeguarding of health and the alleviation of prevalent, recurrent, and complex medical conditions. Traditional Chinese Medicine covers a diverse array of therapeutic procedures for headaches, incorporating Chinese herbal medicine, acupuncture, auricular acupuncture, and life cultivation. This narrative review delves into the fundamental principles of Traditional Chinese Medicine and its categorization of headaches while exploring the potential selected applications of their treatment. Based on recent scientific findings and the ancient history of Traditional Chinese Medicine in the field of headaches, we conclude that selected Traditional Chinese Medicine therapies can be used as an alternative and complementary therapy against headaches.

The Chinese Ear Shenmen Point and the French Cosmonaut Point: Same or Different?

The Shenmen Point is an auricular acupuncture point that is also known in France as the Cosmonaut Point. It is widely utilized therapeutically for its property of reducing stress. In some ways it is a controversial point. Differences of opinion exist regarding the most appropriate name of the point, who discovered it first, its location within the triangular fossa, its best method of detection, its best method of stimulation, its actions, its indications, its contraindications, its therapeutic effects, and even its very existence. Furthermore, given the extent of controversy concerning the Shenmen and Cosmonaut points, one may reasonably question if they represent the same point, or two separate points. The aim of this report will be to review the similarities and differences of opinion regarding the Shenmen and Cosmonaut points, drawing mainly from French, German, Chinese, and American sources. The clinical implications of these comparisons will be summarized.

Effect of acupuncture on the sleep quality of hemodialysis patients in a capital city in the Northeast of Brazil

Objective: Analyze the effect of auricular acupuncture on the sleep quality of hemodialytic patients with chronic pain in a capital city in the Northeast of Brazil. Methods: This study includes double-blind, randomized in blocks and allocated at a rate of 1:1, controlled trial that was conducted in two hemodialysis clinics, with 94 chronic renal patients with chronic pain (auricular acupuncture [AA]: 47, sham acupuncture [SA]: 47). Both received 12 sessions for three months. We collected data using the Pittsburg Sleep Quality Index (PSQI). Data were analyzed using t-tests, Wilcoxon test and ANOVA. Results: Comparing the SA and AA groups, there was a statistically significant difference at baseline (p < 0.001), a significant intergroup difference, and the AA group had better sleep quality than the SA group during and at the end of the 12 sessions (< 0.001). A high magnitude of the effect of auricular acupuncture on sleep quality was found at the end of the sessions (D= -1.94). Conclusion: The auricular acupuncture intervention proved to be effective in improving the subjective sleep classification of renal patients.

Multi-level exploration of auricular acupuncture: from traditional Chinese medicine theory to modern medical application.

As medical research advances and technology rapidly develops, auricular acupuncture has emerged as a point of growing interest. This paper delves into the intricate anatomy of auricular points, their significance and therapeutic principles in traditional Chinese medicine (TCM), and the underlying mechanisms of auricular acupuncture in contemporary medicine. The aim is to delve deeply into this ancient and mysterious medical tradition, unveiling its multi-layered mysteries in the field of neurostimulation. The anatomical structure of auricular points is complex and delicate, and their unique neurovascular network grants them a special status in neurostimulation therapy. Through exploration of these anatomical features, we not only comprehend the position of auricular points in TCM theory but also provide a profound foundation for their modern medical applications. Through systematic review, we synthesize insights from traditional Chinese medical theory for modern medical research. Building upon anatomical and classical theoretical foundations, we focus on the mechanisms of auricular acupuncture as a unique neurostimulation therapy. This field encompasses neuroregulation, pain management, psychological wellbeing, metabolic disorders, and immune modulation. The latest clinical research not only confirms the efficacy of auricular stimulation in alleviating pain symptoms and modulating metabolic diseases at the endocrine level but also underscores its potential role in regulating patients' psychological wellbeing. This article aims to promote a comprehensive understanding of auricular acupuncture by demonstrating its diverse applications and providing substantial evidence to support its broader adoption in clinical practice.

Long-Term Effects of Auricular Medicine – A Key to the Future of Preventive Medicine?

Auricular medicine, based on the concept that the ear reflects the entire body, has gained recognition for treating various conditions through targeted acupuncture. Despite documented short-term benefits, such as pain relief and nervous system regulation, research into its long-term effects is limited. This editorial discusses the need for further long-term studies to explore whether regular auricular acupuncture can offer sustained health benefits and serve a preventive role. It summarizes two studies: one on auricular therapy with magnetic pearls for elderly insomnia and another on frequency-controlled ear acupuncture for COVID-19-related olfactory dysfunction. Both studies suggest potential benefits, underscoring the importance of continued research to fully understand and harness auricular medicine’s preventive and therapeutic potential.

Auricular laser acupuncture as an adjunct for parental anxietymanagement during children's surgery: Arandomized-controlled study.

Pediatric surgery is associated with high levels of anxiety for both children and parents/caregivers. To mitigate anxiety, auricular acupuncture has shown its potential in the perioperative setting. Accordingly, our team developed a wearable prototype auricular laser acupuncture system, AcuHealth V1.0, as a portable acupuncture device and conducted a proof-of-concept evaluation with parents of children undergoing surgery. The primary aim of this study was to conduct feasibility testing of the AcuHealth V1.0 system in delivering auricular laser acupuncture. Parents of children who were scheduled to undergo outpatient surgery were randomly assigned to one of three groups: authentic acupuncture (laser beams at known anxiolytic acupoints, n = 13), sham acupuncture (non-anxiolytic acupoints, n = 14), or a placebo control group (inactive laser, n = 14). Parent self-reported anxiety (0-10 numerical rating scale) was assessed at baseline, pre-intervention (once child was taken to the OR), post-intervention, and at 30 min after the intervention. Usability and acceptability data regarding the device were assessed after the intervention. Baseline data revealed no significant difference in anxiety between the three groups. Parent-reported anxiety level at 30-min post-intervention as compared to baseline in the authentic group was significantly decreased (delta mean ± std = -3.58 ± 2.07) compared to both the sham acupuncture (-1.35 ± 2.65) and placebo control group (0.54 ± 1.13). Evaluation of changes in parent-reported anxiety between groups over time using two-way repeated-measures analysis of variance (ANOVA) revealed a significant difference between the three groups (p = 0.001). Post hoc analysis with Scheffe test pairwise comparisons showed that at 30-min post-intervention compared to baseline, the authentic intervention group was significantly less anxious compared with both the sham group (p = 0.033) and the placebo control group (p = 0.001). Additionally, feedback regarding the usage of the device supported the acceptability and usability of the device with no adverse events. This pilot study administering laser auricular acupuncture via the AcuHealth V1.0 system decreased parental anxiety after 30 min in parents who received treatment immediately after their children were taken to the operating room with no adverse effect.

Immediate efficacy of auricular acupuncture combined with active exercise in the treatment of acute lumbar sprains in 10 minutes: Protocol of a randomized controlled trial.

Acute lumbar sprain (ALS) is common musculoskeletal disorder characterized by severe low back pain and activity limitation, which significantly impacts the patient's work and life. Immediate relief of pain and restoration of mobility in a short period of time are the main needs of patients when they visit the clinic. This study aims to evaluate the immediate efficacy of this combined treatment for ALS within 10 minutes. This is a single-center, prospective, randomized clinical trial. 128 eligible patients with ALS will be randomly allocated in a 1:1 ratio to either the auricular acupuncture (AA) group or the sham auricular acupuncture (SAA) group. All patients will receive a single 10-minute treatment. The primary outcome will be the change in pain intensity after 10 minutes of treatment. The secondary outcomes include changes in pain intensity at other time points (2, 5 minutes), changes in lumbar range of motion (ROM) at different time points, blinded assessment, treatment effect expectancy scale evaluation, and treatment satisfaction scale evaluation. All participants will be included in the analysis according to the intention-to-treat principle. This is the first randomized controlled trial to assess the immediate efficacy of AA combined with active exercise for ALS. The findings of this study are expected to provide a simple and rapid treatment for ALS in clinical. Chinese Clinical Trial Registry ChiCTR2400083740. Registered 30 April 2024.

The Use of Complementary and Integrative Medicine in Combination With Pharmacological Antiemetics to Address Chemotherapy-Induced Nausea and Vomiting in Pediatric Oncology: A Scoping Review.

Background: Chemotherapy is a common treatment in childhood cancer but causes significant side effects, among the most notable being nausea and vomiting, known as chemotherapy-induced nausea and vomiting (CINV). Pharmacological antiemetics and complementary and integrative medicine (CIM) have been studied separately to manage CINV, but a gap exists in understanding their use together. We aimed to investigate the potential multimodal effects of CIM and pharmacological antiemetics on CINV in pediatric oncology patients undergoing chemotherapy. Method: Systematic searches were conducted in four databases to identify studies evaluating the efficacy of CIM in combination with pharmacological antiemetics in patients ages 0-21 with cancer undergoing chemotherapy. Relevant data were extracted from each study and evaluated. Results: Eighteen sources examining CIM therapies in three distinct categories (herbal, physical, and psychological) were identified. Three of four herbal interventions yielded significant results, all of which implemented oral ginger. Physical interventions included manual and wristband acupressure, auricular acupuncture, and needle and laser acupuncture. Significant results were found in only four of these 10 studies. Among psychological interventions, two of four yielded significant results. Discussion: There is no clear evidence of benefit from CIM therapies in addition to pharmacological antiemetics to better control CINV. However, this review provides support and direction for future research to examine potential effects. Complementary therapies generally have little potential for harm, are relatively low cost, and low burden. Therefore, if there is a perceived benefit for patients and families, complementary and integrative therapies should be considered.

Acupuncture for clinical improvement of endometriosis-related pain: a systematic review and meta-analysis

BackgroundEndometriosis is a common chronic gynecological condition characterized by the presence of endometrial tissue outside the uterine cavity, leading to chronic inflammation, pelvic nodules and masses, pelvic pain, and infertility. Acupuncture has been shown to improve pain associated with endometriosis by modulating abnormal levels of prostaglandins, β-endorphins, dynorphins, electrolytes, and substance P. This review aims to evaluate the clinical efficacy of acupuncture in treating endometriosis, specifically focusing on its efficacy in relieving pain associated with endometriosis.MethodsA comprehensive search was conducted in eight databases (PubMed, EMBASE, Cochrane, Web of Science, China National Knowledge Infrastructure (CNKI), the China Biology Medicine (CBM), Wanfang, and Weipu database) to identify randomized controlled trials (RCTs) published from database inception to December 16, 2022, which investigated the use of acupuncture for endometriosis-related pain. Two researchers independently screened articles, extracted data, and assessed methodological quality using the Cochrane Collaboration’s risk of bias tool. Meta-analysis was performed using Stata statistical software.ResultsA total of 1991 articles were identified, and ultimately, 14 studies involving 793 patients (387 in the acupuncture group and 359 in the control group) were included. The control interventions in the included studies included placebo, traditional Chinese medicine (TCM), and Western medicine treatments. Meta-analysis results showed that compared to the control group, acupuncture treatment for pain associated with endometriosis demonstrated significant reductions in pain severity [SMD = − 1.10, 95% CI (− 1.45, − 0.75), P < 0.001], improved response rate [RR = 1.25, 95% CI (1.09, 1.44), P = 0.02], and decreased serum CA-125 levels [SMD = − 0.62, 95% CI (− 1.15, − 0.08), P = 0.024]. Furthermore, subgroup analysis revealed that electroacupuncture and auricular acupuncture were superior to the control group in reducing pain severity, while auricular acupuncture and warm needling showed greater clinical efficacy compared to the control group. However, there were no significant differences between electroacupuncture or fire needling and the control group in terms of pain relief. The findings suggest that acupuncture is effective in improving pain associated with endometriosis.ConclusionsIn conclusion, acupuncture is effective in alleviating dysmenorrhea and pelvic pain associated with endometriosis, reducing serum CA-125 levels, decreasing the size of nodules, improving patients’ quality of life, and lowering the recurrence rate. However, it should be noted that the current evidence is limited by the design and quality flaws of the original studies, as well as a lack of research specifically focusing on subtypes of acupuncture. Therefore, caution should be exercised when interpreting the results.

Effects of auricular stimulation on weight- and obesity-related parameters: a systematic review and meta-analysis of randomized controlled clinical trials.

Over the last three decades, the number of randomized controlled trials (RCTs) using stimulation of auricular vagal sensory nerves by means of electrical stimulation, auricular acupuncture, or acupressure to support weight loss has increased markedly. This systematic review focuses on the effects of auricular stimulation (AS) on anthropometric parameters and obesity-related blood chemistry. The following databases were searched until November 2021: MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ISI Web of Science, and Scopus Database. Data collection and analysis were conducted by two reviewers independently. Quality and risk assessment of included studies was performed using the risk of bias tool of the Cochrane Handbook, and the meta-analysis of the effect of the most frequently assessed biomarkers was conducted using the statistical software RevMan. The full texts of 1,274 studies were screened; 22 contained data on obesity-related outcomes, and 15 trials with 1,333 patients were included in the meta-analysis. The overall quality of the included trials was moderate. AS significantly reduced body mass index (BMI) (mean difference (MD) = -0.38 BMI points, 95% CI (-0.55 to -0.22), p < 0.0001), weight (MD = -0.66 kg, 95% CI (-1.12 to -0.20), p = 0.005), waist circumference (MD = -1.44 cm, 95% CI (-2.69 to -0.20), p = 0.02), leptin, insulin, and HOMA insulin resistance compared to controls. No significant reduction was found in body fat, hip circumference, ratio of waist/hip circumference, cholesterol, LDL, triglycerides, adiponectin, ghrelin, and glucose levels. The AS was safe throughout the trials, with only minor adverse reactions. The study results suggest that a reduction of weight and BMI can be achieved by AS in obese patients; however, the size of the effect does not appear to be of clinical relevance. The effects might be underestimated due to active sham trials. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021231885.

Practice and Research Progress of Auricular Massage Therapy for Insomnia in Patients with Breast Cancer

This paper discusses the practice and research progress of traditional Chinese medicine (TCM) auricular acupuncture massage therapy for insomnia in breast cancer patients. Firstly, it introduces the background and significance of insomnia in breast cancer patients, pointing out the limitations of traditional treatment methods. It then elucidates the theoretical basis of TCM auricular acupuncture massage for insomnia, including ear acupuncture theory, the association between massage and insomnia, and the treatment mechanism. Subsequently, it describes the clinical practice of TCM auricular acupuncture massage in the treatment of insomnia in breast cancer patients, including research methods, practical processes, and result analysis. Finally, it summarizes the current research progress and prospects future research directions and trends.

Clinical research progress on acupuncture for the treatment of otogenic vertigo.

Otogenic vertigo is a common disorder that affects the vestibular system, which often results in considerable discomfort and impaired daily functioning. Traditional Chinese medicine (TCM), including acupuncture and moxibustion, has been historically utilized to manage the symptoms of vertigo. However, the effectiveness and methodology of these treatments have rarely been investigated in the medical literature. This study reviews the existing literature on the point selection, method, and therapeutic effect of acupuncture and moxibustion to provide a reference for the TCM treatment of otogenic vertigo. A literature search was performed using the PubMed search engine. The terms used included otogenic vertigo, acupuncture treatment, and acupuncture point selection. A total of 34 relevant articles were retrieved from PubMed. These suggest that the clinical treatment of otogenic vertigo should consider the functions of zang-fu organs and meridians and select different acupuncture treatment methods according to syndrome differentiation based on the difference between deficiency and excess. Acupuncture and moxibustion therapy should be based on acupoint selection, considering the syndrome differentiation, supplemented with experience. The treatment of otogenic vertigo with acupuncture and moxibustion refers to the selection of appropriate acupuncture methods under the guidance of TCM theory and following the principles of syndrome, disease, and meridian differentiation. Common acupuncture methods include body acupuncture, auricular acupuncture, scalp acupuncture, acupoint injection, electroacupuncture, and moxibustion. There are many acupuncture and moxibustion acupoints selected for the treatment of otogenic vertigo. Individualized treatment according to the patient's specific condition is effective and safe, which can help to improve the patient's vertigo symptoms and cerebral blood perfusion.

Adding thread-embedding acupuncture to auricular acupuncture enhances short-term weight reduction in overweight and obesity: A double-blinded, randomized, sham-controlled trial

BackgroundAuricular acupuncture (AA) has been widely used in overweight and obesity management due to its safety and effectiveness. The combination of other acupuncture therapies with thread-embedding acupuncture (TEA) has shown enhanced effects. However, there is a lack of evidence regarding AA plus TEA for overweight and obesity. This study was conducted to address this question. MethodsA randomized placebo-controlled trial was conducted involving 66 overweight or obese participants, divided into two groups: 33 received AA plus TEA, and 33 received AA plus sham TEA over eight weeks. The primary outcome was body weight (BW) reduction. Secondary outcomes included changes in body mass index (BMI) and waist circumference (WC), hip circumference (HC), waist-hip ratio (WHR), food cravings questionnaire-trait-reduced (FCQ-Tr) and food craving visual analog scale (VAS) scores. Safety outcomes were adverse events (AEs). ResultsAfter eight weeks, BW decreased by a mean (SD) of -4.45 (1.29) kg and -2.05 (1.33) kg in the AA plus TEA and AA plus sham TEA groups, respectively (MD [95 % CI]: 2.40 [1.75; 3.05]). BMI, WC, WHR, and food craving VAS score decreased significantly more in the AA plus TEA group than in the AA plus sham TEA group. No significant differences were found in FCQ-Tr and HC between groups. Seven AEs were recorded that were mild and resolved without treatment. ConclusionThe addition of TEA to AA is a safe and effective management of overweight and obesity. Further studies should incorporate dietary and lifestyle modifications and follow-up after the intervention to assess long-term effectiveness. Trial registrationThe study protocol had been registered on ClinicalTrials.gov (NCT06091761).

Efficacy of Needling at Sympathetic Point (an Auricular Acupuncture Point) in Migraine Patients: A Randomized Controlled Study

Efficacy of Needling at Sympathetic Point (an Auricular Acupuncture Point) in Migraine Patients: A Randomized Controlled Study

An Adaptive Pragmatic Randomized Controlled Trial of Emergency Department Acupuncture for Acute Musculoskeletal Pain Management

Acute musculoskeletal pain in emergency department (ED) patients is frequently severe and challenging to treat with medications alone. The purpose of this study was to determine the feasibility, acceptability, and effectiveness of adding ED acupuncture to treat acute episodes of musculoskeletal pain in the neck, back, and extremities. In this pragmatic 2-stage adaptive open-label randomized clinical trial, Stage 1 identified whether auricular acupuncture (AA; based on the battlefield acupuncture protocol) or peripheral acupuncture (PA; needles in head, neck, and extremities only), when added to usual care was more feasible, acceptable, and efficacious in the ED. Stage 2 assessed effectiveness of the selected acupuncture intervention(s) on pain reduction compared to usual care only (UC). Licensed acupuncturists delivered AA and PA. They saw and evaluated but did not deliver acupuncture to the UC group as an attention control. All participants received UC from blinded ED providers. Primary outcome was 1-hour change in 11-point pain numeric rating scale. Stage 1 interim analysis found both acupuncture styles similar, so Stage 2 continued all 3 treatment arms. Among 236 participants randomized, demographics and baseline pain were comparable across groups. When compared to UC alone, reduction in pain was 1.6 (95% confidence interval [CI]: 0.7 to 2.6) points greater for AA+UC and 1.2 (95% CI: 0.3 to 2.1) points greater for PA+UC patients. Participants in both treatment arms reported high satisfaction with acupuncture. ED acupuncture is feasible and acceptable and can reduce acute musculoskeletal pain better than UC alone.

Adapting and Evaluating a Theory-Driven, Non-Pharmacological Intervention to Self-Manage Pain.

The existing literature has limited detail on theory-driven interventions, particularly in pain studies. We adapted Bandura's self-efficacy framework toward a theory-driven, non-pharmacological intervention using auricular point acupressure (APA) and evaluated participants' perceptions of this intervention on their pain self-management. APA is a non-invasive modality based on auricular acupuncture principles. We mapped our study intervention components according to Bandura's key sources of self-efficacy (performance accomplishments, vicarious experience, verbal persuasion, and emotional arousal) to facilitate the self-management of pain. Through a qualitative study design, we conducted virtual interviews at one and three months after a 4-week APA intervention among 23 participants using purposive sampling to describe their experiences in managing their pain based on our theory-driven APA intervention. Using thematic analyses, we found four themes: the enhanced self-management of pain, improved pain outcomes, the feasibility of technology, and the sustainability of APA. Describing how interventions are mapped according to the elements of theoretical frameworks can help to guide intervention development, advance science and knowledge development, and promote the implementation of interventions. As such, using Bandura's self-efficacy theory as a foundation for the APA intervention, APA was found to be feasible and sustainable, improving self-management, pain intensity, and pain-related outcomes. Participants provided recommendations for the further improvement of this theory-driven intervention.

Energy Alterations in Patients with Chronic Headaches and How Can We Treat This Condition Without Using Pain Killers?

Introduction: A chronic headache condition occurs when a person has fifteen or more headaches per month. The purpose of this study is to demonstrate that patients with chronic headaches have an energy deficiency inside the five internal massive organs (Liver, Heart, Spleen, Lungs and Kidneys) according to the Five Elements theory of traditional Chinese medicine, and the procedure for this condition involves treating the cause of the chronic headache formation and not just treating the symptoms. Methods: A study was done through the examination of two case reports of patients with frequent daily episodes of headaches who had been seen by neurologists and had been using medication to reduce their pain without any improvement. These two patients were submitted to the measurement of their energy within their five internal massive organs using the radiesthesia procedure. Results: All organs were found to be at their lowest level of energy with a rating of one out of a scale of eight. The treatment of this condition where it was necessary to replenish and rebalance the internal energy consisted of using Chinese dietary counseling, auricular acupuncture with apex ear bloodletting, systemic acupuncture, crystal-based medication and, also highly diluted medication following the theory of Constitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine. All of these were important in the treatment of their headache condition without the use of painkillers. Both patients saw an improvement in their headache symptoms without the need for painkillers.The Conclusion of this study hopes to show that patients with headaches have energy deficiencies inside their five internal massive organs as pertaining to the Five Elements theory (Liver, Heart, Spleen, Lungs and Kidneys), and the treatment of this condition of rebalancing the internal energy using Chinese dietary counseling, auricular acupuncture with apex ear bloodletting, systemic acupuncture and replenishing the internal energy using highly diluted medications according to the theory of Constitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine as well as crystal-based medication can all reduce or even cure headache symptoms without the use of painkiller medication.

A Possible Correlation Between Auricular Angiomas and Breast Cancer Through Auricular Acupuncture Diagnosis: An Observational Case-Control Study.

Introduction Auricular acupuncture (AA) can be used for both diagnosis and therapy. Diagnosis done with AA has become more prominent, with inspection by evaluating skin alterations considered the most important step. Literature on AA diagnosis in cancer patients is scarce. Globally, breast cancer (BC) is the most commonly diagnosed cancer in women. Materials and methods Subjects accessing the outpatient Breast Unit Clinic of Padua for BC were evaluated for auricle angiomas, with collected data including a number of angiomas, Romoli's Sectogram sector of identified angiomas, laterality of the auricle with the angioma, age, and laterality of BC. Results Of the 438 subjects evaluated, 129 had BC, and 64 had an identifiable auricle angioma. The odds of an auricular angioma were higher in subjects with BC diagnosis, mainly localized in tumor area II and predominantly ipsilateral to the side affected by BC. Conclusions AA auricle inspection is a simple, quick, and easy diagnostic tool. Screening for the presence and location of auricular angiomas may help health practitioners refer women for BC screening for early diagnosis.

Auricular acupuncture plays a neuroprotective role in 6-hydroxydopamine-induced Parkinson's disease in rats

BackgroundParkinson's disease (PD) is the second-most common neurodegenerative disease. Currently, PD treatment is symptomatic and involves the use of dopamine-based therapies. This study investigated auricular acupuncture on motor and cognitive abilities in rats with 6-OHDA-induced PD. MethodsA PD rat model was established by bilaterally injecting 6-OHDA into the lateral dorsal striatum. Then, 2- or 15-Hz auricular electroacupuncture (EA) was applied to the auricular CO15 and CO12 points bilaterally for 20 min three times a week for four consecutive weeks. ResultsBoth the latency to fall and rest time of the open field test in the EA15 group were greater than in the 6-OHDA group (p < 0.001 and p < 0.05). The time spent on the two-object recognition task was greater in the EA15 group and EA2 group than in the 6-OHDA group (p < 0.01 and p < 0.05). More tyrosine hydroxylase (TH)-positive neurons and fibers were noted in the dorsolateral striatum and substantia nigra (SN) (all p < 0.05). TH expression in the SN was greater in the EA15 group than that in the 6-OHDA group (p < 0.05), while α-synuclein expression in the SN was stronger in the 6-OHDA group than in the EA15 group (p < 0.05). The l-DOPA level in the striatum was higher in the EA15 group than in the 6-OHDA group (p < 0.05). ConclusionAccording to the results, rats with 6-OHDA-induced PD may benefit from auricular EA in terms of motor and cognitive behavior as well as neuroprotection.

Stepped Care for Patients to Optimize Whole Recovery (SC-POWR): An Effectiveness Trial Evaluating a Stepped Care Model for Individuals With Opioid Use Disorder and Chronic Pain.

Many patients who receive treatment for opioid use disorder (OUD) report experiencing chronic pain (CP), which is associated with high levels of ongoing nonmedical opioid use and low retention in OUD treatment. In pilot studies of patients with OUD receiving buprenorphine or methadone who had CP, cognitive behavioral therapy (CBT) attenuated nonmedical opioid use compared with treatment-as-usual (TAU), but patients in both treatment arms exhibited similar pain improvements. Adding exercise and stress reduction to this model may augment pain-related outcomes. With funding from National Institutes of Health, we plan to conduct a randomized clinical trial of 316 patients with OUD and CP to test the effectiveness of TAU compared with Stepped Care for Patients to Optimize Whole Recovery (SC-POWR) to reduce nonmedical opioid use and pain (primary outcomes) (Aim 1) and decrease pain intensity and interference, alcohol use, anxiety, depression and stress, and improve sleep (secondary outcomes) (Aim 2). Eligible participants will be randomized to receive TAU (buprenorphine or methadone and at least once a month individual or group counseling) or SC-POWR (ie, TAU and up to 12 CBT sessions) for 24 weeks. Based on prespecified nonresponse criteria, SC-POWR may be stepped up at week 6 to receive onsite weekly group sessions of exercise (Wii Fit, Tai Chi) and "stepped up" again at week 15 to receive weekly group sessions of stress reduction (relaxation training, auricular acupuncture). They will be followed for another 24 weeks to evaluate durability of treatment response for illicit opioid use, alcohol use, pain, anxiety, depression, stress, sleep, and retention in medications for OUD (Aim 3).