Electroacupuncture Therapy Research Articles

BackgroundCognitive impairment is highly prevalent in people with diabetes. Electroacupuncture improves diabetes-associated cognitive impairment (DACI), but its regulatory mechanism remains unclear.MethodsThe DACI model was established in rats via high-fat diet combined with low-dose intraperitoneal streptozocin. The acupuncture points Yishu (EX-B3), Zusanli (ST36), and Neiting (ST44) were chosen for electroacupuncture therapy. Cognitive function was assessed by Morris water maze test. Staining with hematoxylin and eosin was used to find the pathological changes in the hippocampus. The expression levels of relative proteins were analyzed by Western blot and immunofluorescence. In addition, ELISA was used to measure the levels of lactate and pyruvate in the hippocampus.ResultsElectroacupuncture can improve the learning and memory ability of DACI model rats (P<0.01) and hippocampal morphology; electroacupuncture can significantly increase the phosphorylated protein ratios of P-insulin receptor substrates 1 (P-IRS1)/IRS1, P-phosphoinositide 3-kinase (P-PI3K)/PI3K, and P-protein kinase B (P-AKT)/AKT (P < 0.001) and mean fluorescence intensity of P-IRS1, P-PI3K, and P-AKT (P < 0.01); electroacupuncture can promote the expression of glucose transporters (GLUTs) (P < 0.01) and monocarboxylic transporters (MCTs) (P < 0.01) and improves the contents of pyruvate and lactate in the hippocampus of DACI model rats (P < 0.01); Signaling pathway inhibitor LY294002 attenuated the above improvement (P < 0.05).ConclusionElectroacupuncture’s mechanism may be involved in activating the IRS1/PI3K/AKT pathway, promoting the expression of GLUTs and MCTs, and regulating hippocampal energy metabolism.

Rationale:Facial numbness typically arises from disorders affecting the facial or trigeminal nerves, yet chemotherapy-induced facial numbness is exceedingly rare. Herein, we present a CARE-compliant case of a patient with oxaliplatin-induced facial numbness who experienced symptom improvement following electroacupuncture (EA) treatment.Patient concerns:A 73-year-old patient with rectal cancer developed severe bilateral facial numbness, affecting the periorbital, perinasal, and perioral regions after oxaliplatin-based chemotherapy.Diagnoses:The patient was diagnosed with facial numbness secondary to oxaliplatin-induced peripheral neuropathy.Interventions:The patient was treated with EA therapy to improve facial numbness symptoms.Outcomes:After 3 EA sessions, the patient’s facial numbness improved significantly; a subsequent 3-session course resulted in complete resolution of symptoms.Lessons:The case suggests that EA may serve as an effective alternative treatment for chemotherapy-induced facial numbness.

Neuropathic pain (NP) affects mental health and social functioning of people. Electroacupuncture (EA) has been shown to be effective in relieving NP in clinical practice, but the specific mechanism is still unclear. In our study, we aimed to explore the mechanism of how EA relieving NP by chronic constriction injury (CCI) rat model. EA treatment was performed at acupoints Zusanli (ST36) and Yanglingquan (GB34) after CCI 1 week and after AAV dorsal root ganglion (DRG) injection 3 weeks. EA was performed 30 minutes per day for 7 days. The paw withdrawal threshold (PWT) and paw withdrawal latency (PWL) were checked. The expressions of DNA Methyltransferase 3 Alpha (DNMT3a), Mu opioid receptors (MOR), pain-related signals (Fos, ERK1/2, and pERK1/2) and glial cell activity-related factors (CD11b, Iba1, and GFAP) in spinal cord dorsal horn (SCDH) and DRG were detected by western blotting, quantitative polymerase chain reaction reverse transcription (RT-qPCR). The expressions of DNMT3a and MOR in SCDH and DRG were also observed by immunofluorescence experiments. Our results revealed that CCI increased DNMT3a and decreased MOR expressions in DRG, which could be reversed by EA. EA at Unilateral acupoints Zusanli (ST36) and Yanglingquan (GB34) increased the PWT as well as PWL of the hind paw of CCI rats by down-regulating the expression of pain-related signals (Fos, ERK1/2, and pERK1/2) and glial cell activity-related factors (CD11b, Iba1, and GFAP) in SCDH as well as DRG. EA therapy could produce favorable analgesic results in individuals who experienced pain sensitivity arising from peripheral nerve injury. EA may improve analgesia by increasing MOR expression through the inhibition of DNMT3a in DRG.

The mechanism of electroacupuncture treatment for post-stroke spasticity: A systematic review and Meta-analysis.

BackgroundBone cancer pain is a common complication of advanced malignant tumors.Chemotherapeutic drugs, regardless of their origin or type, are often associated with various adverse effects such as gastrointestinal toxicity, immune suppression, and acquired drug resistance, which can compromise patients’ quality of life and treatment compliance. Electroacupuncture, known for its safety and analgesic effects, has been increasingly studied in bone cancer pain but the underlying mechanism is not fully understood.ObjectiveTo explore the mechanism of electroacupuncture in rats with bone cancer pain.MethodsForty-eight SD rats were divided into four groups: blank control, sham electroacupuncture, electroacupuncture-1, and electroacupuncture-2, with 12 rats in each group. Except the control group, rats were inoculated with cancer cells in the left tibia to induce bone cancer pain. The electroacupuncture groups received interventions starting on the 6th day after modeling. Mechanical pain sensitivity (PWT) and thermal pain sensitivity (PWL) were assessed, and the expression of phosphorylated glycogen synthase kinase-3 (p-GSK-3) and glial fibrillary acidic protein (GFAP) in the spinal cord were analyzed. HE staining was used to observe tibial pathological changes.ResultsFrom the 6th day, PWT and PWL were significantly reduced in the control group compared to the sham group (P < 0.05). Electroacupuncture-1 significantly increased PWT and PWL compared to the sham group (P < 0.05), while no significant changes were observed in electroacupuncture-2 compared to the control. On day 12, spinal p-GSK-3 levels were significantly lower and GFAP levels significantly higher in the model and control groups compared to the electroacupuncture-1 group (P < 0.05). The electroacupuncture-2 group showed no significant changes. Inflammatory cytokines IL-1, IL-6, and TNF-α were significantly elevated in the model group compared to the control (P < 0.05), but significantly reduced in the electroacupuncture-1 group (P < 0.05). HE staining showed cancer cell infiltration and bone tissue damage in the sham and electroacupuncture groups.ConclusionElectroacupuncture significantly reduced the pain threshold in rats with bone cancer pain. This effect is likely due to the down-regulation of GSK-3 activity, inhibition of astrocyte activation, and reduction in inflammatory responses.

Effectiveness of Fu's subcutaneous needling on pain and physical function in patients with knee osteoarthritis: A systematic review and meta-analysis.

To observe the effects of electroacupuncture (EA) on olfactory function, olfactory epithelial cell apoptosis, olfactory marker protein (OMP), cysteinyl aspartate-specific protease-3 (Caspase-3), and the expression of inflammatory factors in rats with allergic rhinitis (AR)-induced olfactory dysfunction, so as to explore the underlying mechanism by which EA improves olfactory function in AR-induced olfactory dysfunction. SD rats were randomly divided into control, model and EA groups, with 8 rats in each group. AR-induced olfactory dysfunction rats model was established using ovalbumin sensitization. Bilateral "Yingxiang" (LI20) acupoints were stimulated with EA (2 Hz/15 Hz, 1 mA) for 10 min, once daily for 14 days. After the intervention, AR symptom scores of each group of rats were evaluated. Olfactory function was assessed using the buried food pellet test. HE staining was performed to observe the morphological changes in olfactory mucosa tissue. ELISA was used to detect plasma IgE, interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) contents in plasma and nasal lavage fluid. Immunofluorescence staining was used to detect OMP and Caspase-3 positive expressions in olfactory mucosa. TUNEL staining was performed to detect olfactory epithelial cell apoptosis condition. Compared with the control group, rats in the model group showed significantly thinner olfactory mucosal epithelium, reduced number and disorganized arrangement of olfactory receptor neurons (ORNs), increased inflammatory cell infiltration, significantly decreased olfactory function, significantly decreased OMP expression in olfactory mucosa (P<0.01), significantly increased nasal symptom scores, plasma IgE contents, IL-1β and TNF-α contents in plasma and nasal lavage fluid, significantly increased Caspase-3 expression in olfactory mucosa (P<0.01), and significantly increased occurrence of olfactory epithelial cell apoptosis (P<0.01). Compared with the model group, rats in the EA group showed significantly thicker olfactory mucosal epithelium, increased number and more orderly arrangement of ORNs, reduced inflammatory cell infiltration, significantly improved olfactory function, significantly increased OMP expression in olfactory mucosa (P<0.01, P<0.05), significantly decreased nasal symptom scores, plasma IgE contents, IL-1β and TNF-α contents in plasma and nasal lavage fluid (P<0.05, P<0.01), significantly decreased Caspase-3 expression in olfactory mucosa (P<0.01), and significantly decreased occurrences of olfactory epithelial cell apoptosis (P<0.01). EA therapy can improve olfactory function of olfactory-malfunctioned AR rat. The mechanism could be inhibition of the AR-induced damage of inflammatory cytokines to olfactory epithelium and neurons.

To explore the effects of electroacupuncture (EA) on pregnancy outcomes after assisted reproduction and mitochondrial function of granulosa cells (GCs) in patients with polycystic ovary syndrome (PCOS) and phlegm-dampness syndrome. In this randomized controlled trial, 90 infertile women with PCOS and phlegm-dampness syndrome were recruited between August 2022 and December 2022. Patients were randomly assigned to the EA and control groups using a random sequence of codes in the order of enrolment, with 45 in in each group. Both groups underwent the ovarian stimulation protocol. The patients in the EA group received EA therapy including Zhongwan (CV 12), Qihai (CV 6), bilateral Xuehai (SP 10), Sanyinjiao (SP 6), Yinlingquan (SP 9), Tianshu (ST 25), Zusanli (ST 36), and Fenglong (ST 40), and the patients in the control group was treated with pseudo-acupuncture. The intervention was 25 min twice a week for a total of 6 times until the trigger day after menstruation had ended in the cycle before oocyte retrieval. The primary outcomes were clinical pregnancy rate (CPR) and the number of high-quality embryos. The secondary outcomes were (1) pregnancy-related indicators, including fresh embryo transfer rate (ETR), ovarian hyperstimulation syndrome (OHSS) rate, early pregnancy loss rate (ePLR), ectopic pregnancy rate, live birth rate (LBR), and cumulative CPR; (2) mitochondrial autophagy and mitochondrial membrane potential (MMP) in GCs; and (3) scoring for Chinese medicine syndrome. Adverse events to assess clinical safety were also monitored. The cumulative CPR was significantly higher in the EA group (42/45, 93.3%) than in the control group (38/45, 84.4%, P=0.036). The number of high-quality embryos and fresh ETR in the EA group were higher than those in the control group (3.80±1.65 vs. 2.44±1.34, P<0.001; 46.7% vs 24.4%, P=0.028). Ectopic pregnancies were not observed in either group. There were no significant differences in the fresh CPR, OHSS rate, ePLR or LBR between the two groups (P>0.05). Compared with the control group, the EA group showed lower expression levels of miR-146a-5p mRNA and P62 protein in GCs and higher levels of MMP and the LC3-II/LC3-I protein ratio (all P<0.01). The phlegm-dampness syndrome scores of the EA group were significantly lower than those of the control group (P<0.01). EA significantly improved pregnancy outcomes in patients with PCOS and phlegm dampness syndrome. Mechanistically, this effect may be related to EA in decreasing miR-146a-5p mRNA expression, promoting mitochondrial autophagy in GCs, and improving mitochondrial function, which may contribute to improved oocyte quality. (Trial registration No. ChiCTR2200062915).

Insomnia, a common complication following stroke, significantly impairs patients' clinical outcomes. Electroacupuncture (EA), an advanced acupuncture technique, has demonstrated efficacy in alleviating insomnia symptoms. Agomelatine (AT), a melatonin receptor agonist, is widely utilized for depression management. This study aimed to evaluate the therapeutic effects of combined EA + AT therapy for post-stroke insomnia. A total of 120 stroke-related insomnia patients were randomly assigned to three intervention groups (n = 40 each): EA therapy, AT treatment, and EA + AT combination therapy. Sleep efficiency and cognitive function were comprehensively assessed using the Cardiopulmonary Coupling-based sleep quality evaluation system, Montreal Cognitive Assessment (MoCA), and National Institutes of Health Stroke Scale (NIHSS). The results revealed that all three interventions significantly enhanced sleep efficiency (EA: 78.23 ± 4.19; AT: 75, 5; EA + AT: 80.97 ± 4.21) and MoCA scores (EA: 24, 2; AT: 24, 2; EA + AT: 27, 2), with the combination therapy showing superior effectiveness. Similarly, NIHSS scores exhibited marked reduction across all treatment groups (EA: 6, 2; AT: 7, 2), particularly in the EA + AT combination cohort (EA + AT: 4, 3). Notably, post-treatment analysis revealed significant positive correlations between sleep efficiency and MoCA scores in all groups, with the strongest correlation observed in the AT group (r = 0.87). These findings demonstrate that EA + AT combination therapy outperforms monotherapies in treating post-stroke insomnia. In conclusion, this study establishes EA + AT as an effective intervention for improving both sleep quality and cognitive function in stroke-related insomnia patients, offering a promising therapeutic strategy for this clinical condition.

Background:Ischemic stroke (IS) is a common disease that can cause cognitive dysfunction. Electroacupuncture (EA) is an effective way to alleviate cognitive dysfunction, but its molecular regulatory mechanism is still unclear. Long noncoding RNA-MEG3 (MEG3) is an important factor in the incidence and progression of IS. Herein, we explored the mechanism of EA in IS.Methods:A middle cerebral artery occlusion (MCAO) model was established in Sprague-Dawley rats to simulate IS in vivo, followed by electroacupuncture (EA) therapy. AAV-control and AAV-MEG3 were injected into the lateral ventricle of rats. All rats except for the sham group underwent MCAO. EA was performed at Shenting and Baihui points for 30 min, once a day for 14 days. The MEG3 and miR-4640-3p levels in brains were measured by qRT-PCR. Dual-luciferase reporter analysis validated the relationship between MEG3 and miR-4640-3p. The Morris water maze test and the neurological function test were carried out. The pathological morphology of the brain tissue was evaluated by H&E staining. Apoptotic cells in brains were examined utilizing TUNEL staining. The contents of Bax, Bcl-2, caspase-3, and CytC were assessed by western blot.Results:EA treatment reduced the content of MEG3 but enhanced miR-4640-3p levels in MCAO rats. MEG3 was a sponge for miR-4640-3p. EA treatment alleviated cognitive dysfunction in MCAO rats by inhibiting MEG3. EA treatment reduced MCAO-induced neural damage and apoptosis by inhibiting MEG3.Conclusion:EA improved cognitive dysfunction in IS rats by adjusting the MEG3/miR-4640-3p axis, suggesting that EA may be an effective potential therapeutic strategy for improvement of cognitive dysfunction in IS. This study provided a more reliable experimental basis for clinical EA treatment of IS patients.

Pulmonary hypertension (PH) is the most prevalent cardiovascular complication of chronic obstructive pulmonary disease (COPD). Dyspnea is the most prevalent and distressing symptom in Pulmonary Hypertension Associated with COPD (PH-COPD) patients. This study elucidates the operational details of electroacupuncture therapy, encompassing instrument preparation, acupuncture point selection, procedure, precautions, and emergency handling. By assessing with the Modified Medical Research Council Dyspnea Scale (mMRC), the 6-Minute Walk Test (6MWT), the Modified Borg Scale, the UCSD Shortness of Breath Questionnaire (UCSD-SOBQ), and the oxygen partial pressure in arterial blood (PaO2), the efficacy and safety of electroacupuncture as a supplementary intervention for dyspnea in patient with PH-COPD were explored. An exploratory randomized controlled study was conducted on 14 patients, with the electroacupuncture group receiving both conventional therapy and electroacupuncture treatment, and the control group receiving only conventional therapy. After 2 weeks, dyspnea improved in both groups, with the electroacupuncture group showing superior results. No serious adverse reactions occurred in either group. The study indicates that electroacupuncture can effectively alleviate dyspnea in PH-COPD patients, enhance their quality of life, and is simple, safe to operate, and worthy of further investigation and promotion, offering an effective adjunct therapy for PH-COPD.

ABSTRACTBackgroundPost‐stroke cognitive impairment (PSCI) is a common complication following stroke, with limited effective treatments. This randomized controlled trial aims to evaluate the efficacy of two non‐pharmacological interventions—electroacupuncture therapy (EA) and herbal olfactory therapy (HOT)—in improving cognitive function in PSCI patients, both as standalone treatments and in combination.MethodsThis parallel‐group, assessor‐blinded, randomized controlled trial will recruit 210 PSCI patients, randomly assigned to one of six groups: control, EA, HOT, combination therapy, sham therapy, or the healthy (ratio 1:1:1:1:1:1). All participants will receive standard cognitive training and basic medical care. The EA group will receive 4 weeks of electro‐acupuncture at specific acupoints. The HOT group will receive 4 weeks of aromatic inhalation therapy using Acorus tatarinowii volatile oil. The combination group will receive both interventions. The primary outcome measure is cognitive function, assessed using the Montreal cognitive assessment (MoCA) at baseline, week 4, and week 8. Secondary outcomes include the mini‐mental state examination (MMSE), functional magnetic resonance imaging (fMRI), near‐infrared spectroscopy (fNIRS), and anxiety assessment using the state‐trait anxiety inventory (STAI) at baseline and week 4. Data analysis will be conducted using a modified intention‐to‐treat approach.AimsThis study aims to evaluate the clinical efficacy of EA at cervical acupoints combined with HOT for PSCI, with a specific focus on determining the therapeutic superiority of this combined approach over monotherapy interventions.

The chemotherapy agent Utidelone (UTD1), as a novel option for drug-resistant breast cancer patients, is prone to cause severe neurotoxicity. This study aims to evaluate the clinical effects of electroacupuncture (EA) and Mecobalamin (MeCbl) in treating Utidelone-induced peripheral neuropathy (UIPN), providing preliminary evidence to optimize clinical management strategies. A total of 60 eligible breast cancer patients with UIPN were randomly assigned in a 1:1 ratio to either the EA group or the MeCbl group. Evaluations were conducted after 4weeks of treatment and again following a 4-week follow-up period (week 8). The primary outcome was the overall response rate of the Patient Neurotoxicity Questionnaire (PNQ), which was defined as a reduction of at least one grade in PNQ sensory or motor symptoms at week 4 compared to baseline. Secondary outcomes included the PNQ sensory, PNQ motor, and NCI-CTCAE grades, the EORTC QLQ-CIPN20 and QLQ-C30 scales. 28 of 30 participants in the EA group and 29 of 30 participants in the MeCbl group completed the study. The responder rate of PNQ overall in the EA group was significantly higher than that in the MeCbl group at week 4 (P=0.015) and at week 8 (P=0.01). EA group exhibited significant improvements in PNQ sensory, PNQ motor, and NCI-CTCAE grades compared to baseline at week 4 (all P<0.05). EA treatment also demonstrated the ability to alleviate UIPN symptoms and improve the quality of life in several aspects, as indicated by the EORTC QLQ-CIPN20 and QLQ-C30 scales. There were no serious treatment-related adverse events in either group. This randomized clinical trial indicated that EA therapy showed a potential benefit to alleviate symptoms of UIPN in breast cancer patients. Nevertheless, further research involving larger sample sizes and extended follow-up periods is warranted to elucidate these effects. No. ChiCTR2200062741.

Electroacupuncture (EA) has been reported to improve post-stroke dysphagia (PSD) effectively. However, the underlying afferent neural circuit and neurological mechanism involved in improving PSD remain poorly understood. A PSD mouse model was established via the photochemical embolization method. Laser scatter contrast imaging was used to evaluate blood perfusion. Videofluoroscopic swallowing study, flexible endoscopic evaluation swallowing, and electromyography were used to assess the swallowing function. Neuronal activities and neuron types were detected by immunofluorescence. Synaptic connections between the nucleus tractus solitarii (NTS), the ventral posteromedial thalamic nucleus (VPM), and the primary sensory cortex (S1) were verified by neural tracing. Finally, photogenetic, chemogenetic, and invivo electromyography or electrophysiological records were used to explore the possible afferent neural circuits of EA therapy for PSD. EA treatment potentiated the blood perfusion of CV23 and S1, improved the area under the curve, pharyngeal transit time, and vocal fold mobility in PSD model mice. EA also activated neuronal activities in VPM, while chemical genetic inhibition of VPM attenuated the swallowing function of EA enhanced in PSD mice. Neural tracing revealed the presence of direct synaptic connections in the neural circuit of NTS-VPM-S1, and excitatory neurons were the predominant type of synaptic projection. Activation of this circuit improved the swallowing function in PSD mice, whereas its inhibition impaired the swallowing function; this effect was reversible by EA-CV23. Our findings uncover the importance of sensory afferent neural circuits NTS-VPM-S1 in driving the protective effect of EA-CV23 against dysphagia and thus reveal a potential strategy for PSD intervention.

Diplopia (DP) can have a significant negative impact on one's quality of life, many clinical investigations lend credence to the notion that acupuncture could be used to treat DP symptoms, randomized controlled trials are lacking, and only clinical observational studies have assessed the effectiveness of acupuncture in managing DP. To examine the influence of electro-acupuncture on diplopia in patients with oculomotor and abducens nerve palsy. Forty eyes diagnosed with diplopia were randomly classified into study group (A) that received electro acupuncture therapy and standard prophylactic medications for 4weeks at points selected for treating double vision, and control group (B) who received standard prophylactic medications only. The Hess screen test was used to measure degrees of deviation. There were statistically significant differences in the post-test (p=0.38 and 0.003 respectively) in favor of the study group. In conclusion, integration between acupuncture therapies and standard prophylactic medications yields better results in treating DP.

The use of external therapies for knee osteoarthritis (KOA) in traditional Chinese medicine (TCM) is supported by several guidelines and systematic reviews. However, the relative advantages and disadvantages of TCM external therapies and their mechanisms of action have not yet been confirmed in evidence-based medicine. We used network meta-analysis to rank the effectiveness and safety of TCM external therapies, screen the optimal TCM external therapies. TCM external therapies for KOA published before October 2024 were comprehensively retrieved from eight electronic databases. Using the Cochrane Reviewers' Handbook, two independent reviewers performed study selection, data extraction, and bias assessment of the included randomized controlled trials (RCTs). Data analysis was conducted using Stata 16.0 and RevMan 5.4 software. A total of 68 RCTs were identified, including 6571 participants, involving 11 interventions, 4.41% of which showed a high risk of bias. The results of the network meta-analysis revealed that in terms of improving Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function scores, each external therapy was better than conventional medicine. Electroacupuncture may be the most effective intervention in improving the VAS score and TNF-α level. Moxibustion resulted in the greatest improvement in WOMAC function and IL-6 levels. The most effective interventions for reducing WOMAC pain scores were the manual needle knife, followed by electroacupuncture and Tuina therapy (SUCRA = 82.9%, 79.0%, and 71.4%, respectively). Warming acupuncture dominantly increased Lysholm scores. The safety results showed that the three safest interventions were the sham intervention, Tuina therapy, and moxibustion (SUCRA = 90.6%, 83.1%, and 68.8%, respectively). Silver needle had the best comprehensive effect. Electroacupuncture has the best effect on improving pain symptoms, and moxibustion can be prioritized when functional limitations are the main symptoms. To some extent, the changes in inflammatory factors correlated with an improvement in KOA symptoms.

Effectiveness and safety of acupoint embedding therapy for treating intractable facial paralysis: A systematic review and meta-analysis.

This paper mainly provides an overview of the brief history of ear acupoints and introduces the clinical application and brain mechanisms of auricular electroacupuncture therapy for depression. Auricular electroacupuncture is a transcutaneous auricular vagus nerve stimulation (taVNS) technique derived from traditional Chinese medicine ear acupoint theories and modern medicine’s vagus nerve theories. It uses microcurrent to stimulate visceral-related acupoints in the concha region and the subcutaneous vagus nerve, producing therapeutic effects on various brain disorders. This article focuses on the evidence-based controlled clinical trials of taVNS for mild-to-moderate depression, as well as recent functional magnetic resonance imaging (fMRI) studies that elucidate its complex brain networks.

Over the past years, a number of clinical and preclinical investigations have been documented, suggesting treatment strategies and pharmaceuticals for neuropathic pain and depressive disorders, potentially beneficial in cases where these conditions are comorbid. This review lists these potential treatment options and discusses the proposed underlying mechanisms of action and their limitations, in terms of both physiotherapy and pharmacotherapy. Physiotherapy includes electroacupuncture and repetitive transcranial magnetic stimulation therapy, both of which affect neuronal function by altering the physiological state of the neurons. Pharmacological treatments include tricyclic antidepressants, gabapentin, ketamine, minocycline, and Chinese medicine, which alter ion channel activity, affect neurotransmitter release, and exert anti-inflammatory effects. As such, this review may help to improve future research endeavors and therapeutic options for this frequently occurring comorbidity.

Post-stroke insomnia (PSI) is a common complication following stroke, which seriously affects patients' life quality. Electro-acupuncture (EA) is an innovative form of traditional Chinese acupuncture that combines electricity with needles to achieve the prevention and treatment of diseases. However, there is limited understanding regarding the treatment mechanism of EA in PSI. In our study, we aimed to investigate the role of EA on PSI development. Our study findings indicated that the quality of sleep, levels of neurotransmitters 5-hydroxytryptamine (5-HT) and gamma-aminobutyric acid (γ-GABA), and antioxidant levels showed significant improvement following EA treatment in PSI clinical samples and rat models, while the levels of pro-inflammatory factor interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-α), and astrocyte damage were notably reduced. Furthermore, it was discovered that the levels of sirtuin 1 (Sirt1) were reduced in PSI, a condition that was significantly ameliorated by EA treatment. Additionally, the inhibition of Sirt1 caused a marked elevation in astrocyte apoptosis, inflammatory response, and oxidative stress. Besides, the nuclear factor E2-related factor 2 (Nrf2)-antioxidant response element (ARE) pathway was deactivated in the PSI rat model and Sirt1-silenced cells. However, the suppressive impact was successfully counteracted by EA or estazolam (ES), and the overexpression of Nrf2 partially alleviated the increase in apoptosis, inflammation, and oxidative stress caused by Sirt1 knockdown. Taken together, these findings indicated that EA improved sleep quality and silenced Sirt1-induced apoptosis, inflammation, and oxidative stress in PSI by activating the Nrf2-ARE pathway.