Frequency Electroacupuncture Research Articles

Comparing different session regimens of electroacupuncture for chronic plantar fasciitis: study protocol for a randomized clinical trial

BackgroundPlantar fasciitis (PF) is one of the most common causes of plantar heel pain, and previous studies found that acupuncture is effective for relieving pain in patients with PF. Nevertheless, the impact of different sessions of electroacupuncture on PF has not been investigated through randomized, controlled trials. Methods/design: This is a two parallel-group, assessor-blinded, randomized controlled trial, consisting of a four-week treatment phase followed by a 12-week follow-up. Eighty patients with chronic PF will be recruited and randomly allocated to receive 12 (three sessions per week; the multiple electroacupuncture weekly treatment group (group M)) or four (one session per week; single electroacupuncture weekly treatment group (group S)) sessions of electroacupuncture treatment in a 1:1 ratio. The primary outcome to be studied is the response rate, defined as a minimum of 50% improvement in most severe pain intensity with first steps in the morning, compared with baseline. We will perform all analyses based on the intention-to-treat principle, with differences considered significant when the P value < 0.05 on a two-sided basis. DiscussionThis prospective trial will provide high-quality evidence on evaluating the efficacy and safety of different electroacupuncture sessions (one session per week versus three sessions per week) for chronic PF. This study aims to contribute in produce up-to-date, rigorous evidence on the most effective frequency of electroacupuncture in managing chronic PF.Trial registration Clinicaltrials.gov Identifier: NCT06284993. Registered on February 17, 2024.

Map activation of various brain regions using different frequencies of electroacupuncture ST36, utilizing the FosCreER strategy

Objective: Electroacupuncture (EA) is an alternative treatment option for pain. Different frequencies of EA have different pain-relieving effects; however, the central mechanism is still not well understood. Methods: The Fos2A-iCreER (TRAP):Ai9 mice were divided into three groups (sham, 2 Hz, and 100 Hz). The mice were intraperitoneally injected with 4-hydroxytamoxifen (4-OHT) immediately after EA at Zusanli (ST36) for 30 min to record the activated neurons. One week later, the mice were sacrificed, and the number of TRAP-treated neurons activated by EA in the thalamus, amygdala, cortex, and hypothalamus was determined. Results: In the cortex, 2 Hz EA activated more TRAP-treated neurons than 100 Hz EA did in the cingulate cortex area 1 (Cg1) and primary somatosensory cortex (S1), and 2 and 100 Hz EAs did not differ from sham EA. TRAP-treated neurons activated by 2 Hz EA were upregulated in the insular cortex (IC) and secondary somatosensory cortex (S2) compared with those activated by 100 Hz and sham EA. In the thalamus, the number of TRAP-treated neurons activated by 2 Hz EA was elevated in the paraventricular thalamic nucleus (PV) compared with those activated by sham EA. In the ventrolateral thalamic nucleus (VL), the number of TRAP-treated neurons activated by 2 Hz EA was significantly upregulated compared with those activated by 100 Hz EA, and sham EA showed no difference compared with 2 or 100 Hz EA. TRAP-treated neurons were more frequently activated in the ventral posterolateral thalamic nucleus (VPL) by 2 Hz EA than by 100 Hz or sham EA. Conclusions: Low-frequency EA ST36 effectively activates neurons in the Cg1, S1, S2, IC, VPL, PV, and VL. The enhanced excitability of the aforementioned nuclei induced by low-frequency EA may be related to its superior efficacy in the treatment of neuropathological pain.

Investigation into the Mechanism of ATP-Induced Senescence Treated with Hegu and Taichong Electroacupuncture

Objective: The purpose of this study was to clarify the aging mechanism of ATP injection combined with Electroacupuncture at Hegu and Taizhong points, and to provide scientific basis for subsequent clinical research. Methods: 60 rats were randomly divided into 5 groups: control group was injected with normal saline; Model group rats were injected with ATP solution; In the intervention group, the frequency of electroacupuncture was 20Hz, 30Hz and 50Hz, respectively. Electroacupuncture at Hegu Point and Taizhong point once a day for 20 minutes each time. Blood RNA was extracted by TRIzol method, and gene sequencing was performed to identify the differential genes. In addition, the "Senescence" gene data was retrieved from the NCBI gene database and intersected with the sequencing data. The core genes were analyzed by enrichment analysis, module analysis, miRNA-mRNA regulatory network analysis and PCR validation. In addition, cell cycle, apoptosis, ROS levels, and mitochondrial membrane potential were evaluated. Results: DGE analysis found 3,510 DEGs in the sequencing data, of which 3,487 up-regulated genes and 23 down-regulated genes. According to KEGG, These genes are mainly involved in the T cell receptor signaling pathway, Human T−cell leukemia virus 1 infection, Protein processing in endoplasmic reticulum and Phosphatidylinositol signaling system. The 59 common genes of aging identified by Venn diagram analysis, KEGG was mainly involved in AGE−RAGE signaling pathway in diabetic complications, Non−alcoholic fatty liver disease and FoxO signaling pathway and other pathways. Venn diagram is used to show the seven core genes identified by all four algorithms: HSPA4, CASP3, AKT1, PARP1, NFKB1, GSK3B, FOXO3. Electroacupuncture can inhibit apoptosis in ATP-induced aging treatment of rats, and significantly increase mitochondrial membrane potential. In Electro-acupuncture group, cells in G0\G1 cycle significantly increase, and ROS level significantly decrease. Conclusion: Electroacupuncture can inhibit Senescence induced by ATP injection.

Electroacupuncture stimulation enhances the permeability of the blood-brain barrier: A systematic review and meta-analysis of preclinical evidence and possible mechanisms.

An important cellular barrier to maintain the stability of the brain's internal and external environment is the blood-brain barrier (BBB). It also prevents harmful substances from entering brain tissue through blood circulation while providing protection for the central nervous system. It should be noted, however, that the intact BBB can be a barrier to the transport of most drugs into the brain via the conventional route of administration, which can prevent them from reaching effective concentrations for the treatment of disorders affecting the central nervous system. Electroacupuncture stimulation has been shown to be effective at opening the BBB in a series of experimental studies. This study systematically analyzes the possibility and mechanism by which electroacupuncture opens the BBB. In PubMed, Web of Science, VIP Database, Wanfang Database, and the Chinese National Knowledge Infrastructure, papers have been published for nearly 22 years aimed at opening the BBB and its associated structures. A comparison of EB content between electroacupuncture and control was selected as the primary outcome. There were also results on vascular endothelial growth factor (VEGF), nerve growth factor (NGF), P-Glycoprotein (P-gp), Matrix Metalloproteinase 9 (MMP-9), and glial fibrillary acidic protein (GFAP). We utilized Review Manager software analysis to analyze correlations between studies with a view to exploring the mechanisms of similarity. Evans Blue infiltration forest plot: pooled effect size of 2.04, 95% CI: 1.21 to 2.87, P < 0.01. These results indicate that electroacupuncture significantly increases EB penetration across the BBB. Most studies have reported that GFAP, MMP-9, and VEGF were upregulated after treatment. P-gp expression decreased as well. Electroacupuncture can open the BBB, and the sparse-dense wave is currently the most effective electroacupuncture frequency for opening the BBB. VEGF plays an important role in opening the BBB. It is also important to regulate the expression of MMP-9 and GFAP and inhibit the expression of P-gp.

A randomized controlled trial with a combination of low frequency electroacupuncture and cognitive behavioral therapy for short-term insomnia

ObjectiveTo explore the therapeutic effects of low frequency electroacupuncture (EA) combined with cognitive behavioral therapy (CBT) for short-term insomnia. MethodsPatients with “short-term insomnia” were randomly divided into the treatment and control groups. Patients in the treatment group were treated with low-frequency EA combined with CBT, while those in the control group were only treated with low-frequency EA. The Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), and Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS) scores in the two groups were compared before and after treatment within the same group, as well as between the two groups. After four weeks of treatment, the comprehensive therapeutic effects of both treatment modalities and the number of people who developed chronic insomnia were compared. ResultsThe differences in PSQI score, PSQI sleep rate, ISI score, and DBAS score band after treatment, within the same group and between groups were statistically significant. There was significant difference in DBAS score between the two groups before and after treatment, and in the composition ratio of comprehensive therapeutic effects between the two groups. ConclusionLow-frequency EA combined with CBT and low-frequency EA alone can significantly improve sleep cycles in patients with insomnia, reduce the sleep severity index, prevent daytime sleepiness symptoms in patients, and improve cognition in patients. Low-frequency EA combined with CBT had better therapeutic effects and improved cognition in patients, and hence can be recommended.

Electroacupuncture regulates microglial polarization via inhibiting NF-κB/COX2 pathway following traumatic brain injury

BackgroundNeuroinflammation and oxidative stress are important pathological mechanisms following traumatic brain injury (TBI). The NF-κB/COX2 pathway regulates neuroinflammation and oxidative damage, while microglia also play an important role in neuroinflammation. Since NF-κB is involved in microglial polarization, targeting this pathway and microglial polarization is a critical component of TBI treatment. Currently, electroacupuncture (EA) is widely used to treat various symptoms after TBI, but the mechanisms of EA remain poorly understood. Additionally, the optimal frequency of EA remains unclear, which affects its efficacy. This study focuses on exploring the optimal frequency parameters of EA on TBI and investigating the underlying mechanisms of EA through NF-κB/COX2 pathway and microglial polarization. MethodsThe study was divided into two parts. In Experiment 1, 42 Sprague Dawley (SD) rats were induced and randomly divided into seven groups (n = 6). Except for the sham group, all rats underwent controlled cortical impact (CCI) to establish TBI model. Four EA groups (with different frequencies) and manual acupuncture (without current stimulation) received stimulation on the acupoints of Shuigou (GV26), Fengchi (GB20) and Neiguan (PC6) once a day for 7 days. The neurological function was assessed by modified Neurological Severity Scores (mNSS), and the rats’ memory and learning were examined by the Morris water maze (MWM). SOD, MDA, and GSH-Px were detected to evaluate the levels of oxidative stress. The levels of IL-1β, IL-6, and TNF-α were evaluated by Enzyme Linked Immunosorbent Assay (ELISA). Detection of the above indicators indicated a treatment group that exerted the strongest neuroprotection against TBI, we then conducted Experiment 2 using this screened acupuncture treatment to investigate the mechanism of acupuncture. 48 rats were randomly divided into four groups (n = 12): sham, TBI model, acupuncture and PDTC (NF-κB inhibitor). Evaluations of mNSS, MWM test, SOD, MDA, GSH-Px, IL-1β, IL-6, TNF-α, and IL-10 were the same as in Experiment 1. Western blot was applied for detecting the expression levels of NF-κB, p-NF-κB, COX2, and Arg-1. TUNEL was used to examine neuronal apoptosis. Brain structure was observed by H&E. Iba-1, COX2, and Arg-1 were investigated by immunofluorescence staining. ResultsEA with frequency of 2/100 Hz markedly improved neuronal and cognitive function as compared to the other treatment groups. Moreover, it downregulated the expression of MDA, IL-6, IL-1β, and TNF-α and upregulated the levels of SOD and GSH-Px. In addition, Both EA with 2/100 Hz and PDTC reduced the levels of p-NF-κB, COX2 and M1 markers (COX2, IL-6, IL-1β, TNF-α) and increased the levels of M2 markers (Arg-1, IL-10). Moreover, they had similar effects on reducing inflammation, oxidative stress and apoptosis, and improving neuronal and cognitive function. ConclusionsThe collective findings strongly suggest that EA with 2/100 Hz can improve neurologic function by suppressing neuroinflammation, oxidative stress and apoptosis. Additionally, we confirm that EA promotes microglial polarization towards the M2 phenotype through the suppression of NF-κB/COX2 pathway, thus exerting neuroprotective effects after TBI.

Dose-effect relationship between electroacupuncture with different parameters and the regulation of endogenous opioid peptide system: 不同参数电针对内源性阿片肽系统调节的量效关系

Endogenous opioid peptides (EOP) are the neurochemical basis of the anesthetic and analgesic effects of acupuncture, and the quantity of acupuncture stimulus can be controlled accurately by using electroacupuncture (EA). The present study explores the dose-effect relationship between EA with different parameters and the regulation of EOP system. In this paper, the intervention effects of EA on EOP system were specially discussed in terms of the single factor and the different combinations of the frequency, waveform and current intensity. This study shows that EOP system presents a frequency-response specificity. The low frequency of EA promotes the release of enkephalin, β-endorphin and endomorphin, the high one activates the dynorphin system selectively, and the intermediate frequency works on promoting the release of enkephalin and β-endorphin, as well as dynorphin. Sparse-dense wave of EA may induce the release of enkephalin, β-endorphin, endomorphin and dynorphin, presenting a synergistic effect. However, the waveform of EA should be selected flexibly in clinical practice. Sometimes the better therapeutic effect can also be obtained with the continuous wave of EA. EOP system is involved in mediating appropriate intensity of EA, while the acupuncture effect generated by an extra strong EA stimulation refers to a kind of stress response of non-opioid mechanism. The different combinations of EA parameters result in various effects. The combination of EA parameters should be optimized in accordance with different diseases, which is valuable for guiding clinical practice and the development of EA therapy.

Network visual data mining and analysis of literature on electroacupuncture treatment of post-stroke sequelae

To analyze the optimum stimulating parameters and acupoint combination law of electroacupuncture (EA) treatment of post-stroke sequelae (PSS) through the network visual data mining and analysis of the literature，so as to provide reference for clinical application. The related articles of acupuncture treatment of PSS patients published from January 1, 2005 to December 31, 2021 were collected from databases of CNKI, Wanfang, Weipu（VIP), SinoMed, CHAOXING, DUXIU, PubMed, Ovid, Embase and Cochrane Library. After the articles were screened according to our formulated inclusion and exclusion criteria, a "Clinical Literature Database of EA Treatment of PSS" was established. The SPSS Modeler14.1 software was used for modeling (by using the parameters of EA, types of apoplexy sequelae, names of acupoints, methods of acupoint matching, acupoint-attributed meridians, etc.) and association rule analysis, and the Cytoscape 3.6.0 software was used for data network visualization analysis. A total of 354 articles were collected, including 13 types of PSS, among which the hemi-plegia accounts for the highest proportion (51.13%), followed by depression (17.51%) and dysphagia (14.97%). A total of 228 acupoints are used, with a total frequency-time of 1 690. Among the 8 PSS (hemiplegia, depression, dysphagia, cognitive impairment, urinary incontinence, urinary retention, speech disorders, constipation) with the frequency of application of acupoints greater than or equal to 3, 275 articles are involved, with the frequency of dense wave being the highest (123 times), followed by continuous waves (95 times). The stimulation frequency of EA appears 275 times, with the low frequency being the highest (188 times). For hemiplegia type of PSS, low frequency and continuous waves or dense waves are mostly used, and the high correlation acupoint groups are Zusanli(ST36)/Hegu(LI4), LI4/Quchi(LI11) and ST36/LI11. For depression, low frequency and dense waves are mostly used, and the high correlation acupoint groups are Baihui(GV20)/Yintang(EX-HN3), GV20/Shenting(GV24) and GV20/Neiguan(PC6). For swallowing disorder, the mostly used stimulation parameter is low frequency, and the high correlation acupoint groups are Lianquan(CV23)/ST36/Fenglong(ST40), Tongli(HT5)/Yifeng(TE17)/PC6/ST40, and TE17/HT5/PC6/LI4. EA therapy is frequently used in the treatment of PSS, for which ST36, LI4 and LI11 are most frequently used in the treatment of hemiplegia, with the stimulation parameters being low-frequency and continuous waves or dense waves. For depression, GV20, EX-HN3, GV24 and PC6 are used, with the stimulation parameters being low frequency and dense waves. For dysphagia, CV23, HT5, TE17, PC6, ST36, ST40 and LI4 are employed, with low frequency electrical stimulation.

Study of electroacupuncture with different frequencies for the treatment of headache and anxiety-depression symptoms in patients with migraine: A randomized clinical trial: 不同频率电针改善偏头痛患者头痛及焦虑抑郁症状的差异性研究-随机临床试验

: To observe the effects of electroacupuncture (EA) with varied frequencies on headache and anxiety-depression symptoms in patients with migraine and to screen optimal frequency of EA for patients with such conditions. : Single-center, randomized, controlled clinical trial was designed, and the outcome assessors and statisticians were blinded. The patients with migraine were randomized into 2 Hz EA group, 100 Hz EA group and sham-stimulation group. In each group, the changes in migraine attacks, days with headache, the scores of visual analogy scale (VAS), self-rating anxiety scale (SAS), self-rating depression scale (SDS) and migraine-specific quality-of-life questionnaire (MSQ), as well as the dosage of analgesics were observed at the baseline, during treatment, in 1, 2 and 3 months of follow-up separately. : Patients were enrolled in the Third Affiliated Hospital of Zhejiang Chinese Medical University, between 1st August 2018 and 31st July 2021. : Sixty-five migraine patients with or without aura. : In the EA groups, the acupoints were bilateral Fengchi (GB20), Gongxue (Extra), Sizhukong (TE23), Taiyang (EX-HN5), Shuaigu (GB8), Waiguan (TE5) and Yanglingquan (GB34). Electric stimulation was exerted at GB20 and Gongxue (Extra), with 2 Hz and 100 Hz separately. In the sham-stimulation group, the shallow acupuncture was operated at the sites 1 cm lateral to GB20 and Gongxue (Extra), and on the radial side of TE5 and GB34. The output wires were cut off after attached to the acupoints. The patients in each group received the treatment 3 times weekly, once every two days, for consecutive 4 weeks. The complete intervention was composed of 12 treatments. : Changes in numbers of migraine attacks at treatment phase (week 1 to week 4) from the baseline(week -4 to week 0) in patients of each group : (1) Changes in migraine attacks and days with headache: In the 2 Hz EA and 100 Hz EA groups, the changes for migraine attacks and days of headache were higher significantly when compared with that in the sham-stimulation group at the same time stage (P < 0.05). There was no statistical difference between two EA groups. (2) Changes of VAS score: In the 2 Hz EA and 100 Hz EA groups, the changes of VAS score were significantly higher when compared with that in the sham-stimulation group at the same time stage (P < 0.05). There was no statistical difference between two EA groups. (3) Assessment of anxiety and depression: The differences in the changes of SAS and SDS scores had no statistical significance in patients of each group at each assessment stage (P > 0.05). (4) Assessment on the quality of life: Compared with the sham-stimulation group at the same time stage, the improvement in MSQ score was increased significantly during treatment in patients of the 2 Hz EA group (P < 0.05). There was no statistical difference between two EA groups. (5) Assessment on safety and compliance: The patients of each group had sound compliance. There was no adverse events during trial, suggesting promising safety of treatment. : EA may effectively reduce the migraine attacks, and the days and intensity of headache, presenting promising safety. However, there was no significant improvement on anxiety-depression symptoms, and no significant difference between high and low frequencies of EA treatment in relieving headache and anxiety/depression symptoms in the patients with migraine. : ChiCTR1800017259

Effect of Different Frequencies of Electroacupuncture on Chronic Low Back Pain in Older Adults: A Triple-blind, Placebo-controlled, Randomized Clinical Trial

BACKGROUND: Acupuncture is one of the most widely used therapies to treat chronic low back pain, whose analgesic effect seems to be potentiated by the addition of electric current (electroacupuncture). However, we are not aware of any clinical trial that has evaluated the effectiveness of this technique in adults &gt; 65 years. OBJECTIVE: To evaluate the effect of electroacupuncture in the treatment of chronic low back pain in the elderly. STUDY DESIGN: Triple-blind, controlled, and randomized clinical trial. SETTING: Faculty of Medicine, University of São Paulo (USP); Sector of Biological Sciences - Physiotherapy Course, Federal University of Paraná (UFPR). METHODS: The study included 125 elderly people with chronic nonspecific low back pain who were randomized to one of 5 study groups: 3 of electroacupuncture; one control; and one placebo, all of them treated for 5 weeks. The primary endpoint was pain intensity, and secondary endpoints included the qualitative aspect of pain, functional disability (Roland-Morris and sit and stand test), emotional functioning (depression and anxiety), and psychosocial factors. Data analysis followed the intention-to-treat principle. The confidence interval was set at 95% and the significance level at 5%. RESULTS: All groups achieved a reduction in pain intensity; however, a significant difference was only detected between electroacupuncture and placebo, where the latter showed greater pain reduction. Regarding secondary outcomes, all groups showed good posttreatment results for all assessments but without statistical significance. Among the groups, the placebo was the one that obtained the best results between the pre- and post-treatment for depression, qualitative aspect of pain, and functional disability, but only for the qualitative aspect of pain and for the sit-and-stand test was a significant reduction found in the intergroup comparison. The analysis of the overall effect perceived by the participants in relation to low back pain revealed that individuals from all groups felt close to full recovery. LIMITATIONS: Absence of follow-up and a relatively small number of patients. CONCLUSIONS: This study provides evidence that there is no one frequency of electroacupuncture that is most effective in treating chronic low back pain in the elderly and that electroacupuncture is not superior to manual acupuncture or placebo treatment. KEY WORDS: Electroacupuncture, acupuncture, low back pain, aged, health of the elderly, rehabilitation, clinical trial, interdisciplinary research Clinical trials registration: NCT03802045 (January 2019).

Research trends of acupuncture therapy for hypertension over the past two decades: a bibliometric analysis.

Acupuncture has already been extensively utilized to treat high blood pressure (hypertension) in several nations. Nevertheless, the bibliometric research on the worldwide usage of acupuncture for hypertension is mostly unclear. As a result, our objective for the research aimed to investigate the present state as well as developments in the global usage of acupuncture on hypertension during the last 20 years using CiteSpace (5.8.R2). The Web of Science (WOS) database examined papers on acupuncture treatment of hypertension from 2002 to 2021. We examined the number of publications, cited journals, nations/regions, organizations, authors, cited authors, cited references, and keywords utilizing CiteSpace. The record of 296 documents was obtained between 2002 and 2021. The quantity and frequency of annual publications rose gradually. Regarding frequency and centrality of citations, Circulation and Clin Exp Hypertens (Clinical and Experimental Hypertension) scored top and second respectively. China had the most publications among countries/regions, as well as the five largest institutions were also in China. Cunzhi Liu was the most productive author, while P Li was the most referenced author. XF Zhao produced the first article inside the quantity of cited references classification. 'Electroacupuncture' had a significant frequency with centrality for the keywords, which suggested electroacupuncture is a popular treatment in this field. In the treatment of hypertension, electroacupuncture has a beneficial effect on reducing blood pressure. However, because of the many different applications of electroacupuncture frequencies in research, whether the electroacupuncture frequency is connected to the therapeutic impact should be given more significant consideration. The findings of this bibliometric analysis give an overview of the present state as well as developments of clinical studies on acupuncture for hypertensive patients during the last two decades, which could assist researchers in identifying hot subjects and exploring novel directions in further study within the field.

Research progress of acupuncture for peripheral inflammatory response

Acupuncture can regulate peripheral inflammatory response mainly through somatosensory-vagal/sympathetic nerve-splenic/adrenal/local reflex pathway. Besides, acupuncture may also play an anti-inflammatory role through gut microbiota and neuro-endocrine pathway. The effects of acupuncture have acupoint specificity and time window effect, and are influenced by voltage, current and frequency of electroacupuncture. Future research should focus on the connection and interaction of multiple targets, pathways and mechanisms in the brain, and clarify the multi-target advantages of acupuncture anti-inflammatory.

Efficacy of electroacupuncture with different frequencies in the treatment of chemotherapy-induced peripheral neuropathy: A study protocol for a randomized controlled trial.

IntroductionChemotherapy-induced peripheral neuropathy (CIPN) is a common complication in patients with cancer during chemotherapy. It mainly leads to severe numbness of the hands and feet and causes great pain in patients. Electroacupuncture (EA) is considered to be beneficial in improving peripheral neuropathy and relieving numbness of the hands and feet. This trial aims to evaluate the therapeutic effect of different frequencies of EA on CIPN in patients with cancer.Methods and analysisThis study is a randomized controlled trial. In total, 160 eligible CIPN patients are randomly assigned to the 2 Hz EA group, 100 Hz EA group, 2/100 Hz EA group, and control group in the ratio of 1:1:1:1. All patients in the EA treatment groups receive treatment with EA three times a week for 4 weeks and following up for 4 weeks. The patients in the control group are given Mecobalamin (MeCbl) tablets orally, one tablet at a time, three times a day, for 4 weeks, and following up for 4 weeks. The primary outcome measures are the participant neurotoxicity questionnaire (PNQ) and the peripheral neurotoxicity assessment rating (NCI CTCAE V5.0). Secondary outcomes are the quality of life scale (EORTC QLQ-C30) and the measurement of peripheral nerve conduction velocity (NCV). The results are evaluated at baseline, post-treatment phase, and following up for 4 weeks. All major analyses are based on the intention to treat principle.Ethics/disseminationThis protocol was approved by the Medical Ethics Committee of the Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital) on 7 December 2021. The license number is IRB-2021-458. This study provides clinical efficacy data of different frequencies of EA in the treatment of CIPN. The results help to prove whether EA is an effective therapy for CIPN and optimize the frequency of EA for CIPN. The results of this study are shared with health care professionals, the public, and relevant organizations through the publication of manuscripts and conference reports.Trial registration numberChiCTR2100054458.

Effect of Electroacupuncture on Hippocampal Functional Activity and Molecular Expression Profile in Rats with Vascular Cognitive Impairment

<sec><title>Objective</title> To explore the effect of Tongdu Tiaoshen electroacupuncture method on the hippocampal function and the gene expression profile of the hippocampal tissue in rats with vascular cognitive impairment. </sec><sec><title>Methods</title> A total of 24 healthy male SD rats were randomly divided into the sham operation group, the model group and the electroacupuncture group, with 8 rats in each group. Bilateral common carotid artery ligation was used to prepare a rat model of vascular cognitive impairment in the model group and the electroacupuncture group, only bilateral common carotid artery was separated without ligation in the sham operation group. The electroacupuncture group was intervented by stimulating at Baihui (GV20) and Shenting (GV24) acupoints, the frequency of electroacupuncture was 1/20 Hz, 30 min each time, once a day, dilatational wave, continous intervention for 28 days, and the other two groups were grabbed under the same conditions without any other intervention. Barnes maze test was used to evaluate the spatial learning and memory ability of rats; Y maze test was used to evaluate the spatial working memory ability of rats; small animal 7.0 T magnetic resonance resting brain functional imaging was used to analyze the changes of regional homogeneity (ReHo) of hippocampal functional activity; Agilent mRNA expression microarray was used to analyze the differential gene expression of the whole hippocampus genome. </sec><sec><title>Results</title> ① Behavioral analysis results: compared with the sham operation group, the Barnes maze escape latency of the model group increased significantly (<italic>P</italic><0.05), the target quadrant duration percentage decreased significantly (<italic>P</italic><0.05), and the Y maze alternation rate decreased significantly (<italic>P</italic><0.05); compared with the model group, the Barnes maze escape latency of the electroacupuncture group decreased significantly (<italic>P</italic><0.05), the target quadrant duration percentage and the Y maze alternation rate increased significantly (<italic>P</italic><0.05). ② ReHo changes results: compared with the sham operation group, the ReHo of functional activitives of the bilateral prefrontal lobes, hippocampus and other brain regions in the model group decreased significantly (<italic>P</italic><0.005); compared with the model group, the ReHo of functional activities of the bilateral hippocampus, prefrontal lobes and piriform cortex in the model group increased significantly (<italic>P</italic><0.005). ③ Genomics results: a total of 705 genes with 2-fold differential expression of hippocampal mRNA between the model group and the sham operation group (<italic>P</italic><0.05), of which 195 genes (such as Sytl1, Trpv6, Klhl14, Npsr1, Myh3, Galnt3, Nr4a1, Bmp3, Egr2, etc.) were down-regulated, of which 510 genes (such as Insl6, Efcab1, Akr1b1, Tagln, Glrb, Akr1c13, Kcne1L, Ubap1, etc.) were up-regulated. A total of 399 genes with 2-fold differential expression of hippocampal mRNA between the electroacupuncture group and the model group (<italic>P</italic><0.05), of which 166 genes (such as Klhl14, Bmp3, Npsr1, Cacna1e, etc.) were up-regulated, of which 233 genes (such as Insl6, Ube2k, Cdkn1c, Camp, Upk1b,etc.) were down-regulated. </sec><sec><title>Conclusion</title> The Tongdu Tiaoshen electroacupuncture at Baihui and Shenting acupoints can improve the cognitive function of rats with vascular cognitive impairment, and its mechanism may be related to enhance the function of hippocampus, prefrontal lobes and other brain regions, regulate the expression of calcium ions and energy metabolism-related molecules by regulating nerve activity activity. </sec>

The Modulation of Working-Memory Performance Using Gamma-Electroacupuncture and Theta-Electroacupuncture in Healthy Adults.

Working memory (WM), a central component of general cognition, plays an essential role in human beings' daily lives. WM impairments often occur in psychiatric, neurodegenerative, and neurodevelopmental disorders, mainly presenting as loss of high-load WM. In previous research, electroacupuncture (EA) has been shown to be an effective treatment for cognitive impairments. Frequency parameters are an important factor in therapeutic results, but the optimal frequency parameters of EA have not yet been identified. In this study, we chose theta-EA (θ-EA; 6 Hz) and gamma-EA (γ-EA; 40 Hz), corresponding to the transcranial alternating-current stimulation (tACS) frequency parameters at the Baihui (DU20) and Shenting (DU24) acupoints, in order to compare the effects of different EA frequencies on WM. We evaluated WM performance using visual 1-back, 2-back, and 3-back WM tasks involving digits. Each participant (N = 30) attended three different sessions in accordance with a within-subject crossover design. We performed θ-EA, γ-EA, and sham-EA in a counterbalanced order, conducting the WM task both before and after intervention. The results showed that d-prime (d′) under all three stimulation conditions had no significance in the 1-back and 2-back tasks. However, in the 3-back task, there was a significant improvement in d′ after intervention compared to d′ before intervention under θ-EA (F [1, 29] = 22.64; P < 0.001), while we saw no significant difference in the γ-EA and sham-EA groups. Reaction times for hits (RT-hit) under all three stimulation conditions showed decreasing trends in 1-, 2-, and 3-back tasks but without statistically significant differences. These findings suggest that the application of θ-EA might facilitate high-load WM performance.

Electroacupuncture Attenuates Cancer-Induced Bone Pain via NF-κB/CXCL12 Signaling in Midbrain Periaqueductal Gray

Electroacupuncture (EA) is effective in various chronic pains. NF-κB and CXCL12 modulate the formation of chronic pain. Herein, we hypothesized that EA alleviates cancer-induced bone pain (CIBP) through NF-κB/CXCL12 axis in midbrain periaqueductal gray (PAG), which participates in "top-down" pain modulatory circuits. In order to filter the optimum EA frequency for CIBP treatment, 2, 100, or 2/100 Hz EA was set up. In addition, ipsilateral, contralateral, and bilateral EA groups were established to affirm the optimal EA scheme. Bilateral 2/100 Hz EA was considered as the optimal therapeutic scheme and was applied in a subsequent experiment. Western blotting along with immunofluorescence illustrated that CIBP induces a rapid and substantial increase in CXCL12 protein level and NF-κB phosphorylation in vlPAG from day 6 to day 12. Anti-CXCL12 neutralizing antibody and pAAV-U6-shRNA(CXCL12)-CMV-EGFP-WPRE in vlPAG remarkably improved the mechanical pain threshold of the hind paw in CIBP model relative to the control. EA inhibited the upregulation of pNF-κB and CXCL12 in vlPAG of CIBP. The recombinant CXCL12 and pAAV-CMV-CXCL12-EF1a-EGFP-3Xflag-WPRE reversed the abirritation of EA in the CIBP rat model. NF-κB phosphorylation mediated-CXCL12 expression contributed to CIBP allodynia, whereas EA suppressed NF-κB phosphorylation in CIBP. According to the above evidence, we conclude that bilateral 2/100 Hz EA is an optimal therapeutic scheme for CIBP. The abirritation mechanism of EA might reduce the expression of CXCL12 by inhibiting the activation of NF-κB, which might lead to the restraint of descending facilitation of CIBP.

Impact of Low Frequency Electro-acupuncture on Glucose and Lipid Metabolism in Unmarried PCOS Women: A Randomized Controlled Trial.

To explore the effect of electro-acupuncture (EA) on glucose and lipid metabolism in unmarried patients with polycystic ovary syndrome (PCOS). Fifty-four PCOS patients were equally randomized into true acupuncture group and sham acupuncture group (control) for totally 16 weeks of treatment by random method with a computerized randomization program. Patients in true acupuncture group accepted traditional acupuncture methods with EA and two sets of acupoint groups were used alternatively. The first set consisted of Zhongji (CV 3), Qihai (CV 6), Guilai (ST 29), Sanyinjiao (SP 6), Yinlingquan (SP 9), Hegu (LI4) and Baihui (GV 20), and the second set consisted of Tianshu (ST 25), ST 29, CV 3, CV 6, SP 6, Taichong (LR 3), Neiguan (PC) 6 and GV 20. Patients in the sham acupuncture group accepted shallow acupuncture methods through EA without electricity at 4 non-meridian points in each shoulder and upper arm. Outcome measures included body mass index (BMI), waist-hip-ratio (WHR), oral glucose tolerance test (OGTT), insulin release test, glucose and lipid metabolism indicators such as total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, adiponectin, leptin, visfatin, resistin, and interleukin (IL-6). Twenty-six subjects in the true acupuncture group and 20 subjects in the sham group completed the clinical trial. After 16 weeks of treatment, no significant difference in the outcome measures were observed between the two groups (P>0.05). However, as compared with baseline data, a reduction in weight, BMI, hipline, WHR, fasting glucose, homeostatic model assessment of insulin sensitivity, visfatin and HDL-C, and an increase in resistin and IL-6 were observed in the true acupuncture group (P<0.05). In addition, a reduction in visfatin and an increase in TC were also observed in the sham group (P<0.05). Acupuncture may have a beneficial effect in the treatment of PCOS by improving glucose and lipid metabolism. Moreover, the sham acupuncture may be not completely ineffective. Sham acupuncture may improve some of the aspects of the glucose and lipid metabolism of PCOS patients through a placebo effect. (Registration Nos. ChiCTR-TRC-12002529 and NCT01812161).

Comparative effect of electroacupuncture with different frequency on headache attacks in migraine outpatients: study protocol for a randomised placebo-controlled trial

BackgroundHeadache attacks severely impaired life quality and increase the economic burden of migraineurs. Electroacupuncture (EA) has been used worldwidely to treat several pain-related diseases including migraines. However, whether EA with low or high frequency exerts a distinct analgesic effect remains unknown and needs further study.Methods/DesignThis study is a randomised, single-blinded, placebo-controlled trial with three parallel arms. A total of 144 migraine outpatients will be randomly allocated to the 2 Hz EA group, 100 Hz EA group and placebo control group. The duration of the trial is 20 weeks, including a 4-week-long baseline assessment period (weeks − 4–0), a 4-week-long treatment period (weeks 1–4) and a 12-week-long follow-up period (weeks 5–16). Twelve treatment sessions will be performed over a 4-week period (weeks 1–4). The primary outcome will be measured by the frequency of migraine attacks in the past 4 weeks at the end of week 4 post-randomisation. The secondary outcome will be measured by the frequency of migraine attacks in the past 4 weeks at the end of weeks 8, 12 and16 post-randomisation; number of days with migraine; dosage of ibuprofen; the scores of visual analogue scale (VAS); Self-Rating Anxiety Scale (SAS); Self-Rating Depression Scale (SDS); and Migraine Specific Quality of Life questionnaire (MSQ) in the past 4 weeks at the end of weeks 4, 8, 12 and 16 post-randomisation. Safety assessment, compliance and blinding evaluation will be carried out at the end of week 16 post-randomisation.DiscussionThe recruitment will be started on 1 June 2021 and expected to finish on 31 May 2023. We aimed to clarify the dominant frequency of EA on headache attacks in a migraineur.Trial registrationChinese Clinical Trial Registry ChiCTR-1800017259. Registered on 20 July 2018.

Effects of Acupuncture on Postoperative Pain After Total Knee Replacement: Systematic Literature Review and Meta-Analysis.

To identify the analgesic effectiveness of acupuncture after total knee replacement by systematic review. A search of randomized controlled trials was conducted in five English medical electronic databases and five Chinese databases. Two reviewers independently searched in five English medical electronic databases and five Chinese databases. Two reviewers independently retrieved related studies, assessed the methodological quality, and extracted data with a standardized data form. Meta-analyses were performed with all-time-points meta-analysis. A total of seven studies with 891 participants were included. The meta-analysis results indicated that acupuncture had a statistically significant influence on pain relief (standardized mean difference = -0.705, 95% CI -1.027 to -0.382, P = 0.000). The subgroup analysis results showed that acupuncture's effects on analgesia had a statistically significant influence (standardized mean difference= -0.567, 95% CI -0.865 to -0.269, P = 0.000). The main acupuncture points that produced an analgesic effect when they were used after total knee replacement included the Xuehai, Liangqiu, Dubi, Neixiyan, Yanglingquan, and Zusanli points. Electroacupuncture frequency ranged between 2 and 100 Hz. As an adjunct modality, the use of acupuncture is associated with reduced pain and use of analgesic medications in postoperative patients. In particular, ear acupuncture 1 day before surgery could reduce analgesia .

Clinical observation of electroacupuncture with different frequencies for migraine without aura

To observe the clinical efficacy of electroacupuncture (EA) with different frequencies in treating migraine. Ninety patients with migraine were divided into a low frequency electroacupuncture (LF-EA) group, a high frequency electroacupuncture (HF-EA) group and a variable frequency electroacupuncture (VF-EA) group by the random number table method. Shuaigu (GB 8), Hegu (LI 4), Waiguan (TE 5), Taichong (LR 3), Taiyang (EX-HN 5), Fengchi (GB 20) and Ashi points were selected for all three groups. After achieving needling sensation (Deqi), the LF-EA group received 2 Hz continuous wave EA stimulation; the HF-EA group received 100 Hz continuous wave EA stimulation, and the VF-EA group received 2 Hz/100 Hz sparse-dense wave EA stimulation. The EA stimulation lasted for 30 min in all the three groups, once a day, 10 times as a course, and the clinical efficacy was evaluated after 2 consecutive courses of treatment. After treatment, the total effective rates in the LF-EA group, HF-EA group and VF-EA group were 77.7%, 83.3% and 93.3%, respectively. The difference in total effective rate between the LF-EA and HF-EA groups was not statistically significant (P>0.05), but the total effective rate was significantly higher in the VF-EA group than in the LF-EA and HF-EA groups (both P 0.05), while the score was significantly lower in the VF-EA group than in the LF-EA and HF-EA groups (both P<0.01). VF-EA (2 Hz/100 Hz), compared with LF-EA (2 Hz) and HF-EA (100 Hz), shows superior clinical efficacy in treating migraine.