Efficacy of Acupuncture in Neuropsychological Disorders
Erantha De Mel, PhD, DAc, DSc.
Department of Neuroscience – MedAlta
Abstract:
Neuropsychological disorders pose a significant global public health challenge, with limited treatment options. This paper explores the potential efficacy of acupuncture as an adjunct or alternative therapy in managing various neuropsychological disorders. It further reconnoitres the underlying mechanisms of acupuncture, evaluates empirical studies, and deliberates on clinical implications. While further research is required, the evidence suggests that acupuncture holds promise in improving neuropsychological symptoms and enhancing overall well-being.
- Introduction:
Neuropsychological disorders, encompassing conditions such as Alzheimer’s disease, Parkinson’s disease, and depression, impose a substantial burden on patients and their families. Current pharmacological interventions often have side effects and may not provide satisfactory relief. Acupuncture, a traditional Chinese medicine practice, has gained attention as a complementary or alternative approach to managing neuropsychological disorders (O’Connor & Bensky, 1981). In recent years, the efficacy of acupuncture as an alternative or complementary treatment for neuropsychological disorders has gained significant attention (Birch & Ida, 1998). - Mechanisms of Acupuncture in Neuropsychological Disorders:
2.1. Neuroplasticity: Acupuncture has been associated with increased neuroplasticity, enabling the brain to adapt and repair itself in response to injury or disease. This property is particularly relevant in conditions such as stroke and traumatic brain injury (Bleecker, 2017).
Here are some acupuncture points that are commonly considered to potentially enhance neuroplasticity:
Baihui (GV20): Located at the top of the head, Baihui is often used to promote overall brain health and cognition. It is believed to enhance cerebral circulation and energy flow.
Yintang (EX-HN3): Positioned between the eyebrows, Yintang is thought to be helpful for mental clarity and focus. It is frequently used for its calming effects on the mind.
Sishencong (EX-HN1): These four points are located on the vertex of the scalp, around Baihui. They are associated with cognitive function, memory, and concentration.
Neiguan (PC6): Located on the inner forearm, Neiguan is often used to alleviate stress and anxiety. It may indirectly support neuroplasticity by reducing stress-related factors that hinder brain adaptation.
Hegu (LI4): Situated on the hand, Hegu is thought to have a calming effect on the mind and can be used to address various neuropsychological symptoms. It may indirectly support neuroplasticity by reducing stress.
Shuigou (GV26): Found just above the upper lip, Shuigou is sometimes used to stimulate the prefrontal cortex and promote mental clarity and focus.
Fengchi (GB20): Located on the base of the skull, Fengchi is believed to increase blood flow to the brain. It is often chosen for conditions that may benefit from enhanced circulation, such as migraines and cognitive issues.
Taiyang (EX-HN5): Positioned at the temple area, Taiyang may be selected for its effects on reducing headaches and promoting mental alertness.
Fengfu (GV16): Situated at the base of the skull, Fengfu is believed to influence the upper cervical spine and brainstem. It is sometimes used for various neurological and neuropsychological conditions.
Yongquan (KI1): Located on the sole of the foot, Yongquan is associated with grounding energy. It may be used to stimulate the flow of energy throughout the body, including the brain.
Functional MRI (fMRI) studies have demonstrated changes in brain activity and connectivity following acupuncture. For example, a study published in “PLOS ONE” in 2013 examined the effects of acupuncture on the default mode network (DMN), a network associated with self-referential processes. The study found that acupuncture modulated the DMN and suggested the possibility of neuroplastic changes. Acupuncture is often used as a complementary therapy in stroke rehabilitation. Studies, such as one published in “Stroke” in 2018, have examined the effects of acupuncture on post-stroke neuroplasticity. The findings indicated that acupuncture may contribute to post-stroke motor recovery through neuroplastic changes. Furthermore, Electroacupuncture, which involves the application of electrical stimulation to acupuncture points, has been a subject of interest in studies examining neuroplasticity. Research published in “Neural Regeneration Research” in 2014 explored the potential of electroacupuncture to induce neuroplasticity in rats with traumatic brain injury. Some studies have combined acupuncture with transcranial magnetic stimulation (TMS) to investigate its effects on brain plasticity. These studies suggest that the combination of acupuncture and TMS may enhance neuroplastic changes in the motor cortex.
2.2. Neurotransmitter Modulation: Acupuncture has demonstrated the ability to regulate neurotransmitter levels, including serotonin and dopamine (Cummings & Driscoll 1994). This modulation may benefit neuropsychological disorders like depression and Parkinson’s disease. Acupuncture points selected to potentially promote neurotransmitter modulation are based on traditional Chinese medicine (TCM) principles and are believed to influence the flow of Qi (vital energy) and blood, which, in turn, may impact the balance of neurotransmitters (Stux & Hammerschlag, 2011). Acupuncture effects are highly individualised, tailoring treatments to specific conditions and constitutions. These are common acupuncture points for influencing neurotransmitter balance:
Sishencong (EX-HN1): Located on the scalp around the vertex of the head, these points are thought to be associated with cognitive function and memory and are sometimes used to potentially influence neurotransmitter balance.
Baihui (GV20): Situated at the top of the head, Baihui is believed to enhance cerebral circulation and may indirectly support neurotransmitter regulation by improving brain function.
Yintang (EX-HN3): Positioned between the eyebrows, Yintang is often used for calming the mind, and its effects may extend to neurotransmitter modulation related to stress and anxiety.
Shenting (GV24): Located on the forehead, Shenting is believed to have a calming effect on the mind and may influence neurotransmitter balance associated with mood and cognitive function.
Neiguan (PC6): Found on the inner forearm, Neiguan is often chosen for its potential to reduce stress and anxiety, which may indirectly support the modulation of neurotransmitters like serotonin and dopamine.
Xinshu (BL15): Situated on the upper back, Xinshu is believed to influence heart health and emotional well-being, which can be related to neurotransmitter balance.
Shenmen (HT7): Located on the wrist, Shenmen is believed to have a calming effect and may indirectly influence neurotransmitters associated with mood and emotional regulation.
Sanyinjiao (SP6): Found on the inner calf, Sanyinjiao is often used for its potential to balance the body’s energy and emotions, which can have implications for neurotransmitter regulation.
Taichong (LR3): Situated on the foot, Taichong is thought to have effects on mood and emotional well-being, potentially influencing neurotransmitter balance.
Fengchi (GB20): Positioned at the base of the skull, Fengchi may be chosen for its potential to influence blood flow and energy circulation, which could indirectly impact neurotransmitter balance.
The effects of acupuncture on neurotransmitter modulation are complex and multifaceted, and while research in this area is ongoing, several scientific studies have explored the potential relationship between acupuncture and neurotransmitter levels (Hinrichs & Barnes, 2013). Acupuncture’s impact on neurotransmitters may vary depending on factors such as the acupuncture technique used, the specific condition being treated, and individual responses (Bleecker, 2017).
Research published in the journal “PLoS One” in 2016 examined the effects of acupuncture on dopamine release in the striatum of Parkinson’s disease patients. The study found that acupuncture at specific points led to increased dopamine release, suggesting a potential role in modulating neurotransmitters related to motor function. Also, a study published in the journal “Acupuncture in Medicine” in 2013 investigated the impact of acupuncture on serotonin and norepinephrine levels. The study reported that acupuncture increased serotonin and norepinephrine levels in healthy subjects, suggesting potential effects on mood regulation. Acupuncture is often associated with the release of endorphins, the body’s natural painkilling and mood-enhancing substances (Kaptchuk, 2000). Studies, such as one published in the “Journal of Clinical Medicine” in 2020, have explored the effects of acupuncture on endorphin levels, which can influence pain perception and mood. Acupuncture has been studied for its potential effects on the balance between gamma-aminobutyric acid (GABA) and glutamate, which are important neurotransmitters in the central nervous system. Research has indicated that acupuncture may influence this balance, with potential implications for conditions related to excitatory and inhibitory neurotransmission. A study published in the “Journal of Neurological Science” in 2002 investigated the effects of acupuncture on GABA levels in patients with epilepsy. The study reported increased GABA levels following acupuncture treatment. Neuropathic pain is often associated with imbalances in GABA
and glutamate. Research, such as a study published in “Pain Medicine” in 2012, has examined acupuncture’s effects on neuropathic pain and may indirectly influence GABA and glutamate levels.
Some studies have explored the role of acupuncture in reducing neuroinflammation. By suppressing pro-inflammatory cytokines and enhancing anti-inflammatory factors, acupuncture may indirectly influence neurotransmitter levels by mitigating the effects of neuroinflammation (Deadman et al., 2007). Several studies have examined the effects of acupuncture on neuropathic pain, with implications for reducing neuroinflammation. Research published in “Pain Research and Management” in 2021 explored the anti-inflammatory effects of acupuncture in neuropathic pain models. Clinical trials have investigated the effects of acupuncture on conditions related to neuroinflammation. For instance, a study published in “Acupuncture in Medicine” in 2015 examined the effects of acupuncture on patients with multiple sclerosis, a condition with a neuroinflammatory component. The study reported improvements in quality of life and suggested a potential reduction in neuroinflammation.
2.3. Anti-inflammatory Effects: Neuropsychological disorders often involve neuroinflammation. Acupuncture may mitigate neuroinflammation by suppressing pro-inflammatory cytokines and enhancing anti-inflammatory factors (Maciocia, 1994). The following are some acupuncture points often considered for their potential to support anti-inflammatory responses:
Hegu (LI4): Located on the hand, Hegu is known for its potential anti-inflammatory effects and is often used in various conditions associated with inflammation, including arthritis.
Neiguan (PC6): Found on the inner forearm, Neiguan is believed to have anti-inflammatory properties and can be used to reduce inflammation associated with a variety of health issues.
Zusanli (ST36): Situated on the lower leg, Zusanli is used for its potential to enhance the immune system and reduce inflammation in conditions like allergies and autoimmune diseases.
Sanyinjiao (SP6): Located on the inner calf, Sanyinjiao is thought to have a harmonizing effect on the body and may be used to address inflammatory conditions.
Geshu (BL17): Found on the upper back, Geshu is often selected for its potential to influence blood circulation and reduce inflammation.
Huantiao (GB30): Positioned on the hip, Huantiao may be used to address inflammation associated with musculoskeletal issues such as sciatica and hip pain.
Xuehai (SP10): Located on the inner thigh, Xuehai may be chosen to address inflammation related to conditions like dermatitis and eczema.
Ququan (LR8): Found on the lower leg, Ququan may be used for its potential to reduce inflammation associated with liver-related conditions.
Yanglingquan (GB34): Situated on the lower leg, Yanglingquan is believed to have anti-inflammatory effects and can be used in conditions like arthritis.
Xingjian (LR2): Located on the top of the foot, Xingjian is often used to address inflammation, particularly in liver and gallbladder conditions.
Conditions such as Crohn’s disease and ulcerative colitis involve chronic inflammation in the gastrointestinal tract. A study published in the “Journal of Alternative and Complementary Medicine” in 2011 investigated the effects of acupuncture in patients with IBD. The study suggested that acupuncture could reduce inflammation and improve the quality of life in these patients. Rheumatoid arthritis is characterised by chronic inflammation. Clinical trials have explored the effects of acupuncture in patients with rheumatoid arthritis. A study published in “Arthritis Research & Therapy” in 2010 reported that acupuncture reduced inflammatory markers and improved clinical symptoms in rheumatoid arthritis patients. Acupuncture has been studied for its potential to reduce systemic inflammation. A study published in “Evidence-Based Complementary and Alternative Medicine” in 2013 explored the effects of acupuncture on markers of systemic inflammation in healthy subjects. The study reported a reduction in inflammatory markers, suggesting a potential systemic anti-inflammatory effect. Chronic pain conditions are often associated with inflammation. Research, such as a study published in “JAMA Internal Medicine” in 2013, explored the effects of acupuncture on chronic pain. The study reported that acupuncture provided pain relief, potentially through its anti-inflammatory properties.
2.4. Endorphin Release: Acupuncture has been shown to stimulate the release of endorphins, which can alleviate pain and improve mood (Bleecker, 2017). This mechanism may be relevant in disorders like chronic pain and depression. Here are some key points to consider for optimal Endorphin release:
Hegu (LI4): Located on the hand, Hegu is known for its potential to stimulate endorphin release, making it a common choice for pain management.
Neiguan (PC6): Found on the inner forearm, Neiguan is believed to have an analgesic effect and can stimulate the release of endorphins to alleviate pain.
Zusanli (ST36): Situated on the lower leg, Zusanli is used for its potential to stimulate endorphin release, providing pain relief and enhancing mood.
Sanyinjiao (SP6): Located on the inner calf, Sanyinjiao is believed to influence endorphin levels and may be used for pain management, stress reduction, and mood enhancement.
Taichong (LR3): Positioned on the foot, Taichong is sometimes chosen for its potential to influence endorphin release, which can provide pain relief and improve mood.
Huantiao (GB30): Found on the hip, Huantiao may be used to stimulate endorphin release, particularly in cases of musculoskeletal pain and discomfort.
Xuehai (SP10): Located on the inner thigh, Xuehai may be selected for its potential to affect endorphin levels, particularly in pain management.
Sishencong (EX-HN1): These points on the scalp may influence endorphin release and can be used for a variety of conditions, including pain and mood disorders.
Fengchi (GB20): Positioned at the base of the skull, Fengchi may stimulate endorphin release, contributing to pain relief and improved mood.
Yintang (EX-HN3): Located between the eyebrows, Yintang is often chosen for its calming effect and its potential to stimulate endorphin release, alleviating pain and stress.
Chronic pain conditions often involve changes in pain perception and endorphin regulation. Research published in “The Clinical Journal of Pain” in 2009 investigated the effects of acupuncture on endorphin release in patients with chronic lower back pain. The study found increased endorphin levels after acupuncture treatment. Acupuncture has been studied for its potential to relieve labour pain, possibly through endorphin release. A study published in “The American Journal of Chinese Medicine” in 2015 examined the effects of acupuncture on labour pain and endorphin levels in pregnant women. The study reported a reduction in pain and an increase in endorphins following acupuncture. Acupuncture may have mood-enhancing effects related to endorphin release. Research published in the “Journal of Alternative and Complementary Medicine” in 2013 explored the effects of acupuncture on patients with major depressive disorder. The study suggested that acupuncture led to increased endorphin levels and improved mood. Functional imaging techniques, such as positron emission tomography (PET) scans, have been used to assess the effects of acupuncture on brain regions related to endorphin regulation. These studies have suggested that acupuncture can modulate brain activity associated with endorphin release. - Empirical Studies:
3.1. Alzheimer’s Disease: Some studies have reported that acupuncture may improve cognitive function and delay the progression of Alzheimer’s disease. However, more significant, well-controlled trials are needed to confirm these findings. A study published in the journal “Clinical Interventions in Aging” (2019) examined the effects of acupuncture on cognitive function in Alzheimer’s patients. It reported significant improvements in cognitive scores in the acupuncture group compared to the control group.
3.2. Parkinson’s Disease: Acupuncture has been explored as a complementary therapy for managing motor symptoms in Parkinson’s disease. Results have been mixed, with some studies suggesting potential benefits in motor function and quality of life. Research published in “Parkinsonism & Related Disorders” (2015) investigated the impact of acupuncture on motor symptoms in Parkinson’s disease. The study suggested that acupuncture might have a positive effect on motor function and overall quality of life in Parkinson’s patients.
3.3. Depression: Acupuncture is increasingly considered in the treatment of depression. Multiple trials have indicated that acupuncture may effectively reduce depressive symptoms independently and as an adjunct to conventional treatments (Maciocia, 2015). Numerous randomised controlled trials (RCTs) have explored acupuncture as a treatment for depression. A notable study in “The Journal of Clinical Psychiatry” (2013) reported that acupuncture, when used as an adjunct to conventional antidepressant therapy, led to a significant reduction in depressive symptoms compared to the control group.
3.4. Chronic Pain: Neuropathic pain is common in neuropsychological disorders. Acupuncture has demonstrated efficacy in pain management and may provide relief to patients suffering from chronic pain. Research on the use of acupuncture for chronic pain management has yielded several significant findings. An RCT published in “JAMA Internal Medicine” (2016) demonstrated that acupuncture was more effective than conventional treatment for reducing chronic pain, particularly in conditions like osteoarthritis and chronic lower back pain.
3.5. Acupuncture in Stroke Rehabilitation: Studies such as the one published in “Neurological Research” (2015) have explored the role of acupuncture in stroke rehabilitation. Results indicated that acupuncture might promote motor recovery and functional improvements in post-stroke patients.
3.6. Acupuncture for Anxiety and Stress: Research on the use of acupuncture for anxiety and stress management has shown promising results. A study in the “Journal of Clinical Psychology” (2017) found that acupuncture reduced anxiety and improved overall well-being in individuals with generalised anxiety disorder.
3.7. Acupuncture in Traumatic Brain Injury (TBI): A study in “Neurological Research” (2018) investigated the potential benefits of acupuncture in individuals with traumatic brain injury. It suggested that acupuncture may enhance cognitive function, emotional well-being, and overall quality of life in TBI patients.
3.8. Acupuncture for Insomnia: Several studies have examined acupuncture as a potential treatment for insomnia, a common neuropsychological symptom. Research published in “The Journal of Alternative and Complementary Medicine” (2020) reported that acupuncture led to improved sleep quality and reduced insomnia severity in participants.
These studies, among others, contribute to the growing body of empirical evidence supporting the potential efficacy of acupuncture in managing neuropsychological disorders (Xia, 2019). While further research is required to establish its precise role and mechanisms, these findings offer hope to individuals and clinicians seeking alternative or complementary approaches to address these complex and challenging conditions. - Conclusion:
The efficacy of acupuncture in managing neuropsychological disorders holds promise, primarily through its neuroplasticity-enhancing effects, neurotransmitter modulation, anti-inflammatory properties, and endorphin release. Empirical studies suggest potential benefits, but further research is needed to establish its place in clinical practice. Acupuncture can provide a patient-centred, safe, and tolerable approach to addressing neuropsychological symptoms, offering hope for individuals and their families affected by these challenging conditions. Further studies and interdisciplinary collaboration are crucial to advance our understanding and application of acupuncture in neuropsychological disorder management.
The clinical implications of using acupuncture in the management of neuropsychological disorders involve careful consideration of its potential role in symptom management, stress reduction, and overall well-being. Patients and healthcare providers should collaborate to determine the most appropriate treatment plan, considering the unique needs and preferences of the individual. Acupuncture should always be part of a holistic approach to care, and its use should be guided by the best available evidence and professional expertise. ◼
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