Acupuncture Continuing Education

Acupuncture Protects Brain Cells From Stroke

New research demonstrates that acupuncture stimulates brain cell proliferation in the cerebrum. The researchers note that electroacupuncture “exerts a neuroprotective effect in ischemic stroke.” The researchers also successfully measured the biochemical pathway by which acupuncture exerts this medical benefit to the brain. Acupuncture helps brain cell proliferation after a stroke. Stimulation of two acupuncture points was shown to activate the extracellular signal-related kinase (ERK) pathway, an important protein communication pathway involved in cell proliferation.

The experiment measured the biochemical responses to electro-acupuncture delivered to acupuncture points LI11 (Quchi) and ST36 (Zusanli), bilaterally. LI11 is located at the lateral end of the transverse cubital crease, a point located somewhat near the elbow. ST36 is located near the anterior crest of the tibia on the lower leg. According to Traditional Chinese Medicine (TCM) theory, both acupuncture points are related by their location on the hand and leg Yangming channels respectively. The traditional uses of these acupuncture points varies greatly in many clinical circumstances. According to TCM theory, both ST36 and LI11 are He Sea and Earth points thereby giving them another similarity beyond sharing placement on a Yangming channel. Interestingly, a common pairing of ST36 is with LI10. ST36, Zusanli, is translated as leg three measures and LI10, Zhousanli, is translated as arm three measures. This refers, in part, to each acupuncture point’s ability to strengthen patients with weak conditions. Here, the researchers paired ST36 with LI11 instead.

Traditionally, LI11 is commonly used to quell inflammatory conditions such as sore throats, toothaches, red & painful eyes, urticarria, various skin conditions and febrile diseases. LI11 is also used for the treatment of upper limb paralysis. ST36 is commonly used to nourish and strengthen patients with weak bodily constitutions. However, it is indicated for inflammatory conditions including enteritis, gastritis and breast abscesses. ST36 is commonly used by licensed acupuncturists for the treatment of gastric pain, vomiting, abdominal distention, diarrhea, constipation, mastitis, edema, asthma, anemia, indigestion, mania and neurasthenia. ST36 is also traditionally indicated for the treatment of apoplexy, shock and hemiplegia.

The investigators noted that electro-acupuncture “significantly ameliorated neurological deficits and cerebral infarction” in cases of cerebral injuries. In addition, specific biological responses showed a healthy stimulation reaction to the application of electro-acupuncture. The researchers discovered that electro-acupuncture significantly increased phosphorylation levels of ERK and protein expression of Ras, cyclin D1 and cyclin-dependent kinase. All of these findings led to the conclusion that acupuncture “exerts a neuroprotective effect in ischemic stroke.”

There have been numerous studies with similar conclusive evidence demonstrating the beneficial effects of acupuncture after a stroke and for brain repair. A study of the acupuncture points TB3 (Zhongzhu) and TB5 (Waiguan) demonstrated the ability of these points restore hand function and walking after a stroke. The study also concluded that general activities of daily living function improved.

Another study discovered that acupuncture is able to “promote the proliferation and differentiation of neural stem cells in the brain… accelerate angiogenesis and inhibit apoptosis.” The research measured acupuncture’s role in angiogenesis, the physiological process involving the growth of new blood vessels from pre-existing vessels. Acupuncture at GV20 (Baihui) and GV14 (Dazhui) increased neural repair following cerebral ischemia. These researchers also noted that acupuncture points GV20 (Baihui) and GV26 (Shuigou) regulate cells which “increase the release of nerve growth factors (NGFs) to make nerve cells survive and axons grow, synthesize neurotransmitters, (and) metabolize toxic substances….” The investigation also revealed that needling acupuncture points CV24 (Chengjiang), CV4, (Guanyuan), GV26 (Shuigou) and GV20 (Baihui) “could inhibit excessive proliferation of the hippocampal astrocytes and promote cellular differentiation.”

Just last year, a study revealed that acupuncture is an “effective therapy for CVS (cerebrovascular vasospasm) after subarachnoid hemorrhage.” This is important because cerebral blood vessel spasms lead to vasoconstriction and subsequent cerebral ischemia, which causes necrosis and may lead to a stroke. In this study, acupuncture at points Baihui (GV20, Du20) and Fengchi (GB20) were tested. The researchers note that the acupuncture group’s medical improvements were ““superior to that in the conventional treatment group.” Also, patients receiving acupuncture combined with medications showed greater improvements that those who only received medications.

Scalp acupuncture has also shown benefits for the treatment of intracerebral hemorrhages (ICH). Clinical investigators note, “The evidence from clinical studies suggested that SA (scalp acupuncture) therapy may produce significant benefits for patients with acute ICH.” The researchers note that studies confirm that scalp acupuncture “has rapid and powerful effects to remove limb paralysis caused either by cerebral infarct or by cerebral haemorrhage….” Research also shows that acupuncture at GV20 and GB7 significantly and beneficially regulates the cascade of endogenous inflammatory chemicals released after a stroke. Additionally, the investigators note that neuro-electrophysiologic measurements of scalp acupuncture responses demonstrate that acupuncture at GV20 and Taiyang improves “coordination and compensation functions among cortical functional areas” in ICH patients.

It is often the everyday aches and pains that follow a stroke that cause difficulty for patients. A large sample size study concluded that acupuncture reduces shoulder pain after a stroke. A meta-analysis of 453 randomized controlled studies investigated the effects of acupuncture for the treatment of shoulder pain after a stroke. The findings were tabulated and the researchers concluded that “acupuncture is an effective treatment for shoulder pain after (a) stroke.”

Xie, Guanli, Shanli Yang, Azhen Chen, Lan Lan, Zhicheng Lin, Yanlin Gao, Jia Huang et al. "Electroacupuncture at Quchi and Zusanli treats cerebral ischemia‑reperfusion injury through activation of ERK signaling." Experimental and Therapeutic Medicine 5, no. 6 (2013): 1593-1597.

Cheng XK, Wang ZM, Sun L, Li YH. [Post-stroke hand dysfunction treated with acupuncture at Zhongzhu (TE 3) and Waiguan (TE 5)]. Zhongguo Zhen Jiu. 2011 Feb;31(2):117-20.

Research advances in treatment of cerebral ischemic injury by acupuncture of conception and governor vessels to promote nerve regeneration. Zhou-xin Yang, Peng-dian Chen, Hai-bo Yu, Wen-shu Luo, Yong-Gang Wu, Min Pi, Jun-hua Peng, Yong-feng Liu, Shao-yun Zhang, Yan-hua Gou. Journal of Chinese Integrative Medicine, Jan. 2012. vol. 10, 1. Department of Acupuncture and Moxibustion, Shenzhen Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Guangdong Province, China.

Zhongguo Zhen Jiu. 2012 Mar;32(3):193-7. Observation of clinical efficacy of acupuncture for cerebral vasospasm after embolization of ruptured aneurysms]. Jiang YZ, Li C, Xu JY, Lu YZ, Xu R, Han B, Lu WH. Department of Neurosurgery, Wuxi Integrated Chinese and Western Medicine Hospital, Jiangsu Province, China.

Evidence-Based Complementary and Alternative MedicineVolume 2012 (2012), Article ID 895032, 9 pages. doi:10.1155/2012/895032. History and Mechanism for Treatment of Intracerebral Hemorrhage with Scalp Acupuncture. Zhe Liu, Ling Guan, Yan Wang, Cheng-Long Xie, Xian-Ming Lin and Guo-Qing Zheng. The Third Clinical College of Zhejiang Chinese Medical University, Hangzhou. Department of Acupuncture and Moxibustion, General Hospital, Beijing. Center of Neurology and Rehabilitation, The Second Affiliated Hospital of Wenzhou Medical College, Wenzhou.

Jung Ah Lee, Si-Woon Park, Pil Woo Hwang, Sung Min Lim, Sejeong Kook, Kyung In Choi, and Kyoung Sook Kang. The Journal of Alternative and Complementary Medicine. September 2012, 18(9): 818-823. doi:10.1089/acm.2011.0457.