The brain science behind acupuncture

There are those who believe acupuncture to be a bunch of mumbo jumbo. I’m convinced it works, though. Acupuncture was first performed thousands of years ago, and it’s still being done today. That alone should tell you there’s something to it. Early practitioners believed they were balancing life force and rhythm. Modern science has proven that acupuncture may alter brain circuitry, change brain cell anatomy, and improve brain blood flow.

Way back in 2004, evidence emerged regarding acupuncture altering a specific brain pathway: from the gracile nucleus (an area in the medulla – a primitive brain area responsible for crucial life functions such as heart rate and breathing) to the thalamus (the main relay station for signals going from and coming to the brain). By stimulating this dorsal medulla-thalamic pathway, acupuncture effects may spread upwards to different parts of the cerebral cortex (mediating acupuncture effects on things such as pain, cravings, and anxiety) and downwards to the spinal cord (mediating acupuncture effects on things such as heart rate and digestion).

Over the ensuing two decades, new tools have evolved, which have made the study of brain circuits more precise. Chief among these is functional magnetic resonance imaging (fMRI). Like a standard MRI, fMRI yields beautiful, lifelike brain images. What’s more, fMRI uses blood flow or sugar metabolism to evaluate the activity of various brain regions and subregions.

In 2022, scientists evaluated patients with chronic migraine headaches who responded to acupuncture. After acupuncture or sham (control) treatment, the patients underwent clinical testing and fMRI. The researchers discovered a brain circuit altered by acupuncture: the medulla, cerebellum (a part of the brain responsible for muscular coordination), and precuneus (a part of the brain that allows one to feel in control of one’s actions and events in the external world).

One specific target, known as the Neiguan point, has received a lot of scientific attention. You know those wristbands with the little button they sell for seasickness? Sure, it seems like a scam, but there’s some science behind it. Way back in the prehistoric era of 2001, Swedish scientists enrolled sixty pregnant women in a randomized placebo-controlled trial. They proved that acupressure at the Neiguan point improved symptoms of nausea and vomiting. Subsequent analysis of twenty-six separate scientific studies bolstered the evidence, proving that stimulation of the Neiguan point improved nausea and vomiting, both due to morning sickness and other reasons. If you’re wondering why that goofy wristband never worked for you, you probably don’t know what the Neiguan point is and probably wore the darned thing on some random point on your wrist.

Stimulation of the Neiguan point has proven beneficial for more than just nausea and vomiting. A lot more! Brain cells (neurons) have receptors on their surfaces (like minuscule dream catchers) where floating proteins (neurotransmitters) can lodge. When a neurotransmitter attaches to a receptor, the activity of the neuron changes. Acupuncture at the Neiguan point may alter neuronal receptors, especially in the hippocampus (part of the brain responsible for learning and memory). Based on this knowledge, doctors began testing acupuncture at the Neiguan point to treat memory problems.

In 2023, scientists evaluated fMRI of patients with Alzheimer’s Disease immediately after acupuncture treatment. The researchers reported changes in the activity of the cingulate cortex (a brain area involved with emotion, learning, and memory), frontal lobe (an area of the brain that controls executive functions), and cerebellum of treated subjects. Based on this anatomy, they concluded that acupuncture may change the activity in the default mode network (DMN) of the brain. The DMN is a wide network of far-flung neuronal nodes in the neocortex, wired together by white matter (axonal) cables. The DMN is active in the background of your consciousness and is crucial for inner thoughts such as reminiscing and daydreaming. The DMN becomes especially active when you think about others or plan for future events.

Also in 2023, different scientists studied the effects of acushock (electrical stimulation of acupoints) at the Neiguan and Shiguo points after traumatic brain injury. The scientists enrolled more than eighty patients after mild to moderate head trauma and randomly assigned half of them for treatment. Those who received acushock had laboratory evidence (blood tests) of less brain damage and also enjoyed a better level of cognitive (thinking) function. The scientists concluded that acupuncture may improve the flow of oxygen and nutrients and thus limit the secondary effects of brain injury.

Yet another research team examined the effects of acushock in a cohort of elderly patients undergoing a type of surgery known to induce cognitive decline (surgery on the heart and lungs) and separately a group of patients undergoing bowel surgery. The researchers stimulated the Neiguan and Zuslani points in half of the patients (randomly assigned). Those who received acushock had laboratory evidence (blood tests) of less brain damage and also enjoyed a better level of cognitive (thinking) function.

I don’t know whether reading this has made you an acupuncture believer, but I hope it opened your mind, at least a little bit.

Marc Arginteanu is a neurosurgeon and author of Azazel’s Public House.

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