A neuroanatomical basis for electroacupuncture to drive the vagal–adrenal axis

• Published  on Nature

Abstract
​Somatosensory autonomic reflexes allow electroacupuncture stimulation (ES) to modulate body physiology at distant sites1,2,3,4,5,6 (for example, suppressing severe systemic inflammation6,7,8,9). Since the 1970s, an emerging organizational rule about these reflexes has been the presence of body-region specificity1,2,3,4,5,6. For example, ES at the hindlimb ST36 acupoint but not the abdominal ST25 acupoint can drive the vagal–adrenal anti-inflammatory axis in mice10,11. The neuroanatomical basis of this somatotopic organization is, however, unknown. Here we show that PROKR2Cre-marked sensory neurons, which innervate the deep hindlimb fascia (for example, the periosteum) but not abdominal fascia (for example, the peritoneum), are crucial for driving the vagal–adrenal axis. Low-intensity ES at the ST36 site in mice with ablated PROKR2Cre-marked sensory neurons failed to activate hindbrain vagal efferent neurons or to drive catecholamine release from adrenal glands. As a result, ES no longer suppressed systemic inflammation induced by bacterial endotoxins. By contrast, spinal sympathetic reflexes evoked by high-intensity ES at both ST25 and ST36 sites were unaffected. We also show that optogenetic stimulation of PROKR2Cre-marked nerve terminals through the ST36 site is sufficient to drive the vagal–adrenal axis but not sympathetic reflexes. Furthermore, the distribution patterns of PROKR2Cre nerve fibres can retrospectively predict body regions at which low-intensity ES will or will not effectively produce anti-inflammatory effects. Our studies provide a neuroanatomical basis for the selectivity and specificity of acupoints in driving specific autonomic pathways.

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Headaches and Migraines Overview
According to the Migraine Research Foundation more than 39 million Americans have had migraines. That is 18% of women, 6% of men and 10% of children. The chronic crippling headaches, the throbbing pain on the side of the head, keeps people from working and the healthcare costs for a family of someone who suffers from migraines are often times 70% higher.

Acupuncture Treatments
Acupuncture helps treat headaches and migraines by releasing endorphins and dynorphins that help block pain. Among the many acupuncture points that help treat migraines and headaches, one that stands out is called Large Intestine 4. This point is called the command point of the face in Chinese Medicine, and can help treat any problem above the neck. True acupuncture treatments, inserting needles into these specific points, would reduce the number of migraines someone has even more than pharmacology options. According to the 2016 Cochran review acupuncture would reduce the frequency of migraines by more than 50% in up to 57% of patients. This means that for someone suffering from 6 migraines a month on average a series of acupuncture treatments would reduce the number of migraines down to 3.5 migraines a month on average. All of this is with fewer side effects than currently prescribed prophylactic drugs that are used to handle severe chronic migraines. Acupuncture is a much less invasive treatment with almost no side effects. In fact, studies looked at in the Cochran review noted that about 98% patients completed their acupuncture treatments of 6 visits, and 70% fewer patients dropped out of the studies compared to those on prophylactics.

What more to do?
Over the past few years there has been more and more evidence that acupuncture is just as effective that pharmaceuticals, if not more effective, at treating migraines all with fewer side effects. Not just that, there have been additional studies that continued to take it one more step further by following acupuncture appointments with tuina, or cupping. In the Journal of Chinese Medicine tuina plus acupuncture had shown an even higher percent of patients with markedly improvement than with acupuncture alone. Overall there has been more and more evidence showing that acupuncture is more effective at treating migraines than pharmacological alternatives that are currently being used. New York Acupuncture and Chiropractics keeps up with all the current information and has 3 locations in NYC and 1 in Englewood, NJ that can provide any of these services to help reduce you headache and migraine pains. In the meantime, you can start to get a handle on your headaches yourself by following Dr. Chen’s 3 Point Relief for Headaches. 

References:

1. “Migraine Facts.” Migraine Research Foundation, migraineresearchfoundation.org/about-migraine/migraine-facts/.
2. Chen, Pema. “Headaches.” Pema Chen Acupuncture, www.pemachenacu.com/headaches.html.
3. Linde  K, Allais  G, Brinkhaus  B, Fei Y, Mehring  M, Vertosick EA, Vickers  A, White AR. Acupuncture for the prevention of episodic migraine. Cochrane Database of Systematic Reviews 2016, Issue 6. Art. No.: CD001218. DOI: 10.1002/14651858.CD001218.pub3.
4. Sherman, Lisa. "Tuina enhances effect of acupuncture for migraine." The Journal of Chinese Medicine 120 (2019): 81-82.
5. Zhang, Niushen, et al. "Systematic Review: Acupuncture vs Standard Pharmacological Therapy for Migraine Prevention." Headache: The Journal of Head and Face Pain 60.2 (2020): 309-317.

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