Title : Study on the mechanism of the wake-promoting and neuroprotective efficacy of acupuncture at hand twelve jing-well points for traumatic brain injury
Abstract:
Traumatic brain injury (TBI) induced coma is a key factor in poor clinical prognosis and poses a significant burden to families and society. However, there is a lack of first-line wake-promoting therapies with proven efficacy and ultra-early intervention. Acupuncture has been certified by the World Health Organization as an effective treatment for a variety of diseases. The Hand twelve Jing-Well Points (HTJW) acupuncture therapy is a unique Traditional Chinese Medicine (TCM) first-aid treatment that has been proven to be effective for comatose patients and improves the neurological deficits of patients suffering from TBI, stroke, or carbon monoxide poisoning. Our team has conducted a series of studies on the wake-promoting and neuroprotective mechanisms of the HTJW acupuncture therapy. Based on behavioral and EEG platforms, we confirmed the wake-promoting effect of the HTJW acupuncture therapy, focusing on the ascending reticular activating system (ARAS), and found that the P2RX7 pathway of Dopaminergic (DAergic) neurons in the ventral periaqueductal gray (vPAG) region may mediate the wake-promoting effect of the therapy and modulate the excitability of Orexinergic (ORXergic) neurons in the lateral hypothalamus. Subsequently, chemogenetic techniques were applied to discover that the vPAG DAergic neurons-lateral hypothalamic ORXergic neurons circuit may be the key link to promote wakeup. Regarding its neuroprotective effect, the therapy improved the symptoms of neurological deficits in TBI rats, and the brainstem JNK/p38 MAPK pathway mediated this effect, and it is speculated that improving inflammation is an important way for the therapy to improve the symptoms of neurological deficits. The HTJW acupuncture therapy provides a new idea for post-TBI treatment, which is especially important to fill the gap of pre-hospital emergency care, and still needs a lot of research and attention in the future to promote its clinical translation.
Audience Take Away
- The HTJW acupuncture therapy is an important complementary and alternative therapy to promote wakeup after central nerve injuries. This study initially reveals the central mechanism of wake-promoting effect of the therapy by modern scientific theory, and provides evidence for expanding its clinical application
- This study provides listeners with new wake-promoting and first-aid therapies, and is of great significance to fill the gap of pre-hospital care. We aim to promote the therapy to receive more academic attention, in order to carry out more high-quality evidence-based research in the future, and to establish better wake-promoting and emergency treatment for TBI
- This study not only reveals the neural circuit of the HTJW acupuncture therapy to promote wakeup, but also confirms the projection of DAergic neurons in the vPAG to ORXergic neurons in the lateral hypothalamus at the functional level, which provides new evidence for the conduction pathway of the ARAS
