Evidence from moderate quality randomised studies suggests that acupuncture is effective for treating lateral elbow pain, according to a systematic review by an international team of authors. A total of 19 RCTs that compared acupuncture and/or moxibustion with sham acupuncture, another form of acupuncture or conventional treatment were included. Results from three RCTs of moderate quality showed that true acupuncture was more effective than sham acupuncture. Results from 10 RCTs of mostly low quality showed that acupuncture or moxibustion was superior or equal to conventional treatment (such as local anesthetic injection, local steroid injection, non-steroidal anti-inflammatory drugs or ultrasound). Six low quality RCTs that compared acupuncture plus moxibustion with manual acupuncture alone all showed that the combination of acupuncture and moxibustion was superior to acupuncture alone. (Acupuncture and moxibustion for lateral elbow pain: a systematic review of randomized controlled trials. BMC Complement Altern Med. 2014 Apr 12;14(1):136).
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Acupuncture
Current evidence supports the use of acupuncture to alleviate the symptoms of post-traumatic stress disorder, according to a systematic review of studies of complementary and alternative medicine treatments. American authors reviewed 33 studies (n=1329) that assessed PTSD outcomes after a variety of CAM interventions. Evidence of benefit for PTSD was judged to be good for acupuncture, hypnotherapy, meditation and visualisation. (Complementary and Alternative Medicine for Posttraumatic Stress Disorder Symptoms: A Systematic Review. J Evid Based Complementary Altern Med. 2014 Mar 27. [Epub ahead of print]).
An fMRI study by Chinese authors has found that acupuncture at Yanglingquan GB-34 (a commonly used acupuncture point), can enhance functional connectivity in the brain’s default mode network (DMN) in stroke patients. The DMN is a network of brain areas that is normally active during rest and which is involved in emotion processing and self-referential mental activity. Its functional connectivity has been shown to be decreased in stroke and other neurodegenerative diseases. Eight stable ischemic stroke patients and ten healthy subjects were recruited to undergo resting state fMRI scanning before and after acupuncture. Amongst the stroke patients acupuncture at Yanglingquan GB-34 resulted in increased functional connectivity between two important parts of the DMN - the posterior cingulate cortex (PCC) and the anterior cingulate cortex (ACC). Both PCC and ACC are regarded as core regions involved in memory and cognitive processing and also serve as important interaction hubs between the DMN and sensorimotor network (SMN). The authors conclude that the modulatory effects of acupuncture on the DMN of stroke patients could therefore relate to the recovery of cognitive ability and motor function. (Acupuncture modulates the functional connectivity of the default mode network in stroke. Evid Based Complement Alternat Med. 2014;2014:765413).
www.ncbi.nlm.nih.gov/pubmed/24734113
Another group of Chinese scientists, who compared fMRI brain scans of 14 Alzheimer’s disease (AD) patients with 14 healthy elderly controls, have shown that acupuncture at Taichong LIV-3 and Hegu L.I.-4 can enhance hippocampal connectivity in AD patients. The hippocampus, which plays a crucial role in memory processes, is one of the earliest brain regions to be affected by AD and the researchers speculate that enhanced hippocampal connectivity may increase information flow, resulting in improvement of cognitive function. Acupuncture may also strengthen cooperation between brain regions in AD patients, resulting in the use of additional neural resources which compensate for memory losses due to the disease. (Acupuncture modulates resting state hippocampal functional connectivity in Alzheimer disease. PLoS One. 2014 Mar 6;9(3):e91160).
Abnormal functional connectivity (FC) in the brain due to Bell’s Palsy (BP) can be reduced by acupuncture, report Chinese investigators. Twenty-two healthy volunteers and 17 BP patients underwent fMRI scans before and after acupuncture at Hegu L.I.-4. Compared with the healthy group, increased FC was found in the patient group in regions that are components of the facial motor network. Acupuncture-induced changes to FC were only observed in the patient group, and were consistent with recovery from BP symptoms, demonstrating that acupuncture can specifically improve abnormal FC in patients with BP.
Functional Connectivity Modulation by Acupuncture in Patients with Bell's Palsy. Evid Based Complement Alternat Med. 2016;2016:5928758. Epub 2016 May 12.