Intermittent 96-Hour Auricular Electroacupuncture for Hot Flashes in Patients with Prostate Cancer: A Pilot Study

Abstract

The hot flash is a common vasomotor disorder that causes distress in menopausal women and that can be debilitating in men with prostate cancer who are treated with androgen deprivation therapy (ADT). The utility of auricular electroacupuncture (AEA) was tested exclusively for a small cohort of men with ADT-induced vasomotor symptoms while the men underwent a course of curative radiotherapy. Prior to and during radiotherapy treatment, men with vasomotor symptoms were given repeated questionnaires regarding severity and frequency of hot flashes, quality of life (QoL), and sleep over a 6-week span of an AEA protocol. Each subject's heart rate variability (HRV) was obtained repeatedly every week in an ambulatory setting with a BlueCardio device (BlueCardio, Miami, FL). The AEA intervention was given with a Neurova device (Nunka Corporation, CM Wellness Clinic, Pompano Beach, FL) that used three needles at Master points Sympathetic,, and Point Zero, which were located precisely with a bipolar point finder. Intermittent microcurrent stimulation was given every other week for 96 hours, using a cyclic programmed output of 2 hours on and 2 hours off. Of 10 men completing the 6-week protocol, all responded with significantly lower frequency, duration, and severity of vasomotor symptoms; QoL and sleep scores improved significantly. The HRV analysis showed significantly lower low-frequency/high-frequency power ratios in each individual, compared to baseline, that were consistent with the subjective responses. Vasomotor disturbance, caused by gender hormone withdrawal-either naturally or in patients treated with ADT, as in this study-is a well-defined neurophysiologic condition. This disorder is a constellation of findings that reflect autonomic disturbances of excessive sympathetic and reduced parasympathetic activity. AEA intervention with the Neurova device is simple to administer, is well-tolerated, and appears to be effective for restoring autonomic balance. Further evaluation of AEA for vasomotor disturbances could provide more insight into the mechanisms of AEA neuromodulation and potentially lead to approaches for treating not only these symptoms but also other neurologic conditions with components of autonomic disturbances.

Intermittent 96 Hour Auricular Electro Acupuncture Using Microcurrent Stimulation for Symptoms of Hot Flashes: Effective Autonomic Modulation?

“…We have shown that the use of an intermittent 96 hour treatment with AEA appears to be very effective for a small cohort of men with hot flashes [1]. In 10 subjects there were highly significant improvements of the quality of life, sleep, and hot flash frequency and duration over the six weeks of the protocol study.…”

“…In a recent publication we describe the major subjective improvement of hot flashes and sleep disruption caused by hormone blockade in prostate cancer patients treated with Auricular Electro Acupuncture (AEA) [1]. Hot flashes are troublesome vasomotor symptoms caused by gender hormone withdrawal that can be caused by androgen depravation therapy (ADT) [2], in breast cancer survivors after chemo/hormonal therapy [3], or naturally in menopausal women [4].…”

Acupuncture or auricular electro-acupuncture as adjuncts to lifestyle interventions for weight management in PCOS: protocol for a randomised controlled feasibility study

“…Several sham-controlled RCTs on acupuncture for a variety of clinical conditions suggest that it is more efficacious than sham in reducing sympathetic tone as measured by HRV [57,71,72]. Previous clinical research showed that AEA resulted in improvement in HRV LF/HF ratios over the course of the protocol intervention, implying improved sympathovagal balance [44]; however, this was measured using ambulatory HRV monitoring, which has not been validated against the gold standard of electrocardiogram (ECG) recordings. To date, the effect of acupuncture on HRV in women with PCOS has not been evaluated, although electro-acupuncture improved HRV and restored oestrous cycling compared to sham handling in a recent rat study [73].…”

“…The intervention in this arm is AEA using a fixed protocol that is informed by both Chinese medical and medical acupuncture principles based on a literature review and expert consensus on the traditional and physiological indications of the points. A pilot study suggests that a novel device, the "Neurova TM " (NESI Corp), may be effective for hot flushes from androgen-deprivation therapy, a condition underpinned by sympathetic hyperactivity [44]. This method involves insertion of indwelling needles into the concha of the ear and delivery of intermittent electrical impulses over 96 h by a small battery-powered device that is worn just below the ear.…”

Ear acupuncture and the quality of life of cancer patients: Integrative Review

“…The articles by Harding et al [21], Valois et al [22] and Rich et al [23] also brought sleep disorder symptom. Patients with cancer often have this disorder, with an incidence of around 30-50%, compared to 15% of the general population [24], negatively impacting QoL because it affects well-being [3].…”