The Impact of Acupuncture on Neurological Recovery in Spinal Cord Injury: A Systematic Review and Meta-Analysis

Ma, Ruijie; Liu, Xin; Clark, Justin; Williams, Gail M.; Doi, Suhail A.R.

doi:10.1089/neu.2014.3866

Cited by 28 publications

(22 citation statements)

References 34 publications

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“…A systematic review by Ma concluded that the use of acupuncture to treat spinal cord injury may have a beneficial effect on neurological and functional recovery. [18] Another review suggested that acupuncture is efficacious in acute TBI [19]. In China, acupuncture has been used for centuries to promote the recovery of consciousness after coma or other DOCs by increasing the excitability of nerve cells [20–22] and the supply of oxygen and blood flow in the traumatized area of the brain, which may be a potential mechanism for its rousing effects [23–25].…”

Section: Introductionmentioning

confidence: 99%

Acupuncture to Promote Recovery of Disorder of Consciousness after Traumatic Brain Injury: A Systematic Review and Meta-Analysis

Tan

Zeng

Wang

et al. 2019

Evidence-Based Complementary and Alternative Medicine

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Traumatic brain injury (TBI) has become an economic and social burden for patients and their families. While acupuncture is an effective tool for promoting recovery of disorder of consciousness (DOC) following TBI, there have been no comprehensive meta-analyses and/or systematic reviews addressing this topic. The present systematic review and meta-analysis aimed to assess the therapeutic efficacy of acupuncture for DOC after TBI. All randomized controlled trials (RCTs) incorporating acupuncture, or acupuncture combined with other interventions for DOC after TBI, were included and assessed by two independent investigators. Six outcome indicators were assessed: Glasgow Coma Scale (GCS); Glasgow Outcome Scale (GOS); mortality; efficacy rate; activities of daily living (ADL); and functional comprehensive assessment. Direct comparisons were performed using RevMan 5.3.0 software, with results presented as mean difference (MD) for continuous outcomes and relative risk (RR) for binary outcomes. A total of 3511 patients from 49 trials were included. Pooled analyses indicated that acupuncture may have a superior effect on GCS score (MD=2.03, 95% CI :1.92 2.43, Z=16.54, and P<0.00001); GOS score (RR=1.23, 95%CI: 1.18 1.35, Z=6.65, and P<0.00001); efficacy rate (RR=1.48, 95%CI: 1.40 1.56, Z=13.49, and P<0.00001); ADL (MD=9.20, 95% CI:8.19 10.21, Z=17.84, and P<0.00001); and mortality (RR=0.50, 95% CI:0.38 0.67, Z=4.70, and P<0.00001). The results demonstrated that the acupuncture group fared better than the control group in the treatment of DOC after TBI. However, studies were generally of poor quality, and publication bias favoring positive studies was obvious. Therefore, rigorous evaluation standards and well-designed studies are necessary in future studies.

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Section: Introductionmentioning

confidence: 99%

Acupuncture to Promote Recovery of Disorder of Consciousness after Traumatic Brain Injury: A Systematic Review and Meta-Analysis

Tan

Zeng

Wang

et al. 2019

Evidence-Based Complementary and Alternative Medicine

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“…A systematic review and meta-analysis on 12 studies by MA demonstrated that acupuncture could have a beneficial effect on neurological recovery, motor function and functional recovery. [10]…”

Section: Discussionmentioning

confidence: 99%

Neuromyelitis optica spectrum disorders with vertigo as the initial symptom

et al. 2019

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Rationale: Brain abnormalities have frequently been reported in neuromyelitis optica spectrum disorders patients, but vertigo as an initial manifestation has rarely been described. Patient concerns: A 64-year-old woman who initially presented with vertigo, then accompanied with other brainstem manifestations and spinal cord involvement. Diagnoses: MRI revealed medulla oblongata, cervical and thoracic spinal cord lesions. NMO-IgG antibody was seropositive. Taken her previous medical history and clinical manifestations into consideration, the patient was eventually diagnosed as neuromyelitis optica spectrum disorders. Interventions: Before diagnosis, symptomatic treatment and acupuncture were adopted, whereas after diagnosis, steroid, intravenous immunoglobulin, and immunosuppressant were supplemented. Outcomes: Her dizziness, nausea and vomiting were gradually relieved by symptomatic treatment and acupuncture before the confirmed diagnosis and immunotherapy. After added treatment with steroid, immunosuppressant, especially intravenous immunoglobulin, diplopia and nystagmus disappeared, and superficial sensation was improving. She was fully recovered six months after admission. Lessons: Vertigo as a rare prodrome of neuromyelitis optica spectrum disorders deserves attention. The symptoms and signs were improved by a combined treatment of steroid, immunosuppressant, acupuncture, and particularly intravenous immunoglobulin.

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“…Pooled analyses in a meta-analysis showed that acupuncture had a beneficial effect on neurological recovery (relative risk: 1.28, 95% confidence interval (CI): 1.12-1.50), motor function (weighted mean difference: 6.86, 95% CI: 0.41-13.31), and functional recovery (standardized mean difference: 0.88, 95% CI: 0.56-1.21). Moreover, acupuncture improved the activity of daily living (ADL) in SCI patients, particularly if applied at the back of the Governor Vessel (GV) and bladder channel acupoints [ 9 , 18 ]. Wong et al [ 19 ] performed an RCT evaluating the efficacy of acupuncture in 100 patients with SCI and demonstrated that acupuncture implemented early in acute SCI increased Functional Independence Measure scores.…”

Section: The Effect Of Acupuncture On Neural Restoration In Spinalmentioning

confidence: 99%

“…Also, it has been reported that acupuncture can effectively ameliorate various complications of SCI, such as pain, neurogenic bladder, pressure sores, spasm, and osteoporosis [ 2 , 21 – 23 ]. However, the above-indicated meta-analysis identified several limitations of the performed studies, such as the lack of high-quality multicenter large-size trials, the lack of uniform acupuncture methods, the bias of clinical trials, and the incidence of adverse events caused by acupuncture [ 18 , 24 ]. Therefore, the standardization of acupuncture procedures may facilitate the evaluation of their efficacy and clinical outcomes.…”

Section: The Effect Of Acupuncture On Neural Restoration In Spinalmentioning

confidence: 99%

Effects and Mechanisms of Acupuncture Combined with Mesenchymal Stem Cell Transplantation on Neural Recovery after Spinal Cord Injury: Progress and Prospects

et al. 2020

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Spinal cord injury (SCI) is a structural event with devastating consequences worldwide. Due to the limited intrinsic regenerative capacity of the spinal cord in adults, the neural restoration after SCI is difficult. Acupuncture is effective for SCI-induced neurologic deficits, and the potential mechanisms responsible for its effects involve neural protection by the inhibition of inflammation, oxidation, and apoptosis. Moreover, acupuncture promotes neural regeneration and axon sprouting by activating multiple cellular signal transduction pathways, such as the Wnt, Notch, and Rho/Rho kinase (ROCK) pathways. Several studies have demonstrated that the efficacy of combining acupuncture with mesenchymal stem cells (MSCs) transplantation is superior to either procedure alone. The advantage of the combined treatment is dependent on the ability of acupuncture to enhance the survival of MSCs, promote their differentiation into neurons, and facilitate targeted migration of MSCs to the spinal cord. Additionally, the differentiation of MSCs into neurons overcomes the problem of the shortage of endogenous neural stem cells (NSCs) in the acupuncture-treated SCI patients. Therefore, the combination of acupuncture and MSCs transplantation could become a novel and effective strategy for the treatment of SCI. Such a possibility needs to be verified by basic and clinical research.

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The Impact of Acupuncture on Neurological Recovery in Spinal Cord Injury: A Systematic Review and Meta-Analysis

Cited by 28 publications

References 34 publications

Acupuncture to Promote Recovery of Disorder of Consciousness after Traumatic Brain Injury: A Systematic Review and Meta-Analysis

Acupuncture to Promote Recovery of Disorder of Consciousness after Traumatic Brain Injury: A Systematic Review and Meta-Analysis

Neuromyelitis optica spectrum disorders with vertigo as the initial symptom

Effects and Mechanisms of Acupuncture Combined with Mesenchymal Stem Cell Transplantation on Neural Recovery after Spinal Cord Injury: Progress and Prospects

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