Electroacupuncture Preconditioning for Stroke Patients
Stroke is one of the most common causes of death and the leading cause of adult disability in the world. Pharmacological treatments are either ineffective or confounded by adverse effects. Electroacupuncture (EA) preconditioning is a recent observation which has been shown to induce ischemic tolerance like the ischemia preconditioning, suggesting that EA preconditioning may be a promising preventive strategy for the patients with high risk of acute brain injury. The purpose of this chapter is to collect the evidence for the neuroprotective effect of EA preconditioning, to summarize the underline mechanisms of EA preconditioning, and to discuss the possibility as a novel strategy for preventive treatment of ischemic damages in clinic.
EA preconditioning was first described in the brain in which EA stimulation at acupoint prior to ischemia led to the rapid and delayed ischemic tolerance. Then, the optimal parameters and acupoint specificity of EA preconditioning-induced neuroprotection were proved. Many studies have demonstrated that mechanisms of EA preconditioning may involve a series of regulatory molecular pathways including activity enhancement of antioxidant, regulation of the endocannabinoid system, and inhibition of neuronal apoptosis and so on. Recently, clinical trials have shown that EA preconditioning alleviated cerebral ischemic injury and promoted postoperative recovery in patients who have undergone craniocerebral tumor resection and open cardiac surgery. However, the underlying mechanisms and pathways need to further elucidate, and the efficiency and feasibility of EA preconditioning need to be investigated in clinical settings.
KeywordsIschemic Precondition Ischemic Tolerance Cerebral Ischemic Injury Acupoint Specificity Antagonist AM251
- Gao J, Zhang L, Wang Y, Lu B, Cui H, Fu W, Wang H, Yu Y, Yu X (2008) Antiarrhythmic effect of acupuncture pretreatment in rats subjected to simulative global ischemia and reperfusion–involvement of adenylate cyclase, protein kinase a, and l-type ca2+ channel. J Physiol Sci 58:389–396PubMedCrossRefGoogle Scholar
- Lei Y, Xiong LZ, Zeng Y, Sun YZ, Chen SY, Wang Q, Yang J, He DY (2003) The compare of preconditioning with repeated electroacupuncture on different acupoints to induce neuroprotection against spinal cord ischemia-reperfusion injury in rabbits. Chin J Clin Rehabil 7:3562–3564Google Scholar
- Lu Z, Xiong L, Zhu Z, Wang Q, Chen M (2002) Acupoint specificity of eiectroacupuncture preconditioning effect on cerebral ischemia injury in rats. Chin Acupunct Moxib 22:671–673Google Scholar
- Xiong L, Lu Z, Hou L, Zheng H, Zhu Z, Wang Q, Chen S (2003) Pretreatment with repeated electroacupuncture attenuates transient focal cerebral ischemic injury in rats. Chin Med J (Engl) 116:108–111Google Scholar
- Xiong LZ, Yang J, Wang Q, Lu ZH (2007) Involvement of delta-and mu-opioid receptors in the delayed cerebral ischemic tolerance induced by repeated electroacupuncture preconditioning in rats. Chin Med J (Engl) 120:394–399Google Scholar
- Yang J, Xiong L, Wang Q, Liu Y, Chen S, Xu N (2004) Effects of different stimulating parameters and their various combinations on electroacupuncture induced cerebral ischemic tolerance in rats. Zhongguo Zhen Jiu 24:208–212Google Scholar