Elsewhere, I’ve discussed acupuncture and its
potential to restore some function after spinal cord injury – perhaps,
in part, through its ability to influence regeneration-enhancing stem
cells. This update summarizes studies documenting these possibilities.
In brief review, under Traditional Chinese Medicine
(TCM), acupuncture stimulates specific skin points by either inserting
needles; applying heat, pressure, or massage; or using various
energy-emitting devices. It originally evolved from observations that a
disorder was associated with an increased sensitivity in specific skin
areas. These areas were consistently linked to a specific organ and
followed a defined topographical pattern. Called meridians, these
as pathways for life-force qi energy. Qi flow through these meridians
could be regulated by the stimulation of acupuncture points located
periodically along the meridians.
Under TCM theory, traumatic SCI damages the Du or
Governor meridian, which, in turn, affects qi circulation for the entire
body. The goal of treatment is to clear and activate meridian channels,
reversing qi stagnation.
The World Health Organization has listed many
disorders amenable to acupuncture, including those supported by more
rigorously designed clinical trials. Accumulating evidence suggests that
acupuncture also has the potential to restore some function after acute
and perhaps chronic SCI.
Drs. Peter Dorsher and Peter McIntosh, Mayo
Clinic (Jacksonville, Florida) have proposed a number of scientific
mechanisms by which acupuncture could exert beneficial effects after
SCI, including 1) decreasing the levels of proteins and cells fostering
injury-site scar formation, 2) reducing the creation of
damage-perpetuating, free-radical molecules, 3) lessening post-injury
spinal-cord atrophy, 4) decreasing stress-related hormones, 5)
increasing various regeneration-enhancing molecules, 6) stimulating
blood flow to the injury area, and 7) releasing neuroprotective,
endorphin-like molecules. As discussed below, acupuncture also may
stimulate function-restoring stem cells.
In these discussions, it is important to note that
only a relatively small percentage of working neurons need to cross the
injury site to have significant function. Through the previously
discussed mechanisms, acupuncture may help preserve enough neurons in
acute injury or turn-on surviving, dormant neurons in chronic injury to
tilt the balance toward function rather than paralysis.
Several SCI-focused acupuncture studies are
summarized below. In some cases critics have questioned their rigor and,
in turn, the amount of positive results. For example, some of the
results may merely reflect spontaneous improvement in individuals with
Dr. X. Gao et al (China) treated 261 individuals with SCI,
of which 79% had been injured at least one year. Ninety-five percent had
some improvement, such as enhanced sensation, bowel-and-bladder
function, spasticity, and walking. The investigators believed that
acupuncture improved spinal-cord circulation.
Dr. H. J. Wang (China) treated 82 patients with SCI with
electroacupuncture (application of a pulsating
electrical current to acupuncture needles). Of these, 93% accrued
functional benefits, including improved lower-limb and bowel-and-bladder
Dr. P. T. Cheng and colleagues (Taiwan) showed that
electroacupuncture-treated patients achieved balanced voiding in fewer
days than controls. Patients starting acupuncture within three weeks of
injury required fewer treatments compared to those treated later.
Dr. A. M. Wong and associates (China) treated acutely
injured patients with electrical and auricular (i.e., ear) acupuncture
starting in the emergency room and measured improvement one-year post
injury. Compared to controls, treated patients recovered more function.
In eight patients, Dr. H. Honjo et al. (Japan)
demonstrated that acupuncture increases bladder capacity, decreasing
Dorsher and McIntosh reported that an individual with SCI
becoming “completely continent of urine and able to void volitionally
after treatment with electroacupuncture.”
Dr. S. Nayak and colleagues (USA) reported that 50% of
acupuncture-treated patients with SCI had chronic pain relief.
Dr. T. A. Dyson-Hudson
et al. (USA) suggested that acupuncture reduced chronic shoulder
pain in wheelchair users with SCI.
Dr. L. M. Rapson et
al. (Canada) treated 36 subjects with below-level central
neuropathic pain characterized by generalized burning with
electroacupuncture. Twenty-four had reduced pain.
Acupuncture & Stem Cells
Stem cells are
going to play an ever-increasing role in restoring function lost by
disability, disease, or the entropy of aging. From conception until
death, they are the cells of renewal and regeneration through which many
regenerative energies are mediated. And when our body’s own stem cells
are insufficient to do the job, transplanted stem cells may provide the
needed regenerative boost.
Harvard University’s Dr. Charles Shang
believes that the acupuncture system and stem cells are closely linked
through an “organizing center network” composed of under-differentiated,
electromagnetically sensitive cells. This network is created early in
embryogenesis before the formation of other body systems (e.g., spinal
cord) and has the potential to influence these later-formed systems
throughout life. Under this model, acupuncture has extensive
growth-control effects and can trigger network stem cells into action.
As a crude analogy, view the acupuncture-sensitive
“organizing center network” as a behind-the-lines’ general ready to send
in green reserve troops (i.e., stem cells) who will evolve into the
front-line combatants replacing those who have fallen from the attacks
of disease, trauma, and aging. In the case of transplanted stem
cells, Shang speculates that they can be recruited into a new network
for repair and regeneration.
have shown that acupuncture influences stem-cell expression in animal
models of neurological disorders, including SCI:
In rats with transected spinal cords, Dr Y. Ding and
colleagues (China) concluded that electroacupuncture promotes the
survival and differentiation of transplanted stem cells. Transplantation
combined with electroacupuncture “could promote axonal regeneration and
partial locomotor recovery in the transected spinal cord in rats and
indicates a promising avenue of treatment of spinal cord injury.”
In another article, these investigators concluded that 1)
electroacupuncture promotes the differentiation of stem cells and
regeneration of nerve fibers in the injured cord through the induction
of neural growth factors, and 2) the combination of electroacupuncture
and stem-cell transplantation improves functioning of paralyzed hind
Dr. Z. Sun et al (China) demonstrated that treatment with
electroacupuncture combined with bone-marrow-derived stem-cell
transplantation restored more function in rats than either treatment by
itself. The investigators attributed this improved outcome to the
enhanced differentiation of the transplanted stem-cells into neuronal
Dr. C. Yang and colleagues (China) concluded that
electroacupuncture inhibits in rats the proliferation of astrocytes
(neuronal support cells) after SCI and prevents the formation of the
Acupuncture is a
nothing-to-lose-and-perhaps-everything-to-gain therapy that should be
used not only after SCI but also in conjunction with stem-cell
transplantation. It is stunning to think that acupuncture, one of
mankind’s oldest therapies, may augment the effectiveness of stem-cell
transplantation, one of mankind’s most contemporary treatments. Clearly,
ancient wisdom often has much contemporary validity, even if it’s hard
to explain through mechanisms that most biomedical scientists have been
taught to understand.
Adapted from article appearing in April 2010 Paraplegia News (For subscriptions,
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