BackgroundVascular dementia (VaD) is characterized by progressive cognitive impairment associated with chronic cerebral hypoperfusion. Monoaminergic neurotransmitter dysfunction has been implicated in its pathogenesis. Acupuncture has shown neuroprotective potential in experimental models; however, its regulatory effects on monoaminergic systems remain to be systematically clarified. This study aimed to evaluate the effects of acupuncture on monoaminergic neurotransmitters and cognitive function in animal models of VaD through a preclinical systematic review and meta-analysis.MethodsIn accordance with the PRISMA 2020 guidelines, a comprehensive search across eight English and Chinese databases was conducted from inception to October 2025 to identify randomized controlled animal studies investigating acupuncture in VaD models. Primary outcomes focused on the levels of monoaminergic neurotransmitters, including serotonin (5-HT), norepinephrine (NE), and dopamine (DA). Secondary outcomes encompassed acetylcholine (ACh) levels, long-term potentiation (LTP), and behavioral performance. Risk of bias was systematically assessed using the SYRCLE tool, and statistical synthesis was performed using R software (version 4.3.1).ResultsNine studies involving 386 rodents were included. Meta-analysis demonstrated that acupuncture elevated the levels of 5-HT (SMD = 1.35), NE (SMD = 2.67), and DA (SMD = 1.43). Furthermore, acupuncture treatment was associated with increased ACh levels (SMD = 3.75) and enhanced synaptic plasticity, as evidenced by improved LTP (SMD = 4.75). Behavioral assessments revealed substantial cognitive improvements, indicated by a reduction in escape latency (SMD = −4.66) and an increased number of platform crossings (SMD = 3.00) in the Morris water maze test.ConclusionAcupuncture may ameliorate cognitive impairment in VaD by modulating monoaminergic systems and enhancing synaptic plasticity. However, substantial heterogeneity and small sample sizes underscore the exploratory nature of these findings. To avoid overgeneralization of mechanistic pathways, further rigorous studies are essential.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD420251179267.

Based on the theory of "treating and regulating the mind", this paper systematically reviews the academic thoughts and clinical characteristics of Lingnan acupuncture for depression. In contemporary clinical practice, Lingnan physicians take the "unblocking and regulating the mind" as the core, focusing on "soothing the liver and regulating qi ", and"unblocking and regulating the primary qi "; with "caring for the middle and nourishing the mind" as the foundation, Lingnan physicians emphasize the coordinated regulation of the spleen and stomach to generate qi and blood; besides, Lingnan physicians take "regulating the heart and calming the mind" as the key, focusing on nourishing the heart, calming the mind,stabilizing the will, and relieving depression. These three aspects are interlinked, forming an acupuncture diagnosis and treatment system targeting the characteristics of depression in the Lingnan region, which are often marked by dampness,stagnation, consumption of qi, and injury to yin, and providing new ideas for the clinical and practical research of acupuncture for treating depression.

It is well known that acupoints have an intricate connection with the nervous system. The specific mechanism of acupuncture in regulating the nervous system and exerting the therapeutic effect is one of the hottest and most difficult aspects in the field of acupuncture research. The regulation of acupuncture on the nervous system involves multi-target and multi-link neurofeedback， and how to find the critical effector neurons in this process is the primary concern. In the present article， we introduce some modern paradigms and methodologies for screening acupuncture-responsive effector neurons starting from elucidation of structural and functional connectivity between acupoints and neurons， for example，1） neurovirus tracing techniques for studying the neuronal structural connections， and immediate early gene labeling for identifying functionally connected neuronal ensembles activated by acupuncture stimulation， 2） neuroimaging techniques for observing the impact of acupuncture on brain functional connections from a macroscopic perspective in real-time， 3） in vitro and in vivo electrophysiological recordings， as well as in vivo fiber-optics recording or two-photon calcium imaging for revealing the activity characteristics of activated neuronal ensembles， 4） analysis of the causal relationship between the key effect neurons， their neural circuit connections and the therapeutic effect of acupuncture by using multiple measures such as optogenetics and chemogenetics， etc. We should further strengthen the connection between the experimental research， basic theory exploration and clinical practice of acupuncture， accelerate the process of revealing the scientific connotations and promote the modernization and internationalization of acupuncture therapy.

Background:Pharmacological treatment of motor disorders in early Parkinson (PD) has reached a bottleneck, and acupuncture as an important component of non-pharmacological therapy has demonstrated therapeutic potential. However, current evidence is limited in both quantity and quality, highlighting the need for further clarification of its efficacy. Methods:A multi-center, investigator and participant blinded, randomized parallel group design was employed. 136 eligible participants were randomly assigned in a 1:1 ratio to either the acupuncture or sham acupuncture group via a central randomization system, received 12 sessions over 4 weeks. The primary outcome was motor function, assessed using the Unified Parkinson's Disease Rating Scale-III (UPDRS-III). Secondary outcomes were objective gait metrics captured with the Ready system, disease stage assessed by the Hoehn and Yahr scale (HY), and quality of life measured by the Activities of Daily Living scale (ADL) and the Parkinson's Disease Questionnaire 39 (PDQ 39). Levodopa dosage was recorded before and after treatment. Assessments were conducted at four time points (weeks 1, 2, 3, and 4), with 8 weeks follow up. Blood samples were collected before and after treatment for LC-MS/MS untargeted metabolomics and deep proteomics analysis. Discussion:This study will aim to clarify the efficacy of acupuncture for early PD motor symptoms through an evidence-based randomized controlled trial (RCT), and explore the underlying mechanisms of acupuncture using multi-omics approaches.

BACKGROUND:Poststroke constipation (PSC) is a prevalent and disabling condition that significantly affects patient quality of life. Although abdominal acupuncture (AA) has demonstrated potential therapeutic effects on PSC, its efficacy remains unclear. This meta-analysis evaluated the efficacy of manual AA (MAA) and abdominal electroacupuncture (AEA) combined with conventional therapy (CT) for PSC. METHODS:A comprehensive literature search was conducted to identify randomized controlled trials comparing the effects of MAA + CT or AEA + CT versus CT alone in PSC treatment. Twelve eligible studies (n = 943) were selected. Primary (efficacy and time to first bowel movement [BM]) and secondary (stool shape) outcomes were evaluated. Trial sequential analysis (TSA) was performed to assess cumulative evidence reliability. RESULTS:Both MAA + CT (relative risk [RR] = 1.26, 95% confidence interval [CI]: 1.13-1.40) and AEA + CT (RR = 1.28, 95% CI: 1.19-1.38) significantly improved efficacy compared with CT alone. Furthermore, MAA + CT (mean difference [MD] = -0.61, 95% CI: -1.02 to -0.19) and AEA + CT (MD = -0.32, 95% CI: -1.09 to -0.46) reduced the time to first BM, albeit evidence regarding stool shape was inconclusive due to significant heterogeneity. TSA demonstrated unclear cumulative evidence and thus could not determine AA efficacy compared with CT. CONCLUSION:MAA + CT and AEA + CT may effectively improve PSC by enhancing efficacy and shortening the time to first BM. Given the limited number of studies, small sample sizes, and significant heterogeneity, further high-quality trials are required to confirm these findings and optimize the acupuncture regimen for PSC treatment.

Combined central-peripheral magnetic stimulation shows promise for post-stroke dysphagia (PSD), but its neural mechanisms remain unclear. We evaluated the its efficacy and cortical mechanisms in PSD patients. In this single-blind, parallel-controlled trial, 44 PSD patients were randomized to four groups: active-rTMS + active-rPMS, active-rTMS + sham-rPMS, sham-rTMS + active-rPMS, or sham-rTMS + sham-rPMS. Clinical scales, such as functional oral intake scale (FOIS) and Penetration-Aspiration Scale (PAS), and Videofluoroscopic Swallowing Study (VFSS) were accessed before, after intervention. Cortical activation during rest and swallowing task was measured by functional near-infrared spectroscopy (fNIRS). Significant interaction effects (time × intervention) were found for FOIS (Wald χ2 = 39.816, p < 0.001) and PAS scores (Wald χ2 = 45.433, p < 0.001), with the active-rTMS + active-rPMS group showing the most pronounced therapeutic gains. Concurrently, this group displayed significant improvements of laryngeal vestibular closure duration (LCD, MD = –3.598, 95

Both clinical and preclinical evidence showed that electroacupuncture (EA) at Baihui (Governing Vessel 20, GV20) and Dazhui (GV14) could relieve sensorimotor disability after ischemic stroke (IS). However, the mechanism behind this therapeutic remains to be unraveled, and the current findings of its underlying mechanism are mainly focusing on neurons, with little evidence from astrocyte. Astrocyte plays an essential role in IS pathology, and IL-17A as a critical mediator in IS. This study aimed to investigate the relationship between the activity of astrocyte and expression of IL-17A during the regulation of sensorimotor function. The sensorimotor-related behaviors in mice were assessed by using Adhesive removal test and Rotarod test, and the expression/function of IL-17A was evaluated by ELISA, RT-PCR, and Western Blot. In vivo calcium activity of astrocyte was detected by two-photon calcium imaging. Our results revealed that EA preconditioning promoted the recovery of sensorimotor function in IS mice, and this therapeutic effect was absent when the astrocytic activity was chemogenetically inhibited. In addition, astrocytic calcium activity of IS mice could be mimicked by overexpressing IL-17A. Altogether, these results suggested the IL-17A in the astrocyte may play a key role in the functional recovery after stroke. These findings not only elucidate a critical pathway for understanding how IL-17A in astrocytic calcium activity influences the functional recovery after stroke, but also suggest a potential valuable therapeutic strategy for stroke.

BackgroundChronic heart failure (CHF) constitutes the terminal stage of ischemic heart disease and is characterized by a high mortality rate. Our previous studies have demonstrated that electroacupuncture (EA) modulates the paraventricular nucleus (PVN) of the hypothalamus, thereby exerting a cardioprotective effect against myocardial ischemia. However, the specific mechanisms underlying the role of corticotropin-releasing hormone (CRH) neurons, which are critical for regulating sympathetic outflow and stress responses within the PVN, remain unclear in the context of CHF. Additionally, CHF has been proven to cause an imbalance in the autonomic nervous system. This study seeks to investigate whether EA can re-establish cardiac autonomic homeostasis and ameliorate CHF by modulating PVNCRH neurons, thereby suppressing excessive sympathetic outflow.MethodsThe CHF rat model was established via permanent ligation of the left anterior descending coronary artery. Subsequently, EA was administered at the HT7 (Shenmen) acupoint. ECG signals were recorded, and heart rate variability analyzed. The neural connection was demonstrated using viral tracing techniques. Electrophysiological techniques recorded PVN neuron activity, while echocardiography measured left ventricular function. ELISA detected serum N-terminal pro-brain natriuretic peptide and norepinephrine levels. Histological heart examination used staining methods, and c-Fos-positive neurons expression in the PVN was assessed. The PVN was lesioned with kainic acid, and PVNCRH neurons activity was modulated using chemogenetics.ResultsThis study indicated that EA significantly ameliorated CHF. In the CHF rat model, we observed excessive activation of the sympathetic nervous system, concomitant with an increased number of c-Fos-positive neurons in the PVN. EA intervention effectively reversed these changes. Viral tracing revealed neural connections between the heart, HT7 acupoint, and PVN. Following lesioning of the PVN, the therapeutic efficacy of EA was attenuated. Furthermore, chemogenetic experiments revealed that inhibiting the activity of PVNCRH neurons produced a protective effect against CHF similar to that of EA, whereas activating these neurons counteracted the protective effects of EA.ConclusionEA ameliorated CHF by inhibiting the activity of PVNCRH, suppressing sympathetic overactivation. These findings provided scientific evidence for the potential clinical application of acupuncture in cardiovascular disease management.

Background:Acupuncture shows potential in treating nausea and vomiting (CINV) induced by highly emetogenic chemotherapy (HEC). However, the certainty of its efficacy evidence remains unclear, warranting a comprehensive evaluation. Method:Two independent reviewers systematically searched eight databases from inception to December 2024 to identify eligible randomized controlled trials (RCTs). Relevant data were extracted using a standardized form, and risk of bias was assessed using the Cochrane risk of bias tool version 2.0 (ROB 2.0). Meta-analysis was performed using R Studio 4.4 software. Subgroup analysis was conducted based on acupuncture type. Additionally, publication bias was detected using appropriate methods according to the heterogeneity of different outcomes, where appropriate. Finally, evidence quality was rated using the GRADE system. Result:A total of 58 RCTs were included in this meta-analysis. Rob 2.0 result indicated that most studies were at high risk of bias, with low methodological quality. For the primary outcome, acupuncture significantly improved the complete control rate during the overall (RR 1.54, 95% CI 1.36-1.75; P < 0.001; I 2 = 36%) and the delayed phase (RR 1.56, 95% CI 1.32-1.86; P < 0.001; I 2 = 0%). For other CINV outcomes, acupuncture demonstrated considerable therapeutic potential for vomiting-related outcomes, while uncertainty in alleviating nausea symptoms. Subgroup analyses showed that different acupuncture types had distinct advantages. Sensitivity analyses for several outcomes were unstable, and there were indications of publication bias. According to GRADE, only the acute vomiting duration score was rated as moderate quality; all other outcomes were rated as low or very low quality. Conclusion:Although acupuncture for HEC-induced CINV shows some positive effects, there are various limitations that render the current evidence insufficient to conclusively establish its efficacy; therefore, further high-quality studies are required. Systematic review registration:PROSPERO, identifier: CRD42024588165.

Objective Cerebrovascular repair plays a crucial role in promoting post-stroke neurological recovery. However, effective strategies to enhance cerebrovascular repair and the underlying mechanisms remain elusive. Here, we investigated whether post-stroke electroacupuncture (EA) treatment could promote cerebrovascular repair and thereby improve neurological function, as well as the potential mechanisms involved. Methods Eight-week-old male C57BL/6 J mice were subjected to photothrombosis-induced brain ischemia. Following successful model induction, the mice were randomly assigned to the model group, the EA continuous wave group (EA[Co]), and the EA dense-sparse wave group (EA[SD]), with 10 animals in each group. A sham-operated group (n = 10) served as the control. The EA groups received a 4-week EA intervention targeting the acupoints “Neiguan(PC6)” and “Sanyinjiao(SP6)”. EA was administered five times per week with bilateral stimulation, and the affected side was connected to the EA device. The EA(SD) group received stimulation at 2/10 Hz, whereas the EA(Co) group received continuous wave stimulation at 2 Hz or 50 Hz; both were delivered at an intensity of 1 mA for 20 min per session. Twenty-four hours after photothrombosis induction, laser speckle contrast imaging and 2,3,5-triphenyltetrazolium chloride staining were performed to confirm model establishment and cerebral ischemic injury. Neurological function was evaluated using behavioral tests, including the adhesive removal test, hanging wire test, and elevated plus maze test. Immunofluorescence staining was performed to assess neuronal viability, cerebral microvascular structure, endothelial cell proliferation, and vascular repair markers in the peri‑infarct cortex. Results Significant reductions in cerebral blood perfusion (P < 0.05) and non-infarct volume (P < 0.05) were observed in the ipsilateral hemisphere of model mice compared with the contralateral hemisphere, confirming successful establishment of the photothrombosis-induced ischemia model. (1) In the adhesive removal test, the model group exhibited significantly prolonged adhesive removal latency compared with the control group (P < 0.05). EA treatment shortened latency compared with the model group (P < 0.05), with no statistically significant difference between the EA(Co) and EA(SD) groups (P > 0.05). (2) In the wire hanging test, the model group exhibited significantly lower muscle strength scores than the sham group (P < 0.05). EA treatment significantly enhanced muscle strength performance (P < 0.05), and the improvement was greater in the EA(Co) group than in the EA(SD) group (P < 0.05). (3) In the elevated plus maze test, the model group showed significant decreases in total distance traveled, percentage of open-arm entries, and time spent in open arms compared with the control group (all P < 0.05). Following EA treatment, all three parameters were significantly restored compared with the model group (all P < 0.05), with no statistically significant difference between the EA(Co) and EA(SD) groups (P > 0.05). (4) Immunofluorescence staining showed a significantly reduced density of Nissl⁺/NeuN⁺ double-labeled neurons in the peri‑infarct regions of the model group compared with the control group (P < 0.05). Nissl⁺/NeuN⁺ neuronal density was significantly restored in the EA groups compared with the model group (all P < 0.05), with no statistically significant difference between the EA(Co) and EA(SD) groups (P > 0.05). (5) In terms of cerebrovascular structure, the model group exhibited significantly reduced vascular volume, microvascular branching density, and microvascular length in the peri‑infarct regions compared with the control group (all P < 0.05). EA treatment restored all three vascular parameters compared with the model group (all P < 0.05). Moreover, the EA(Co) group showed significantly greater enhancement of cerebrovascular structural integrity than the EA(SD) group (P < 0.05). (6) Compared with the control group, the model group showed no significant change in the density of Ki67⁺/CD31⁺ double-labeled endothelial cells (P > 0.05). Following EA treatment, this density was significantly increased compared with the model group (P < 0.05), with no statistically significant difference between the EA(Co) and EA(SD) groups (P > 0.05). (7) Compared with the control group, the model group exhibited significant reductions in lectin-labeled glycocalyx in vessels and basement membrane protein collagen IV expression (all P < 0.05), indicating disruption of cerebrovascular integrity. EA treatment significantly restored both indicators compared with the model group (all P < 0.05), with no statistically significant difference between the EA(Co) and EA(SD) groups (P > 0.05). Conclusion This study demonstrates that EA promotes cerebrovascular repair and neurological recovery after ischemic stroke by enhancing microvascular remodeling, stimulating endothelial proliferation, and restoring basement membrane and glycocalyx integrity. EA(Co) is more effective than EA(SD) in repairing vascular structure. These findings provide mechanistic evidence that EA is a promising therapeutic approach for post-stroke rehabilitation and suggest that waveform optimization may enhance its clinical efficacy.

OBJECTIVES:To observe the effect of electroacupuncture (EA) on the activities of N-terminal B-type natriuretic peptide (NT-proBNP)/vascular endothelial growth factor (VEGF)/neurogenic site-gap homologous protein (Notch) signaling pathway and related factors in rats with chronic heart failure (CHF), so as to explore its regulatory mechanism underlying improvement of CHF. METHODS:Male SD rats were randomly divided into sham-operation, CHF model, EA and EA+inhibitor [DAPT (GSI-IX), a γ-secretase inhibitor] groups (n=6 in each group). The CHF model was established by ligating the anterior descending branch of the left coronary artery. EA (2 Hz, an electric current intensity to induce slight shaking of the inserted acupuncture needles) was applied to bilateral "Neiguan"(PC6) and "Shenmen"(HT7) for 30 min, once daily, for 7 d. Rats of the EA+inhibitor group received intraperitoneal injection of DAPT (3 mg/kg) 30 min before each EA intervention. A small animal color Doppler ultrasound machine was used to collect the left ventricular ejection fraction (LVEF), left ventricular fractional shortening rate (LVFS), left ventricular end-systolic diameter (LVIDs) for evaluating the left ventricle function. Histopathological changes of the cardiac tissue were observed by H.E. staining and Masson staining. The contents of serum NT-proBNP and VEGF were detected by using ELISA. The microvascular density (MVD) of the left ventricular myocardium was observed by CD34 immunohistochemistry. The expression levels of myocardial Notch signaling pathway-related proteins Notch1 and Delta-like 4 ligand (DLL4) were detected by using Western blot. RESULTS:Compared with the sham operation group, the model group had a significant increase in the LVIDs, serum NF-proBNP content, MVD and expression levels of Notch1 and DLL4 protein in the left ventricular myocardial tissue (P<0.000 1, P<0.001, P<0.01), and a significant decrease in the LVEF, LVFS and serum VEGF content (P<0.000 1). In comparison with the model group, the EA group had a significant decrease in the LVIDs and serum NF-proBNP content(P<0.001), and a significant increase in the LVEF, LVFS and serum VEGF content (P<0.001, P<0.000 1), while the MVD and expression levels of Notch1 and DLL4 protein in the left ventricular myocardial tissue were more increased (P<0.001, P<0.05, P<0.01). In comparison with the EA group, both the striking increase and decrease of the indexes mentioned above were all reversed in the EA+inhibitor group (P<0.05, P<0.01, P<0.000 1, P<0.001) except LVIDs. Histopathological observation showed obvious myocardial fiber rupture, irregular arrangement, cell necrosis, unclear nucleoli, fibrous hyperplasia, deposition of collagenous fibers, and a large number of inflammatory infiltration in the myocardial tissue of the model group, which was relatively milder in the EA group but not in the EA+inhibitor group. CONCLUSIONS:EA of PC6 and HT7 can improve the cardiac function of rats with CHF, which may be associated with its functions in promoting the neovascularization of ischemic myocardium, reducing ischemic injury, and protecting myocardial tissue structure via up-regulation of the serum VEGF content and the expressions of Notch1 and DLL4 protein.

ObjectiveTo evaluate the effectiveness of “Tongdu Tiaoshen” acupuncture for cancer-related fatigue （CRF）.MethodsSixty patients with CRF were randomly assigned， via a team-developed central randomization system， to an acupuncture group （n=30， with 3 dropouts） and a sham acupuncture group （n=30， with 3 dropouts）. Both groups received the usual care. In the acupuncture group， Baihui （GV20）， Shenting （GV24）， and Dazhui （GV14） were selected as the primary acupoints according to the “Tongdu Tiaoshen” acupuncture. The sham acupuncture group used the same acupoint locations as the acupuncture group， but received a control intervention using a sham acupuncture device designed to simulate the sensation of needling. Needles were retained for 30 min per session， for a total of 10 sessions over 14 days. The primary outcome， the Functional Assessment of Chronic Illness Therapy-Fatigue （FACIT-Fatigue）， and the secondary outcomes， including the Brief Fatigue Inventory （BFI）， the Pittsburgh Sleep Quality Index （PSQI）， and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 （EORTC QLQ-C30）， were assessed at baseline and after 14 d of treatment. In addition， the James Blinding Index （JBI） was used to evaluate blinding， and adverse events in both groups were recorded for safety assessment.ResultsAfter 14 d of treatment， compared with the sham acupuncture group， the acupuncture group showed a significant increase in FACIT-Fatigue scores （reflecting the core symptoms of CRF） （P<0.01）， a significant decrease in BFI scores （P<0.05）， and a significant increase in EORTC QLQ-C30 scores （reflecting quality of life） （P<0.01）， whereas no significant difference was found in PSQI scores reflecting sleep status， P>0.05）. In addition， the JBI indicated successful blinding， and there was no statistically significant difference in adverse events between the two groups， suggesting overall good safety.Conclusion“Tongdu Tiaoshen” acupuncture can effectively improve the core symptoms of CRF and enhance quality of life， but its effect on sleep quality has not yet been fully established.

Existing reporting checklists lack the specificity and comprehensiveness required to effectively guide the documentation of acupuncture case reports. Therefore, we developed a reporting guideline tailored specifically for acupuncture case reports, building upon the CAse REport (CARE) statement. A multidisciplinary group of international experts including clinicians, researchers and methodologists was convened to draft the initial checklist in accordance with the methodology recommended by the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) network. Through an extensive literature review and a series of expert interviews, the final CARE for acupuncture checklist comprised of 30 items. 38 experts from diverse disciplines participated in three rounds of modified Delphi surveys to refine and clarify these items. CARE for acupuncture is a comprehensive reporting guideline focused on acupuncture case reports developed with rigorous methodology. We hope that CARE for acupuncture will further guide authors, editors, peer reviewers and readers to enhance the transparency, completeness and accuracy of reporting of case reports in acupuncture.

BACKGROUND:Hemifacial spasm (HFS) is characterized by maladaptive brain plasticity, yet whether modulating this plasticity can alleviate symptoms remains unclear. OBJECTIVE:To evaluate the efficacy of electroacupuncture (EA)-a form of peripheral nerve stimulation-for HFS and elucidate its underlying neuroplastic mechanisms. METHODS:In this randomized, double-blind, sham-controlled trial (conducted 2016-2023), 84 HFS patients and 84 healthy controls were enrolled. Patients received 30 sessions of distal (hand), local (facial), or sham EA over 15 weeks. Clinical outcomes included Jankovic and Global Rating Scales. Physiological markers, including lateral spread response (LSR), synkinetic response (SR), and blink reflex (BR) excitability, were measured by electromyography (EMG). Motor cortex (M1) excitability was quantified via motor evoked potentials (MEPs) induced by transcranial magnetic stimulation (TMS). Parameter-probing experiments in healthy controls identified optimal stimulation characteristics. RESULTS:At baseline, HFS patients exhibited profound brainstem (BR R1/R2: P < 0.001) and facial M1 hyperexcitability versus controls. Low-frequency, low-intensity hand EA (2 Hz, 0.5-1 mA) significantly reduced Jankovic scores by 3.32 points (95% CI -4.12 to -2.52; P < 0.001; Cohen's d = 1.86) versus sham EA. This clinical improvement was mechanistically linked to a significant suppression of LSR (P < 0.01) and BR amplitude (P < 0.001), a reduction in facial M1 excitability (P < 0.05), and a compensatory increase in hand M1 excitability (P < 0.001). Notably, these neurophysiological and clinical benefits were maintained for 6 months post-treatment. CONCLUSION:Distal low-frequency, low-intensity peripheral stimulation effectively alleviates HFS by modulating maladaptive brainstem and M1 plasticity. These findings highlight the potential of this approach as a promising neuromodulatory strategy for hyperkinetic movement disorders. © 2026 International Parkinson and Movement Disorder Society.

Objective To observe the effect of electroacupuncture (EA) on the activities of N-terminal B-type natriuretic peptide (NT-proBNP)/vascular endothelial growth factor (VEGF)/neurogenic site-gap homologous protein (Notch) signaling pathway and related factors in rats with chronic heart failure (CHF)

Purpose:Chronic neck pain (CNP) is a common but challenging symptom in clinical practice. Acupuncture is widely used in alleviating the symptoms of CNP. The main objective of this study was to evaluate the efficacy and safety of electroacupuncture (EA) in patients with CNP and to quantify the specific effects of EA by controlling for placebo effects. Patients and Methods:A randomized sham-controlled trial was conducted at the outpatient departments of single hospital in China from November 2019 to November 2020 and a total of 105 participants with CNP were enrolled. Participants were randomly assigned (1:1:1) to the EA group, sham electroacupuncture (SEA) group and waiting list (WL) group. The primary outcome was change in the Northwick Park Neck Pain Questionnaire (NPQ). Secondary outcomes included McGill Pain Questionnaire (MG), visual analogue scale (VAS) and pain threshold (PT). Results:This randomized clinical trial included 98 patients. The EA group demonstrated a greater reduction in NPQ scores compared to the SEA group after 10 sessions (-7.2564, 95% CI=-12.2875 to -2.2253, P=0.0054) and at 3-month follow up (-7.0090, 95% CI=-10.5039 to -3.5140, P=0.0002). After 10 sessions, the EA and SEA groups exhibited greater reductions in NPQ scores compared to the WL group (EA vs WL: P <0.001, [95% CI=6.570 to 15.503]; SEA vs WL: P=0.027, [95% CI=0.578 to 9.580]). However, the EA group achieved clinically significant NPQ improvements (>25%), whereas the SEA group failed to meet this criterion. Conclusion:This randomized clinical trial found that, in patients with CNP, EA significantly improved the symptoms compared with SEA and WL groups both immediately and cumulatively (at 5 weeks), and these benefits persisted through week 17. These comparisons demonstrated that EA's clinical benefits exceeded placebo effects.

Background: Acupoint catgut embedding (ACE) is considered an effective treatment for simple obesity, though high-quality clinical evidence remains lacking. To establish a solid evidence base in obesity management, well-designed studies are needed to verify both the short- and long-term efficacy and safety of ACE. Methods: In this randomized controlled, double-blind trial, 120 patients with simple obesity were initially allocated to verum ACE (n = 60) or sham ACE group (n = 60) .One participant allocated to the verum group was excluded during screening for failing to meet BMI criteria (<24 kg/m²), resulting in a final cohort of 59 verum and 60 sham cases completing the 12-week intervention and 12-week follow-up. The primary outcome was the change in body weight from baseline to week 12. Secondary outcomes included body weight change at 12-week follow-up, cumulative weight change by week 24, changes in body mass index (BMI), body fat status, body circumference, and appetite indicators. Results: After the 12-week treatment, both groups showed varying degrees of weight loss, with the verum ACE group experiencing a significantly greater reduction compared to the sham group. At the 12-week follow-up, the visceral fat grade of the verum group was significantly greater than that of sham group. The waist, upper arm, and thigh girths in the verum group decreased significantly more than that in sham group; the reduction degree of waist-hip ratio was significantly better than that in the sham group at all time points. Additionally, the cumulative reduction in appetite factors was significantly higher in the verum group compared to the sham group. Conclusion: ACE can significantly reduce body weight, and is both long-lasting and safe. It also has beneficial effects on fat distribution, body circumference, and appetite, making it a promising complementary therapy for simple obesity. Trial registration: Chinese Clinical Trial Registry, ChiCTR2100046693.

Objective To observe the effect of electroacupuncture(EA)on histone deacetylase 3(HDAC3),synaptic plasticity and N-methyl-D-aspartate(NMDA)receptors in the hippocampus of mice with Alzheimer's disease(AD),so as to explore the underlying mechanism of EA in treatment of AD.Methods 5XFAD mice were randomly divided into EA group,model group and sham-acupuncture group,with 13 mice in both the EA group and the model group,and 7 mice in the sham-acupuncture group.Thirteen wild-type mice from the same litter were taken as the normal control group.The mice in the EA group received EA at"Baihui"(GV20)and"Dazhui"(GV14)for 15 min once daily,6 times a week for 4 weeks.The mice in the sham-acupuncture group received sham EA,i.e.,the needle was inserted into the rubber clay which was placed on the surface of the corresponding acupoints.The novel object recognition(NOR),Y-maze and Morris water maze(MWM)tests were used to observe the cognitive functions of mice.Electrophysiological technique was used to detect long-term potentiation(LTP)of the hippocampal neurons and Western blot was used to detect the relative expressions of HDAC3 and NMDAR-related receptors(NMDAR1,NMDAR2A,NMDAR2B)in the hippocampus.Results Compared with the normal control group,5XFAD mice in the model group showed decreased(P<0.01,P<0.05)preference index for new object recognition,alternative arm ratio(AAR),number of times crossing the original platform,percentage of time and distance traveled in the target quadrant,NMDAR2B,NMDAR2A and NMDAR1 protein expression levels,with prolonged(P<0.01)escape latency,and increased(P<0.05)protein relative expression of HDAC3.At the same time,with high-frequency stimulation,the slope of fEPSP was decreased(P<0.01,P<0.05)in the 5XFAD mice.After EA intervention,comparison between the EA and the model groups revealed that,the preference index for new object recognition,AAR were increased(P<0.01,P<0.05)in the EA group,the escape latency was shortened(P<0.05),and the number of times crossing the platform,percentage of time and distance traveled in the target quadrant,the slope of fEPSP,and the protein relative expressions of NMDAR2B,NMDAR2A and NMDAR1 in the hippocampus were increased(P<0.01,P<0.05),while the protein relative expression of HDAC3 decreased(P<0.01).Compared with sham-acupuncture group,the above indexes improved to different degree in the EA group(P<0.01,P<0.05).Conclusion EA of GV20 and GV14 can restore the impaired LTP and improve the cognitive impairment,which may be related to increasing the expressions of NMDA-related receptor proteins and down-regulating the expression of HDAC3 in the hippocampus of 5XFAD mice.

BackgroundAlthough acupuncture is recommended for managing breast cancer-related hot flashes, the level of evidence is limited. With the updating of randomized controlled trials, it is necessary to reassess its efficacy.ObjectiveTo assess the effectiveness of acupuncture in the treatment of hot flashes in patients with breast cancer.MethodsUp to March 2024, we retrieved data from nine databases and used Stata software (version 14.0, version 17.0) and RevMan software (version 5.3) to conduct a meta-analysis. The Cochrane Collaboration’s risk of bias assessment tool was used for methodological assessment of the risk of bias, and the GRADEpro GDT online assessment tool was used for evidence evaluation.ResultsIn total, 11 randomized controlled trials (RCTs) involved 963 participants were included in the meta-analysis. The result of risk of bias revealed that the included RCTs exhibited a high risk of bias, primarily attributable to deficiencies in randomization and blinding methods. The results of primary meta-analysis indicated that acupuncture can improved the hot flash symptom scale score (SMD, -0.54; 95% CI, -0.83 to -0.24; P < 0.05). However, acupuncture does not reduce the frequency of hot flashes(SMD, -0.20; 95% CI, -0.75 to 0.36; P = 0.48). Further subgroup analyses, including the type of control group and the duration of needle retention, etc. showed different results, highlighting the necessity for further research. Sensitivity analysis confirmed the reliability of these finding. In addition, due to various issues, the level of evidence is low.ConclusionsAlthough acupuncture treatment for hot flashes in breast cancer shows potential, the evidence for the efficacy of acupuncture is still lacking due to various factors such as bias risk and significant differences between studies, and more high-quality RCTs are needed to confirm the efficacy of acupuncture.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024531542.

ABSTRACT Introduction Preliminary studies have indicated that acupuncture may play a role in the management of negative emotions in patients with PCOS. However, the available evidence is predominantly of low quality. Consequently, a meta‐analysis was conducted to assess the validity of acupuncture as a therapeutic modality for treating negative emotional symptoms in patients with PCOS. Methods A meticulous search of nine databases was performed to identify randomized controlled trials assessing the effectiveness of acupuncture in the management of negative emotions in individuals diagnosed with PCOS. The principal outcome was evaluated using the SDS and SAS scales, while secondary outcomes encompassed the Rosenfield scores, Ferriman–Gallwey (F–G) scores, and BMI. The risk of bias was appraised with the Cochrane RoB 2.0 tool. The certainty of evidence was evaluated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. Results This meta‐analysis synthesized the findings of seven studies that collectively provided evidence supporting the hypothesis that acupuncture may be more effective than drug treatment in alleviating SDS. However, the findings did not demonstrate significant efficacy in improving SAS. The analysis further revealed that acupuncture could effectively improve the F–G score in patients with PCOS, although it was not significantly effective for the Rosenfield score. The GRADE assessment assigned a low level of certainty to the SDS and F–G scores and a very low level of certainty to the SAS, Rosenfield, and BMI scores, emphasizing the necessity for additional high‐quality RCTs to validate these findings. Conclusion This study identified the potential of acupuncture in alleviating depression in patients with PCOS. Nonetheless, the evidence substantiating these findings was restricted by the poor quality of the included RCTs, precluding the drawing of definitive conclusions. Until more substantial evidence emerges, caution should be exercised regarding assertions of the therapeutic potential of acupuncture for treating negative emotions associated with PCOS.