Acupuncture: A Promising Therapy for Traumatic Brain Injury

Traumatic Brain Injury (TBI) casts a long shadow over global health. Startlingly, half the world’s population may experience at least one TBI in their lifetime [1, 2]. This condition not only contributes significantly to neurologic disability worldwide [1, 2] but also stands as the leading cause of death among young adults in North America [2]. Consequently, many individuals affected by TBI face lifelong disabilities [3].

What are Traumatic Brain Injuries?

Firstly, TBI typically results from impacts to the head or body [4]. However, it can also stem from strokes and hypoxia, which injure upper motor neurons [5]. While mild TBIs may cause temporary disruptions in brain cell function, severe TBIs can inflict substantial damage, including bruising, torn tissues, and bleeding [4].

Secondly, the spectrum of TBI symptoms varies widely; mild TBIs often manifest as headaches, nausea, fatigue, speech difficulties, dizziness, and vision problems [4] whilst moderate to severe TBIs present more serious symptoms, such as prolonged loss of consciousness, worsening headaches, and seizures [4]. Furthermore, damage to upper motor neurons can lead to spasticity, a condition characterized by involuntary muscle activity and decreased muscle strength [5].

Research Into the Treatment of TBIs With Acupuncture

Additionally, research suggests that acupuncture holds promise for promoting brain tissue recovery [5, 6, 7]. Specifically, it reduces inflammation and regulates cell signaling, thereby modulating the body’s response to injury [5, 6, 7]. Moreover, acupuncture regulates the inhibitory neurotransmitter GABA, increasing its concentration in cerebrospinal fluid and helping to relieve muscle spasms [5, 8].

Furthermore, beyond its anti-inflammatory and muscle-relaxing effects, acupuncture improves blood supply to the cerebral ischemic area which protects neurons and promotes cell proliferation, both of which are crucial for strengthening lower motor neuron control and regulating muscle tension [5, 9, 10].

Neurological Mechanisms

The positive impact of acupuncture on TBI patients extends further. For example, it regulates neurotransmitters, promotes nerve repair and regeneration, and inhibits cell apoptosis, among other beneficial effects [1, 11]. Notably, studies have associated acupuncture with a significantly lower risk of dementia in TBI patients [1, 12].

Delving deeper into the mechanisms of action, research has shown that acupuncture significantly elevates levels of Brain-Derived Neurotropic Factor (BDNF) and tropomyosin receptor kinase B (TrkB) [1, 13]. This therefore suggests that acupuncture activates the BDNF/TrkB pathway, which is pivotal for promoting neurological recovery.

Clinical Evidence

Clinical studies further reinforce these findings. For instance, both auricular and traditional acupuncture have been shown to improve headache-related quality of life in service members with TBI [1, 14]. Similarly, laser acupuncture has demonstrated its ability to improve cognitive function and reduce oxidative stress in animal models of Parkinson’s disease, hinting at its broader neuroprotective potential [15].

Additionally, acupuncture has been shown to protect neurons and delay Wallerian degeneration in cerebral infarction [1, 16]. Finally, electroacupuncture, when combined with Western medicine, has proven more effective than Western medicine alone in treating coma caused by TBI [1, 17].

Conclusion

In summary, a growing body of research underscores acupuncture’s potential as a valuable therapeutic approach for TBI recovery. By addressing a multitude of neurological mechanisms, from reducing inflammation and regulating neurotransmitters to promoting nerve repair and improving blood flow, acupuncture offers a promising avenue for enhancing outcomes for individuals affected by this debilitating condition.

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References:

• 1. Sudhakaran, P. (2023). Traumatic brain injury: acupuncture treatment. Medical acupuncture, 35(5), 251-256.
• 2. Maas, A. I., Menon, D. K., Manley, G. T., Abrams, M., Åkerlund, C., Andelic, N., … & Zemek, R. (2022). Traumatic brain injury: progress and challenges in prevention, clinical care, and research. The Lancet Neurology, 21(11), 1004-1060.
• 3. Rutland-Brown, W., Langlois, J. A., Thomas, K. E., & Xi, Y. L. (2006). Incidence of traumatic brain injury in the United States, 2003. The Journal of head trauma rehabilitation, 21(6), 544-548.
• 4. Mayo Foundation for Medical Education and Research. (n.d.). Traumatic brain injury. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-causes/syc-20378557
• 5. Xie, R., Wang, Y., He, J., & Yang, Y. (2021). Acupuncture treatment for spasticity after brain injury. Journal of Neurorestoratology, 9(1), 60-71.
• 6. Wang S, Hu YH. Effects of acupuncture with different meridians on the expression of PKC in cerebral tissue of spasm rats after stroke [in Chinese]. Chin J Trad Med Sci Technol 2012;19:519–21
• 7. Wang S, Cong Y. Study on the effect of acupuncture with different meridian points on serum IP3 and DAG levels in spasm rats after cerebral apoplexy [in Chinese]. Chin J Trad Med Sci Technol 2012;19:52–4.
• 8. Kakinohana, O., Hefferan, M. P., Nakamura, S., Kakinohana, M., Galik, J., Tomori, Z., … & Marsala, M. (2006). Development of GABA-sensitive spasticity and rigidity in rats after transient spinal cord ischemia: a qualitative and quantitative electrophysiological and histopathological study. Neuroscience, 141(3), 1569-1583.
• 9. Li, J., He, J., Du, Y., Cui, J., Ma, Y., & Zhang, X. (2014). Electroacupuncture improves cerebral blood flow and attenuates moderate ischemic injury via Angiotensin II its receptors-mediated mechanism in rats. BMC complementary and alternative medicine, 14, 1-12.
• 10. Hong, J., Wu, G., Zou, Y., Tao, J., & Chen, L. (2013). Electroacupuncture promotes neurological functional recovery via the retinoic acid signaling pathway in rats following cerebral ischemia-reperfusion injury. International journal of molecular medicine, 31(1), 225-231.
• 11. Guo, Y. X., & Du, R. S. (2020). Progress of researches on mechanism of acupuncture for traumatic brain injury. Zhen ci yan jiu= Acupuncture Research, 45(7), 587-591.
• 12. Juan, Y. H., Livneh, H., Huang, H. J., Lu, M. C., Yeh, C. C., & Tsai, T. Y. (2019). Decreased risk of dementia among patients with traumatic brain injury receiving acupuncture treatment: a population-based retrospective cohort study. The Journal of head trauma rehabilitation, 34(5), E17-E23.
• 13. Li, X., Chen, C., Yang, X., Wang, J., Zhao, M. L., Sun, H., … & Tu, Y. (2017). Acupuncture improved neurological recovery after traumatic brain injury by activating BDNF/TrkB pathway. Evidence‐Based Complementary and Alternative Medicine, 2017(1), 8460145.
• 14. Jonas, W. B., Bellanti, D. M., Paat, C. F., Boyd, C. C., Duncan, A., Price, A., … & Chae, H. (2016). A randomized exploratory study to evaluate two acupuncture methods for the treatment of headaches associated with traumatic brain injury. Medical acupuncture, 28(3), 113-130.
• 15. Wattanathorn, J., & Sutalangka, C. (2014). Laser acupuncture at HT7 acupoint improves cognitive deficit, neuronal loss, oxidative stress, and functions of cholinergic and dopaminergic systems in animal model of Parkinson’s disease. Evidence‐Based Complementary and Alternative Medicine, 2014(1), 937601.
• 16. Shen, Y., Li, M., Wei, R., & Lou, M. (2012). Effect of acupuncture therapy for postponing Wallerian degeneration of cerebral infarction as shown by diffusion tensor imaging. The Journal of Alternative and Complementary Medicine, 18(12), 1154-1160.
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