Does acupuncture at motor-related acupoints affect corticospinal excitability? A systematic review and meta-analysis

IF 4.2 2区医学 Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE

Journal of Integrative Medicine-Jim Pub Date : 2025-03-01 DOI:10.1016/j.joim.2025.02.004

Renming Liu , Aung Aung Kywe Moe , Weiting Liu , Maryam Zoghi , Shapour Jaberzadeh

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引用次数: 0

Abstract

Background

Acupuncture is widely used in modulating brain excitability and motor function, as a form of complementary and alternative medicine. However, there is no existing meta-analysis evaluating the effectiveness and safety of acupuncture on corticospinal excitability (CSE), and the credibility of the evidence has yet to be quantified.

Objective

This study was designed to assess the efficacy and safety of electroacupuncture (EA) and manual acupuncture (MA) in enhancing brain excitability, specifically focusing on CSE as measured by transcranial magnetic stimulation (TMS).

Search strategy

This study followed a systematic approach, searching 9 databases up to August 2024 and examining grey literature, in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Inclusion criteria

Studies were included if they compared the clinical efficacy of EA or MA with sham acupuncture, no treatment or usual training.

Data extraction and analysis

Three investigators independently conducted literature screening, data extraction, and risk of bias assessment. The primary outcome focused on motor-evoked potentials as measured by TMS, with treatment effects quantified using mean differences or standardized mean differences between pre- and post-treatment. Subgroup analyses were conducted using mixed-effects models, while random-effects or fixed-effects models were used to estimate average treatment differences across studies.

Results

Based on 34 studies involving 1031 adults, acupuncture techniques significantly enhanced CSE. EA had a greater impact than MA, with effect sizes of 0.53 mV vs 0.43 mV (95% confidence interval [CI]: [0.30, 0.76], P < 0.00001 vs 95% CI: [0.28, 0.59], P < 0.00001). The 5 most frequently used acupoints were LI4 (Hegu, 32 times), ST36 (Zusanli, 10 times), LI11 (Quchi, 7 times), TE5 (Waiguan, 6 times), and GB34 (Yanglingquan, 5 times).

Conclusion

This systematic review indicates that both EA and MA could effectively and safely enhance CSE, bringing the corticospinal pathway closer to the threshold for firing, which may ultimately improve motor function. LI4, ST36, LI11, TE5 and GB34 are the most commonly used acupoints.

Please cite this article as: Liu R, Moe AAK, Liu W, Zoghi M, Jaberzadeh S. Does acupuncture at motor-related acupoints affect corticospinal excitability? A systematic review and meta-analysis. J Integr Med. 2025; 23(2): 113–125.

查看原文本刊更多论文

针刺运动相关穴位是否影响皮质脊髓兴奋性？系统回顾和荟萃分析。

背景：针灸作为一种补充和替代医学，在调节大脑兴奋性和运动功能方面被广泛应用。然而，目前还没有meta分析评估针刺对皮质脊髓兴奋性（CSE）的有效性和安全性，证据的可信度也有待量化。目的：本研究旨在评估电针（EA）和手针（MA）增强脑兴奋性的有效性和安全性，特别关注经颅磁刺激（TMS）测量的CSE。检索策略：本研究采用系统方法，检索了截至2024年8月的9个数据库，并检查了灰色文献，符合系统评价和荟萃分析指南的首选报告项目。纳入标准：如果将EA或MA与假针灸、不治疗或常规训练的临床疗效进行比较，则纳入研究。资料提取和分析：三位研究者独立进行文献筛选、资料提取和偏倚风险评估。主要结果集中在经颅磁刺激测量的运动诱发电位，治疗效果使用治疗前后的平均差异或标准化平均差异来量化。使用混合效应模型进行亚组分析，而使用随机效应或固定效应模型来估计研究之间的平均治疗差异。结果：基于34项涉及1031名成人的研究，针灸技术可显著提高CSE。EA的影响大于MA，效应值为0.53 mV vs 0.43 mV（95%可信区间[CI]: [0.30, 0.76]， P）。结论：本系统评价提示EA和MA均能有效、安全地增强CSE，使皮质脊髓通路更接近放电阈值，最终可能改善运动功能。LI4、ST36、LI11、TE5、GB34是最常用的穴位。刘r， Moe AAK，刘伟，Zoghi M, Jaberzadeh S.针刺运动相关穴位是否影响皮质脊髓兴奋性？系统回顾和荟萃分析。集成医学[J]；打印前Epub。

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来源期刊

Journal of Integrative Medicine-Jim Medicine-Complementary and Alternative Medicine

CiteScore

9.20

自引率

4.20%

发文量

3319

期刊介绍： The predecessor of JIM is the Journal of Chinese Integrative Medicine (Zhong Xi Yi Jie He Xue Bao). With this new, English-language publication, we are committed to make JIM an international platform for publishing high-quality papers on complementary and alternative medicine (CAM) and an open forum in which the different professions and international scholarly communities can exchange views, share research and their clinical experience, discuss CAM education, and confer about issues and problems in our various disciplines and in CAM as a whole in order to promote integrative medicine. JIM is indexed/abstracted in: MEDLINE/PubMed, ScienceDirect, Emerging Sources Citation Index (ESCI), Scopus, Embase, Chemical Abstracts (CA), CAB Abstracts, EBSCO, WPRIM, JST China, Chinese Science Citation Database (CSCD), and China National Knowledge Infrastructure (CNKI). JIM Editorial Office uses ThomsonReuters ScholarOne Manuscripts as submitting and review system (submission link: http://mc03.manuscriptcentral.com/jcim-en). JIM is published bimonthly. Manuscripts submitted to JIM should be written in English. Article types include but are not limited to randomized controlled and pragmatic trials, translational and patient-centered effectiveness outcome studies, case series and reports, clinical trial protocols, preclinical and basic science studies, systematic reviews and meta-analyses, papers on methodology and CAM history or education, conference proceedings, editorials, commentaries, short communications, book reviews, and letters to the editor. Our purpose is to publish a prestigious international journal for studies in integrative medicine. To achieve this aim, we seek to publish high-quality papers on any aspects of integrative medicine, such as acupuncture and traditional Chinese medicine, Ayurveda medicine, herbal medicine, homeopathy, nutrition, chiropractic, mind-body medicine, taichi, qigong, meditation, and any other modalities of CAM; our commitment to international scope ensures that research and progress from all regions of the world are widely covered. These ensure that articles published in JIM have the maximum exposure to the international scholarly community. JIM can help its authors let their papers reach the widest possible range of readers, and let all those who share an interest in their research field be concerned with their study.