Electrophysiologic Study of Acupuncture's Effect on the Peripheral Nervous System

针刺对周围神经系统影响的电生理学研究

• 批准号: 8751715
• 负责人: Alexandra K Dimitrova
• 金额: $ 13.64万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2019-08-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8751715
• 关键词: Acupuncture Points; Acupuncture procedure; Area; Autonomic nervous system; Biometry; Carpal Tunnel Syndrome; Characteristics; Clinical Research; Detection; Electric Stimulation; Electroacupuncture; Epidemiology; Esthesia; Frequencies; Future; Goals; Grant; Heart; Kidney; Lead; Leg; Manuals; Measurement; Measures; Mechanical Stimulation; Mediating; Medical; Mentors; Modality; Needles; Nerve; Nervous system structure; Neural Conduction; Neuraxis; Neurophysiology - biologic function; Organ; Outcome Study; Outcomes Research; Paper; Peripheral; Peripheral Nerves; Peripheral Nervous System; Peripheral Nervous System Diseases; Physicians; Physiological; Positioning Attribute; Preparation; Public Health; Randomized; Research; Research Design; Research Methodology; Research Personnel; Research Training; Sensory; Skeletal Muscle; Somatosensory Evoked Potentials; Spinal Cord; Stomach; Structure of tibial nerve; Structure of ulnar nerve; Techniques; Testing; Therapeutic Effect; Tissues; Training; Treatment Protocols; Variant; Visceral; afferent nerve; arm; base; career development; experience; improved; knowledge base; median nerve; pericardial sac; peroneal nerve; public health relevance; relating to nervous system; research study; skills; theories; vibration

DESCRIPTION (provided by applicant): The overall goals of this proposed project are 1) to develop Dr. Alexandra Dimitrova into an independent complementary and alternative physician researcher~ and 2) To conduct a clinical research study of acupuncture, assessing its effects on the peripheral nerves. Dr. Dimitrova will develop her knowledge base, experience and skills in 5 key areas through mentored training:1) EMG/Nerve Conduction Studies and Quantitative Sensory Testing~ 2) Clinical research: methodology, biostatistics, epidemiology, grant and paper preparation~ 3) Acupuncture~ 4) Somatosensory Evoked Potentials~ 5) Microneurography. The long-term goal of the research training plan is to master electrophysiologic techniques which will be used in the assessment of acupuncture's effect on the peripheral and central nervous system and thus characterize and quantify acupuncture's effect and its mechanism of action. As a first step, the proposed research study will serve to assess the local effects of three widely-used acupuncture modalities on two anatomically distinct nerves in the arm (Median and Ulnar) and two nerves in the leg (Tibial and Deep Peroneal). Our central hypothesis is that acupuncture to points overlying a peripheral nerve causes nerve-specific changes in nerve conduction studies (NCS) and quantitative sensory testing (QST) only in that nerve, as the needles deliver mechanical and electrical stimulation on the peri-neural tissues. We expect to observe greater physiologic changes in diseased nerves, compared to healthy ones, due to their baseline abnormalities. In a mechanistic study of acupuncture, 36 subjects with carpal tunnel syndrome will be randomized to manual acupuncture, low-and high-frequency electroacupuncture groups. Following baseline measurements of NCS and QST of the Median and Ulnar nerves, each group will undergo acupuncture to the Median nerve (Pericardium channel points) and to the Ulnar nerve (Heart channel points), one week apart, order counterbalanced, followed by repeat NCS and QST measurements. An analogous study will be performed in the Tibial nerve (using Kidney channel points) and Deep Peroneal nerve (using Stomach channel points) in the leg. The specific aims are to 1: Characterize the effects of acupuncture on QST (cold and vibration sensation thresholds) and nerve conduction parameters in the Median and Ulnar nerves. 2: Compare the effects of acupuncture on a diseased nerve (Median) to those of a healthy nerve (Ulnar), using QST (cold and vibration sensation thresholds) and NCS parameters. 3: Compare the effects of manual acupuncture to those of low-frequency and high-frequency electroacupuncture. 4: Conduct an analogous study using NCS and QST to assess the local effects of acupuncture on the Tibial and Deep Peroneal Nerves in the leg, in subjects with peripheral neuropathy. This research is expected to increase our understanding of acupuncture's mechanism of action and capture, characterize and quantify its effect in a way, which has not been accomplished to-date.

描述（由申请人提供）：该项目的总体目标是：1）将Alexandra Dimitrova博士培养为独立的补充和替代医生研究员，2）进行针灸的临床研究，评估其对周围神经的影响。Dimitrova博士将通过指导培训在5个关键领域发展她的知识基础，经验和技能：1）EMG/神经传导研究和定量感觉测试~ 2）临床研究：方法学，生物统计学，流行病学，资助和论文准备~ 3)针灸~ 4）体感诱发电位~ 5）脑神经造影。研究培训计划的长期目标是掌握电生理技术，这些技术将用于评估针灸对外周和中枢神经系统的影响，从而表征和量化针灸的效果及其作用机制。作为第一步，拟议的研究将用于评估三种广泛使用的针灸方式对手臂中两种解剖学上不同的神经（正中和尺骨）和腿部中两种神经（胫骨和腓深神经）的局部影响。我们的中心假设是，针刺到周围神经上的穴位会导致神经传导研究（NCS）和定量感觉测试（QST）中的神经特异性变化，因为针会对周围神经组织进行机械和电刺激。我们希望观察到更大的生理变化，在患病的神经相比，健康的，由于他们的基线异常。在一项针灸机制研究中，36名腕管综合征患者将被随机分为手针组、低频电针组和高频电针组。在正中神经和尺神经的NCS和QST的基线测量之后，每组将接受正中神经（腰肌通道点）和尺神经（心通道点）的针刺，间隔一周，顺序平衡，然后重复NCS和QST测量。将在腿部的胫神经（使用肾通道点）和腓深神经（使用胃通道点）中进行类似研究。具体目标是：1：表征针刺对正中神经和尺神经的QST（冷和振动感觉阈值）和神经传导参数的影响。第二章：使用QST（冷和振动感觉阈值）和NCS参数比较针刺对患病神经（正中神经）和健康神经（尺神经）的影响。3：比较手针与低频、高频电针的疗效。 第四章：使用NCS和QST进行类似研究，以评估针灸对周围神经病变受试者腿部胫神经和腓深神经的局部影响。这项研究有望增加我们对针灸的作用机制和捕获的理解，并以某种方式表征和量化其效果，这是迄今为止尚未完成的。