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: 9543963
• 负责人: Alexandra K Dimitrova
• 金额: $ 15.62万
• 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 2020-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9543963
• 关键词: Acupuncture Points; Acupuncture Therapy; Anatomy; Area; Autonomic nervous system; Biometry; Carpal Tunnel Syndrome; Characteristics; Clinical Research; Detection; Disease; Electric Stimulation; Electroacupuncture; Electrophysiology (science); Epidemiology; Esthesia; Frequencies; Future; Goals; Grant; Heart; Kidney; 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; Perineural Tissue; 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; Standardization; Stomach; Structure of tibial nerve; Structure of ulnar nerve; Techniques; Testing; Therapeutic Effect; Training; Treatment Protocols; Variant; Visceral; afferent nerve; arm; base; career development; experience; improved; knowledge base; median nerve; nerve conduction study; pericardial sac; peroneal nerve; public health relevance; 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(申请人提供)：该项目的总体目标是：1)将Alexandra Dimitrova博士培养成一名独立的补充和替代内科研究人员；2)开展针灸临床研究，评估其对周围神经的影响。迪米特罗娃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)肌电/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、赠款和论文准备3)针灸~4)体感诱发电位~5)显微神经学。研究训练计划的长期目标是掌握电生理技术，用于评估针灸对周围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法对手臂上两条解剖上不同的神经(正中和尺骨)和腿上两条神经(胫骨和腓深)的局部影响。我们的中心假设是，针刺覆盖在周围神经上的穴位在神经传导研究(NCS)和定量感觉测试(QST)中只在该神经中引起神经特有的变化，因为针在神经周围组织上传递机械和电刺激。我们预计，与健康神经相比，患病神经的生理变化更大，因为它们的基线异常。在针灸的机理研究中，36名患有腕管综合征的受试者将被随机分为手动针刺组、低频电针组和高频电针组。在基线测量正中神经和尺神经的NCS和QST后，每组分别针刺正中神经(心包经穴)和尺神经(心经穴)，每隔一周按平衡顺序进行NCS和QST的重复测量。将在腿部的胫神经(使用肾经穴)和腓深神经(使用胃经穴)进行类似的研究。具体目的为：1.研究针刺对正中神经和尺神经冷感和振动觉阈值及神经传导参数的影响。2：比较针刺对患侧神经(正中神经)和健侧神经(尺侧)的影响，使用冷觉和振动觉阈值(QST)和神经传导速度(NCS)参数。3：比较手法针刺与低频电针、高频电针的疗效。4：使用NCS和QST进行类似的研究，以评估针刺对周围神经病受试者小腿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作用机制的了解，并以一种迄今尚未完成的方式对其作用进行表征和量化。