Acupuncture MRI Discovery For Sciatica Relief

Thank you to HealthCMI for this interesting article.

Acupuncture alleviates sciatica and MRIs reveal that acupuncture causes important pain relief related changes in brain functional connectivity. Affiliated Huashan Hospital of Fudan University researchers gathered objective and subjective data in a controlled clinical trial consisting of patients suffering from sciatica. Visual Analogue Scale (VAS) scores indicate that acupuncture produces significant decreases in both pain intensity levels and frequency of pain. Additionally, MRIs show that acupuncture restores pain-free connectivity related activity in the brain; acupuncture changed the functional state of the brain such that patients had greater resting states.

The researchers determined that acupuncture regulates the default mode network (DMN). In addition, the DMN regulation induced by acupuncture treatment correlates to significant reductions in pain for sciatica patients. The DMN is a complex of interconnected activated and deactivated brain regions and the DMN is at its peak activity level when the brain is at rest. Acupuncture facilitated key changes to the brain to allow for the resting state to return. The research indicates that sciatica-related pain disturbs the normal DMN pattern and that acupuncture restores the pattern.

Using functional magnetic resonance imaging (fMRI), the research team discovered that acupuncture “raises negative activation in the brain’s default mode network (DMN) of chronic sciatica patients, especially in the dorsal medial prefrontal cortex and anterior cingulate cortex.” [1] The cingulate cortex and the frontal cortex are known to be involved in pain-related subjective perception and cognition, memory, emotional responses, and attentional responses. [2]

Prior research confirms that decreased negative activation in the DMN is associated with increased pain. Another fMRI study compared chronic lower back pain patients with healthy volunteers. The results showed that patients with chronic lower back pain had significantly decreased negative activation in the default mode network (DMN) of the brain. [3] Negative activation is a form of functional connectivity found during the brain’s resting state. [4]

 

Symptoms
In the Affiliated Huashan Hospital of Fudan University sciatica research, Visual Analogue Scale (VAS) scores of the acupuncture treatment and control groups were compared before and after treatments. VAS was implemented as an instrument for assessing the intensity and frequency of pain. The scores in the acupuncture treatment group decreased from 5.6 ±1.3 before treatment to 1.2 ±0.8 after treatment. There was a statistically significant difference before and after treatment and the acupuncture group significantly outperformed the control group. The subjective data demonstrates that acupuncture reduces both pain intensity and frequency for patients with sciatica.

 

Brain Functional Connectivity
The researchers found that negative activation of the DMN in the healthy control group included the following regions: bilateral posterior cingulate, cuneus, precuneus, inferior parietal lobule, dorsal medial prefrontal cortex, and dorsal lateral prefrontal cortex. Prior to acupuncture, the treatment group showed decreased negative activation in the DMN regions as well, including the dorsal medial prefrontal cortex, dorsal lateral prefrontal cortex, anterior cingulate cortex, and precuneus. After acupuncture treatment, the negative activation in these regions increased. Acupuncture produced significant improvements towards the DMN activity found in the healthy control group; however, a slight decrease in negative activation in the precuneus of chronic sciatic patients persisted.

 

Design
The Fudan University researchers (Li et al.) used the following study design. A total of 20 subjects participated in the study and were divided into two groups, with 10 subjects in each group. The treatment group subjects were selected from the Department of Integrated Traditional and Western Medicine, the Affiliated Huashan Hospital of Fudan University. All were diagnosed with chronic sciatica. The control group subjects included only healthy volunteers. The following selection criteria were applied for the treatment group subjects:

  • Consistent with the diagnostic criteria of chronic sciatica: radiating pain in the sciatic nerve distribution area (i.e., buttocks, posterior thigh, posterior lateral lower leg, lateral dorsum of the foot).
  • Chronic lower extremity pain for more than 3 months.
  • No sedative or analgesic drugs were taken 24 hours before or during acupuncture treatment.
  • No acupuncture treatment within 0.5 years before the study.
  • The visual analogue scale (VAS) score was ≥5 points.
  • Informed consent was signed for each subject.

The following exclusion criteria were applied:

  • History of spinal fractures, tumors, and intervertebral disc surgery.
  • History of nervous and mental disorders.
  • Contraindications for MRI examination (i.e., claustrophobia).

The statistical breakdown for each group was as follows. The treatment group was comprised of 5 males and 5 females. The mean age of the treatment group was 39.5 ±6.0 years. The control group was comprised of 5 males and 5 females. The mean age of the control group was 37.7 ±5.1 years. Both groups were equivalent in all relevant demographics, setting the basis for a fair comparison of results. Only the treatment group received acupuncture treatment. Both groups were scanned twice using fMRIs, once before acupuncture and once after 10 sessions of acupuncture treatment.

 

Acupuncture Procedure
The primary acupoints selected for the treatment of chronic sciatica were the following:

  • BL40 (Weizhong)
  • GB30 (Huantiao)

Additional secondary acupoints were added based on symptom presentation. For lower back pain, the following acupoints were added:

  • BL23 (Shenshu)
  • BL25 (Dachangshu)

For pain radiating to the posterior lower leg, the following acupoint was added:

  • BL57 (Chengshan)

Manual acupuncture was applied prior to the application of electroacupuncture. After deqi was achieved at the acupoints, the acupuncture needles were connected to an electroacupuncture device (2 Hz,2–4 mA, 10 V). The needles were retained for 30 minutes starting from the initiation of electroacupuncture stimulation. One 30 minute electroacupuncture session was administered twice daily, 3 times weekly, for a grand total of 10 sessions for each participant. To learn more about acupuncture procedures to alleviate sciatica, visit the following online course:

Lower Back Pain and Sciatica >

 

Summary
Subjective clinical and objective MRI data indicates that acupuncture is effective for the treatment of chronic sciatica. According to the research, common protocols involve the application of acupoints Weizhong (BL40) and Huantiao (GB30) for this condition. Patients interested in learning more about acupuncture are recommended to contact a local licensed acupuncturist.

 

References:
[1] Li J, Dong JC, Le JJ, et al. Effects of acupuncture on default mode network images of chronic sciatica patients in the resting network state [J]. Chinese Journal of Integrated Traditional and Western Medicine, 2012, 32(12):1624-1627.
[2] Vogt BA, Derbyshire S, Jones AK. Pain processing in four regions of human cingulate cortex localized with co-registered PET and MR imaging [J]. Eur J Neurosci, 1996, 8 (7): 1461 – 1473.
[3] Baliki MN, Geha PY, Apkarian AV, et al. Beyond feeling: chronic pain hurts the brain, disrupting the default mode network dynamics[J]. J Neurosci, 2008, 28 (6) :1398 – 1403.
[4] Raichle ME, MacLeod AM, Snyder AZ, et al. A default mode of brain function[J]. Proc Natl Acad Sci USA, 2001, 98(2): 676 – 682.

2018-10-15T15:50:47+00:00October 15th, 2018|

How CBD has become the USA’s coolest food and drink ingredient

(CNN) — The latest “it” ingredient to hit menus is CBD, short for cannabidiol, one of over 60 cannabinoids found in the cannabis sativa plant (more commonly known as marijuana).
Unlike THC, the most well-known cannabinoid, CBD has no psychoactive effects. So, while it won’t get you high, its reported therapeutic properties have driven CBD sales and popularity in the wellness industry.
While researchers are still trying to determine CBD’s effects, some studies suggest it can help treat inflammation, pain, anxiety and seizures.
The controversy around this superfood stems from inconsistent cannabis regulation at the federal and state level. Despite growing legalization, the DEA still considers cannabis — including CBD, unless sourced from industrial hemp — an illegal drug.
To date, the FDA hasn’t approved any CBD products apart from an epilepsy drug called Epidiolex. State laws vary and are changing all the time.
Take California, a state with legalized recreational cannabis and a famously vibrant cannabis cuisine scene: Just this summer, the California Department of Public Health stopped the sale of CBD additives in food and drink until it receives full FDA approval.
This left restaurants such as Gracias Madre and Superba Food + Bread scrambling to change their menus to accommodate the rule.
With the Golden State out of the culinary cannabis spotlight at the moment, it’s time to highlight some other less celebrated locations where you can find CBD-infused treats out in the wild.
From a sleek, wellness compound in Miami to a Portland dive bar known for late-night hot dogs, here are the coolest spots to find CBD on the menu (for now).

Adriaen Block, Queens, NY

Adriaen Block CBD Negroni

Adriaen Block’s CBD Negroni.
Lily Brown/Adriaen Block
This newly opened Queens cocktail bar and restaurant is a CBD mecca, showcasing the ingredient front and center.
For the uninitiated, the menu offers a word of advice: “CBD will not get you high, but you may experience a calming sensation.”
The infused drinks include the Stoney Negroni, Rolled Fashioned, and the Bakin’ & Eggs, which is made with Pineau des Charente, Lillet Blanc, blood orange bitters, egg white, and garnished with crisped bacon.
Teetotalers can get in on the action too, thanks to an equally thoughtful selection of CBD mocktails made with Seedlip, a swanky, non-alcoholic distilled spirit. Not thirsty? Also on offer are entrees with a side of AB CBD sauce or a pillowy blob of CBD-infused whipped cream to top off dessert.
Adriaen Block, 19-33 Ditmars Blvd, Astoria, NY 11105, +1 (718) 686-1391

Broomwagon, Lexington, KY

A community mecca for bike culture, this bicycle shop is also a beer garden and café serving up locally-sourced coffee, creative comfort food and ice-cold crafts and drafts.
Customers bringing in their bike for repairs can enjoy a snack by the mechanic’s work area while they wait, or check out the latest wheels and accessories. (New pannier bag, anyone?)
They’ll add a dose of CBD to any beverage for $2, or you can order a specialty drink like the Sage Advice Latte, with maple and sage-infused syrup, espresso, steamed milk and CBD.
Broomwagon Coffee + Bikes, 800 N. Limestone St., Lexington, KY 40505, +1 (859) 554-6938

Koku, Brooklyn, NY

kokus zen bowl cbd

This Kokus Zen bowl delivers on its name.
Courtesy Kokus
Think of the Zen Bowl as an ice cream sundae for the Goop set — dairy-free, probiotic-enriched coconut soft-serve heaped with colorful superfood toppings like antioxidant blueberries, nutritious black sesame granola and CBD cacao magic shell.
Available April through October at Brooklyn’s Smorgasburg on Saturdays in Williamsburg and Sundays in Prospect Park, it’s allergy-free and utterly Instagrammable.
You can also find the frozen treat at sporadic pop-ups (check their website for upcoming events), but stay tuned: A brick and mortar location is in the works for next year.
Koku, multiple locations

Donnie Vegas, Portland, OR

The coolest downtown Las Vegas dive bar is actually located in Northeast Portland, serving cocktails on tap and cheap, creative hot dogs like the Seoul Dog (kimchi, sambal aioli, scallion) and Tijuana Dog (cream cheese, pico de gallo, jalepeno) until 2:30 am.
They offer Jell-O shots and wine in a can, and a slushee with a hemp-derived twist — the Prickly Pear CBD Margaweeda, made with fresh lime juice, triple sec, silver tequila and prickly pear puree.
Donnie Vegas, 1203 NE Alberta St, Portland, OR 97211, +1 (503) 477-7244

Green Goddess Cafe, Stowe, VT

This homey café, a neighborhood go-to for fresh-pressed juices and tasty breakfast scrambles, was one the first in Vermont to put the wellness ingredient on the menu after “we experienced the benefits of CBD firsthand with our son, who has autism and a tumor disorder,” owner Athena Scheidet says.
One of their most popular specialty drinks is the Jamaican Me Shake, a CBD smoothie with tropical fruit, spinach, avocado, organic apple juice and whipped cream.
Green Goddess Cafe, 618 S Main St, Stowe, VT 05672, +1 (802) 253-5255

The James New York NoMad, New York City

James Nomad Hotel CBD Menu

The James NoMad brings CBD to R-n-R.
Courtesy The James Nomad
Travelers who want a break from Manhattan’s hectic pace don’t even need to leave their boutique hotel room for the latest way to unwind — CBD-infused room service from notable cannabis chef Annabel Drummer.
The in-room dining menu includes spicy meatballs, gorgonzola salad with walnuts and pear, and house tater tots. Or, you can pick a prepackaged CBD-infused treat like Chef For Higher Gummies, Grön Chocolate bars, and even Bark Avenue dog treats for stressed pets.
The James NoMad, 22 E 29th St, New York, NY 10016, +1 (212) 532-4100

VegeNation, Las Vegas

VegeNation CBD Whiskey Tea

Stay hydrated in Vegas with this whiskey CBD tea.
Courtesy Vege Nation
Downtown Las Vegas’s Fremont East area has become an artsy hub for plant-based eats and health-conscious cocktails — the antithesis of the Strip’s bottle service and Champagne-shower decadence.
Affordable global street food at VegeNation is locally grown and plant-based, and even the cocktails have a positive spin — particularly The Changemaker, a refreshing, infused whiskey tea made with local distilled liquor and tea from Bloomin’ Desert Herb Farm, a brew of rosemary, ginger, holy basil, red clover, nettle, peppermint, clove and raw CBD oil in purified water.
VegeNation, 616 Carson Ave #120, Las Vegas, NV 89101, +1 (702) 366-8515

Plant Miami, Miami

plant medicine miami

The secret ingredient in Plant Miami’s drink isn’t so secret.
Courtesy Plant Miami
Miami isn’t all neon lights, and pumping basslines. When the South Beach scene feels like it’s all too much, find your Zen at Sacred Space Miami.
The minimalist oasis in once-gritty Wynwood features a lush meditation garden, yoga and wellness classes, and Plant Miami, an organic, vegan farm-to-table restaurant.
The tropical Plant Medicine cocktail — with fresh pineapple, house coconut milk, dark rum, and a dose of CBD oil — is the perfect blend of Miami vibes and mindfulness.
Plant Miami, 105 Northeast 24th St, Miami, FL, 33137, +1 786 621 5006

River and Woods, Boulder

The comfort food at this historic cottage includes community-sourced dishes like Aunt Penny’s Mac & Cheese with mushrooms and onion-potato crunch and John’s Gnocchi Verde with spinach, Reggiano cream, and lemon zest.
There are family-friendly picnic tables in back, as well as an adult-centric Airstream that serves as an outdoor bar, where you can add a dose of CBD to cocktails like the Sloe Descent, with Luxardo amaretto, Spirit Works sloe gin, orange and pomegranate juice.
(They’re in the process of formulating a dedicated CBD-infused wellness cocktail, too.)
River and Woods, 2328 Pearl St, Boulder, CO 80302, (303) 993-6301

Coalition Brewing, Portland, OR

coalition brewing CBD beer

IPA + CBD = Coalition Brewing’s Two Flowers brew.
Courtesy Coalition Brewing
This brewery changed the game with Oregon’s first commercially produced CBD-infused beer, Two Flowers IPA, highlighting the kinship between cannabis and hops with an aromatic, grassy flavor.
The beer has become so popular that you can find it all over town at establishments like EastBurn Public House and Dot’s Café, though it’s worth a visit to the tasting room’s new patio where you can enjoy it in its original birthplace.
Coalition Brewing, 2705 SE Ankeny St, Portland, OR 97214, +1 (503) 894-8080

Zenbarn, Waterbury, VT 05676

ZenBarn CBD Burger

Yes, even your burger can help you chill.
Courtesy ZenBarn
You haven’t reached peak Vermont until you’ve visited this rustic barn-turned-restaurant’s periodic “Hemp and Hops” dinners, where five-course meals are infused with CBD and paired with local craft beers.
It’s a community-focused space, with a yoga studio upstairs and live music at night. (Be prepared to hear Grateful Dead covers.)
The daily menu offers CBD-spiked aioli for their burgers, including the vegetarian Zen Burger, a local black bean patty piled with cheddar, chipotle crema, avocado, lettuce, and crispy onion.
There’s also CBD honey vinaigrette for salad, a CBD brownie sundae with house-made CBD caramel, and clever CBD cocktails with names like Gin and Chronic, Le Verde and Up in Smoke.
Zenbarn, 179 Guptil Rd, Waterbury Center, VT 05677, +1 (802) 244-8134

Grön Cafe Portland, OR

Gron drinking chocolate CBD

Grön serves its CBD on the sweet side.
Courtesy Gron
If there was a Willy Wonka of cannabidiol, it would Christine Smith, founder of craft chocolate company GrönCBD.
The manufactory’s confections contain CBD extracted from a hemp alternative — evergreen tree bark combined with citrus peels.
The front of house is a drop-in cafe, where you can order CBD Drinking Chocolate served with whipped cream and a shortbread cookie, as well as infused chocolate lattes, steamers, iced chocolate drinks, chocolate-filled croissants, and truffles.
They’ll indulge your curiosity and your sweet tooth — visitors are encouraged to ask questions or sample the CBD caramel and chocolate sauces, chocolate bars, tinctures and body products.
2018-10-08T13:56:41+00:00October 8th, 2018|

Why Chinese medicine is heading for clinics around the world

Thank you to David Cyranoski for a great article

Choi Seung-hoon thought he had an impossible assignment. On a grey autumn day in Beijing in 2004, he embarked on a marathon effort to get a couple of dozen representatives from Asian nations to boil down thousands of years of knowledge about traditional Chinese medicine into one tidy classification system.

Because practices vary greatly by region, the doctors spent endless hours in meetings that dragged over years, debating the correct location of acupuncture points and less commonly known concepts such as ‘triple energizer meridian’ syndrome. There were numerous skirmishes between China, Japan, South Korea and other countries as they vied to get their favoured version of traditional Chinese medicine (TCM) included in the catalogue. “Each country was concerned how many terms or contents of its own would be selected,” says Choi, then the adviser on traditional medicine for the Manila-based western Pacific office of the World Health Organization (WHO).

But over the next few years, they came to agree on a list of 3,106 terms and then adopted English translations — a key tool for expanding the reach of the practices.

And next year sees the crowning moment for Choi’s committee, when the WHO’s governing body, the World Health Assembly, adopts the 11th version of the organization’s global compendium — known as the International Statistical Classification of Diseases and Related Health Problems (ICD). For the first time, the ICD will include details about traditional medicines.

The global reach of the reference source is unparalleled. The document categorizes thousands of diseases and diagnoses and sets the medical agenda in more than 100 countries. It influences how physicians make diagnoses, how insurance companies determine coverage, how epidemiologists ground their research and how health officials interpret mortality statistics.

The work of Choi’s committee will be enshrined in Chapter 26, which will feature a classification system on traditional medicine. The impact is likely to be profound. Choi and others expect that the inclusion of TCM will speed up the already accelerating proliferation of the practices and eventually help them to become an integral part of global health care. “It will definitely change medicine around the world,” says Choi, now the board chair of the National Development Institute of Korean Medicine in Gyeongsan.

Whether this is a good thing depends on whom you talk to. For Chinese leaders, the timing could not be better. Over the past few years, the country has been aggressively promoting TCM on the international stage both for expanding its global influence and for a share of the estimated US$50-billion global market.

Medical-tourism hotspots in China are drawing tens of thousands of foreigners for TCM. Overseas, China has opened TCM centres in more than two dozen cities, including Barcelona, Budapest and Dubai in the past three years, and pumped up sales of traditional remedies. And the WHO has been avidly supporting traditional medicines, above all TCM, as a step towards its long-term goal of universal health care. According to the agency, traditional treatments are less costly and more accessible than Western medicine in some countries.

Many Western-trained physicians and biomedical scientists are deeply concerned, however. Critics view TCM practices as unscientific, unsupported by clinical trials, and sometimes dangerous: China’s drug regulator gets more than 230,000 reports of adverse effects from TCM each year.

With so many questions about TCM’s effectiveness and safety, some experts wonder why the WHO is increasing support for such practices. One of them is Donald Marcus, an immunologist and professor emeritus at Baylor College of Medicine in Houston, Texas, and a prominent TCM critic. In his opinion, “at some point, everyone will ask: why is the WHO letting people get sick?”

A traditional-medicine pharmacist stands behind a desk covered in dried product

A pharmacy in a traditional-medicine hospital in Beijing dispenses medications.Credit: David Gray/Reuters

Different approach

TCM is based on theories about qi, a vital energy, which is said to flow along channels called meridians and help the body to maintain health. In acupuncture, needles puncture the skin to tap into any of the hundreds of points on the meridians where the flow of qi can be redirected to restore health. Treatments, whether acupuncture or herbal remedies, are also said to work by rebalancing forces known as yin and yang.

Practitioners of TCM and Western-trained physicians have often eyed each other suspiciously. The Western convention is to seek well-defined, well-tested causes to explain a disease state. And it typically requires randomized, controlled clinical trials that provide statistical evidence that a drug work