MULTIPLE SCLEROSIS

Multiple sclerosis (MS) is a chronic autoimmune disease that damages the central nervous system (CNS), disrupting the flow of information within the brain, and between the brain and body. In the CNS, which is made up of brain, spinal cord and optic nerves of the body, the immune system attacks myelin – which is the fatty tissue that surrounds the nerves of the body. Damage to the myelin sheath or nerve fiber distorts nerve impulses and can lead to the following symptoms:

  • Walking (Gait) difficulties
  • Fatigue
  • Spasticity
  • Muscle weakness or spasms
  • Vision problems – blurred vision, poor contrast or color vision
  • Numbness and tingling
  • Sexual problems
  • Poor bladder or bowel control
  • Pain
  • Depression and emotional changes
  • Cognitive changes such as focusing or remembering

Acupuncture is a powerful and complete medical system unlike dry needling technique which physical therapists are now starting to adopt into their repertoire. The Traditional Chinese Medicine (TCM) approach to evaluating patients and selecting acupuncture points allows the acupuncturist to treat the causes not just the symptoms of diseases like MS which are not orthopedic traumatic injuries but internal neurological central nervous symptoms diseases.

There are numerous case reports and acupuncture clinical studies reporting acupuncture’s effective treatment of MS symptoms. Many of these reports are case studies from China, and while these reports do demonstrate successful use of acupuncture in MS patients, additional randomized double blind clinical trials would be beneficial in drawing clearer conclusions and clinical outcomes.

It is, however, worth noting that there have been a number of documented clinical trials of significance. For example, Quispe-Cabanillas et al. measured the impact electroacupuncture (EA) had on the quality of life of 31 patients with relapsing remitting multiple sclerosis while under the treatment with immunomodulators. Although the study’s sample size was small, it was a double blind randomized study in a University outpatient clinic setting. All patients received immunodulators and were divided into two groups, one receiving electroacupuncture treatment and the second placebo group receiving sham acupuncture. The 6-month study found that the placebo group’s pain and depression had continued to worsen while the electroacupuncture group’s deterioration was stalled/progression slowed down. Improvements were also seen in the quality of life in these patients. [1]

To gain further understanding into acupuncture’s impact on the actual MS disease, scientific research in China has focused on the effect acupuncture has on T-cells.

A group of Chinese researchers used an experimental autoimmune encephalomyelitis (EAE) on mice that mimics many of the clinical and pathological features of MS. Liu et al. demonstrated on rats that electrostimulation at the ST 36 (Zusanli) acupoint attenuated EAE severity, while rats receiving non-Zusanli acupoint therapy were still suffering serious disease. Liu et al. also proved that successive eletroacupuncture treatments, up to 21 days at the Zusanli ST36 acupoint of rats, could restore the balance to the Th1,Th2,Th17 Treg T helper cell responses by stimulating the hypothalamus to increase ACTH production [2]. This is significant since the hypothalamus is a key regulator of various physiological and pathophysiological processes including emotion, autonomic activity, and pain. In addition, Liu et al. also found that EA at ST 36 increased the production of β – endorphins, which have a protective role in the context of EAE. Increased β-endorphin production has the potential of reversing the Th1:Th2 ratio thus lowering the EAE severity. It’s important to note that these studies do show that the actual traditional acupuncture point does create a significant palliative biochemical autoimmune response in patients.

Demyelination of the spinal cord is another significant type of integrated Western science and acupuncture research that is important to highlight. Oligodendrocyte precursor cells (OPCs) are one of the potential treating factors for MS. Thus, the production of cells and differentiation of OPCs in a demyelinated spinal cord are highly significant for improvement of the reparative process. Huang et al, investigated the effect of acupuncture along the Governing (Du) Meridian on ethidium bromide microinjected mice which acted as a model for demyelinated spinal cord. After 15 days of EA treatment, neurotrophin-3 (NT-3) levels and the number of NG2-positive OPCs were significantly increased. In rats given longer EA treatment for 30 days, the number of adenomatous polyposis coli (APC)-positive oligodendrocytes increased. Simultaneously, the number of newly formed myelin also increased. There was also an increase in production of endogenous oligodendrocytes involved in myelin formation. The results showed that EA treatment can promote NT-3 expression, increase the cell number and differentiation of endogenous OPCs, and remyelination in the demyelinated spinal cord as well as the functional improvement of demyelinated spinal cord.

In these research studies its important to note that improvements at the biomolecular level appeared after 15 to 30 days of treatment. Therefore, the most beneficial acupuncture care plan for MS patients is with frequent and consistent acupuncture sessions for at least one month, also it’s important to take note that additional large-scale clinical trials need to be performed to further the understanding of and improve acupuncture’s effects on MS.

  1. Juan G Quispe-Cabanillas,1,2 Alfredo Damasceno,1,4 Felipe von Glehn,1,4 Carlos O Brandão,1,4 Benito P Damasceno,4 Wanderley D Silveira,3 and Leonilda MB Santos1.Impact of electroacupuncture on quality of life for patients with Relapsing-Remitting Multiple Sclerosis under treatment with immunomodulators: A randomized study. BMC Complement Altern Med. 2012; 12: 209. Published online 2012 Nov 5. Juan G Quispe-Cabanillas,1,2 Alfredo Damasceno,1,4 Felipe von Glehn,1,4 Carlos O Brandão,1,4 Benito P Damasceno,4 Wanderley D Silveira,3 and Leonilda MB Santos1.Impact of electroacupuncture on quality of life for patients with Relapsing-Remitting Multiple Sclerosis under treatment with immunomodulators: A randomized study. BMC Complement Altern Med. 2012; 12: 209. Published online 2012 Nov 5.
  2. Huang SF1, Ding Y, Ruan JW, Zhang W, Wu JL, He B, Zhang YJ, Li Y, Zeng YS. An experimental electro-acupuncture study in treatment of the rat demyelinated spinal cord injury induced by ethidium bromide. Neurosci Res. 2011 Jul;70(3):294-304.
  3. Yumei Liu,#1 Hongwei Wang,#2 Xinyue Wang,1 Lili Mu,1 Qingfei Kong,1 Dandan Wang,1 Jinghua Wang,1 Yao Zhang,1 Jinfeng Yang,1 Mingyan Zhou,1 Guangyou Wang,1 Bo Sun,1,* and Hulun Li1,3.The Mechanism of Effective Electroacupuncture on T Cell Response in Rats with Experimental Autoimmune Encephalomyelitis. LoS One. 2013; 8(1): e51573. Published online 2013 Jan 28. doi:  10.1371/journal.pone.0051573