title: Acupuncture Reduces Excitability of Spinal Motor Neurons in Patients with Spastic Muscle Overactivity and Chronic Disorder of Consciousness Following Traumatic Brain Injury.
abstract: OBJECTIVE
  Spastic hypertonia usually occurs in patients with chronic disorders of consciousness (DOC) following severe traumatic brain injury (TBI). Spinal motor neuron excitability has been reported to increase in patients with brain damage. The aim of this study was to evaluate the immediate effects of acupuncture on spinal motor neuron excitability in patients with DOC following TBI by using evoked electromyography.
  
  
  METHODS
  Eleven male patients (mean age, 33 ± 14 years) with refractory muscle spasticity of the upper extremity accompanying chronic DOC following TBI and admitted to Chubu Medical Center for Prolonged Traumatic Brain Dysfunction were included.
  
  
  METHODS
  A crossover study design was used. Changes in variables in the acupuncture session were compared with those in the control session in the same patients.
  
  
  METHODS
  Acupuncture treatment was performed at GV 26, Ex-HN 3, bilateral LI 4, and ST 36 for 10 minutes.
  
  
  METHODS
  F-wave was recorded from the abductor pollicis brevis muscle. The main outcome measure was F/M amplitude ratio (F-wave amplitude/M-wave amplitude), calculated as an index for spinal motor neuron excitability. F-waves were recorded before treatment (baseline), 10 minutes after needle insertion (phase 1), and 10 minutes after needle removal (phase 2). The same procedure was followed in the control session without acupuncture on a separate day.
  
  
  RESULTS
  F/M ratio was significantly reduced from baseline to phase 1 (p < 0.001) and phase 2 (p < 0.001) in the acupuncture session, whereas no significant changes were observed in the control session. Changes in F/M ratio from baseline to phase 1 and phase 2 were greater in the acupuncture session than the control session (p = 0.001 and <0.001, respectively).
  
  
  CONCLUSIONS
  The excitability of the spinal motor neurons in patients with DOC following TBI was reduced after acupuncture treatment, suggesting that it is beneficial for reducing spastic muscle hypertonia in these patients.
authors: 1 Chubu Medical Center for Prolonged Traumatic Brain Dysfunction , Kizawa Memorial Hospital, Minokamo, Gifu, Japan .
authors: Jun
authors: J
authors: Matsumoto-Miyazaki
authors: 1 Chubu Medical Center for Prolonged Traumatic Brain Dysfunction , Kizawa Memorial Hospital, Minokamo, Gifu, Japan .|2 Department of Clinical Brain Sciences, Gifu University Graduate School of Medicine , Minokamo, Gifu, Japan .
authors: Yoshitaka
authors: Y
authors: Asano
authors: 1 Chubu Medical Center for Prolonged Traumatic Brain Dysfunction , Kizawa Memorial Hospital, Minokamo, Gifu, Japan .
authors: Yuka
authors: Y
authors: Ikegame
authors: 1 Chubu Medical Center for Prolonged Traumatic Brain Dysfunction , Kizawa Memorial Hospital, Minokamo, Gifu, Japan .
authors: Tomohiro
authors: T
authors: Kawasaki
authors: 1 Chubu Medical Center for Prolonged Traumatic Brain Dysfunction , Kizawa Memorial Hospital, Minokamo, Gifu, Japan .
authors: Yuichi
authors: Y
authors: Nomura
authors: 1 Chubu Medical Center for Prolonged Traumatic Brain Dysfunction , Kizawa Memorial Hospital, Minokamo, Gifu, Japan .|2 Department of Clinical Brain Sciences, Gifu University Graduate School of Medicine , Minokamo, Gifu, Japan .
authors: Jun
authors: J
authors: Shinoda
mesh_terms: D015670:Acupuncture Therapy; D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000503:physiopathology / Q000628:therapy*; D003244:Consciousness Disorders / Q000503:physiopathology / Q000628:therapy*; D018592:Cross-Over Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000502:physiology*; D009122:Muscle Hypertonia / Q000503:physiopathology / Q000628:therapy; D009128:Muscle Spasticity / Q000503:physiopathology / Q000628:therapy*; D013116:Spinal Cord / Q000503:physiopathology*; D055815:Young Adult
keywords: acupuncture; brain injury; disorder of consciousness; hypertonia; spasticity; spinal motor neuron