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Objectives: To investigate the efficacy of acupuncture in preventing cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) and explore its underlying mechanism. Design: A randomized, double-blinded, and placebo-controlled trial. Setting/Location: Subjects were recruited from Kyung Hee University Hospital at Gangdong, Seoul, Korea Subjects: A total of 50 patients admitted with acute SAH. Interventions: The study group received acupuncture treatments (n = 25), while the control group underwent mock transcutaneous electrical nerve stimulation and sham acupuncture (n = 25) six times/week for 2 weeks. Outcome measures: The primary outcome was the incidence of delayed ischemic neurologic deficit (DIND), and secondary measurements included angiographic vasospasm, vasospasm-related infarction, modified Rankin Scale score, and plasma nitric oxide (NO) and endothelin-1 (ET-1) levels. Results: The study group treated with acupuncture showed a lower incidence of DIND (9.1%) than the control group (20.8%); however, this difference in the incidence of DIND was not statistically significant. The study group demonstrated better clinical outcomes, especially in functional recovery. Significant alterations in plasma NO and ET-1 levels after the 2-week intervention were observed only in the study group. Conclusions: Their study shows that acupuncture treatment improved functional recovery after SAH and could potentially prevent cerebral vasospasm. These effects could be attributed to the recovery of endothelial dysfunction by acupuncture through modulating the plasma NO and ET-1 levels. The study protocol has been registered on www.clinicaltrials.gov (NCT02275949). [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the efficacy of acupuncture and bee venom acupuncture (BVA) for idiopathic Parkinson's disease (IPD) through a sham-controlled trial. We also investigated whether there is a sustained therapeutic effect by completing follow-up assessments after treatment completion. Design: A single center, double-blind, three-armed randomized controlled trial. Settings/Location: This study was performed at a university hospital in Seoul, Republic of Korea. Subjects: Seventy-three (73) patients with IPD were the subjects. They were randomly assigned to the active treatment group, sham treatment group, or conventional treatment group. Interventions: The active treatment group received acupuncture and BVA and the sham group received sham acupuncture and normal saline injections, twice a week for 12 weeks. The conventional treatment group maintained anti-parkinsonian drugs without additional intervention. Outcome measures: The Unified Parkinson's Disease Rating Scale (UPDRS) part II and part III score, postural instability and gait disturbance (PIGD) score, gait speed and number, Parkinson's Disease Quality of Life Questionnaire, Beck Depression Inventory, and postural stability at baseline and at 12, 16, and 20 weeks. Results: Sixty-three (63) patients provided a complete data of assessments, including a final follow-up. After 12 weeks of treatment, a significant difference was observed between the active treatment group and the conventional treatment group. After the end of the treatment, the treatment effects were maintained significantly in the active treatment group only. Conclusions: It is suggested that the combined treatment of acupuncture and BVA might be safe and useful adjunctive treatment for patients with IPD. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to examine the effectiveness and safety of combined treatment using acupuncture and bee venom acupuncture (BVA) as an adjunctive treatment for idiopathic Parkinson's disease (PD). Methods: Eleven patients (7 men and 4 women) with idiopathic PD who had been receiving a stable dose of anti-parkinsonian medication for at least 4 weeks. Participants received conventional treatment for 12 weeks. Subsequently, they received additional treatment with acupuncture and BVA twice weekly for 12 weeks while still maintaining conventional treatment. All participants were assessed at baseline, 12 weeks, and 24 weeks by using the Unified Parkinson's Disease Rating Scale (UPDRS), the Parkinson's Disease Quality of Life Questionnaire (PDQL), the speed and number of steps required to walk 20 m, and the Beck Depression Inventory (BDI). Maximum excursion and directional control, measured by computerized dynamic posturography (Balance Master® System, NeuroCom, San Carlos, CA), were used to assess postural stability. Results: Patients who underwent 12 weeks of twice-weekly combined treatment with acupuncture and BVA showed significant improvements in gait speed, PDQL score, activities of daily living (UPDRS part II), motor symptoms (UPDRS part III), and combined UPDRS part II+III scores compared with assessments after conventional treatment. Conclusions: Combined treatment with acupuncture and BVA showed promising results as a safe adjunctive therapy for PD. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the role of herbal medicine in drug-induced parkinsonism (DIP) and identify an optimal treatment approach. Design: Retrospective review of DIP cases treated with herbal medicine. Settings/Location: The Parkinson's clinic at Kyung Hee Traditional Korean Medicine Hospital, Korea. Patients: Twenty-one patients whose clinical outcome and offending drug could be identified. Outcome measures: Clinical features, treatments, and outcomes and summarized the clinical course and treatment in each case. Results: Twelve patients had levosulpiride-induced parkinsonism and 9 had parkinsonism induced by another drug. The offending drugs were discontinued in all patients, and all patients received herbal medications during treatment. Nine of 12 patients with parkinsonism from levosulpiride and 4 of 9 patients with parkinsonism from other drugs had complete reversal of symptoms. The most frequently used herbal formula was Ukgansan (Yigansan). DIP in the levosulpiride group tended to improve faster with herbal medicine, and the percentage of improvement was higher. Conclusions: Optimal herbal medicine treatments chosen after a careful history and evaluation for risk factors may be helpful in reversing DIP. [ABSTRACT FROM AUTHOR]

Objectives: The acupoint GB20 is known to affect vertebrobasilar blood flow regulation. However, no previous study has used transcranial Doppler imaging to examine whether acupuncture at GB20 has a selective effect on blood flow in various cerebral arteries, such as the basilar artery (BA) and the middle cerebral arteries (MCAs). Therefore, this study sought to determine the specific effects of GB20 acupuncture on cerebral blood flow (CBF). Materials and Methods: Blood flow velocity and CO2 reactivity were measured by transcranial Doppler imaging with a 2-MHz pulsed Doppler probe observed through both temporal windows for the MCAs and through the suboccipital window for the BA before and after GB20 acupuncture treatment in 15 healthy young male volunteers. The changes in hyperventilation-induced CO2 reactivity and corrected blood flow velocities at 40 mmHg (CV40) were assessed for the BA and both MCAs. Blood pressure and heart rate were measured before and after the acupuncture treatment. Results: CO2 reactivity in the BA increased significantly after GB20 acupuncture treatment compared with baseline ( p=0.041). In contrast, CO2 reactivity in both MCAs remained unchanged. The CV40 in the BA and the MCAs showed no change after the GB20 acupuncture treatment. The mean heart rate decreased significantly after the GB20 acupuncture, whereas the mean blood pressure showed no change. Conclusions: This study demonstrated that acupuncture treatment on GB20 increases CO2 reactivity specifically in the BA, with no effect in the MCAs. These results clinically support the use of GB20 to treat disorders of posterior cerebral circulation and support the idea that particular acupoints affect specific brain regions and cerebral arteries. [ABSTRACT FROM AUTHOR]

Objectives: The objective of the study was to investigate the effect of acupuncture on the circadian rhythm of blood pressure (BP) in patients with hypertension. Design: The study was designed as a randomized, double-blind, controlled trial. Subjects were randomly divided into an active acupuncture group and a sham acupuncture group. Each patient received real or sham acupuncture treatment twice a week for 8 weeks. Acupuncture needles were inserted at bilateral ST 36 plus PC 6; placebo points. Subjects: Thirty-three (33) patients with essential hypertension were the subjects. Outcome measures: Twenty-four (24)-hour ambulatory BP was assessed before and after treatment. Results: After the treatment period, there was a significant increase in nocturnal diastolic BP dipping compared to that at baseline (10.20±7.56 mm Hg versus 5.21±10.19 mm Hg, p=0.038) in the active acupuncture group but not in the sham acupuncture group. The nocturnal diastolic BP dipping response to active acupuncture treatment was significantly different from the response seen with the sham acupuncture treatment ( p=0.041). The number of dippers also increased from 4 to 8 in the active acupuncture group. Average systolic and diastolic BP was not changed significantly except for nighttime diastolic BP (90.32±11.47 mm Hg to 87.83±9.16 mm Hg, p=0.041). Conclusions: It is suggested that acupuncture treatment could be useful for improving the circadian rhythm of BP in patients with hypertension. [ABSTRACT FROM AUTHOR]

Objectives: To examine the possibility of acupuncture as a new promising treatment to prevent delayed cerebral vasospasm, retrospective comparison was done of patient outcomes in patients with subarachnoid hemorrhage (SAH) treated with and without acupuncture. Materials and methods: Twenty (20) patients with SAH were treated after their ruptured aneurysms had been secured. Acupuncture treatments were applied to the bilateral Zusanli (ST36) and Neiguan (PC6) once a day for 2 weeks, starting within 3 days of the aneurysm rupture. The incidence of angiographic vasospasm and delayed ischemic neurological deficit (DIND), the patient's functional status at discharge, and mortality rate were analyzed. Patient outcomes were compared with those of an age- and severity-matched comparison group composed of patients treated in the hospital without acupuncture. Results: None of the patients who received acupuncture died. Angiographic vasospasms occurred in 5 patients (25.0%) and DIND in 2 (10%). In terms of functional impairment, the modified Rankin score at discharge was ≤2 in 7 patients (35%). In the control group, angiographic vasospasms occurred in 10 patients (55.6%) and DIND in 7 (38.9%), similar to the reported incidence in conventionally treated patients. Conclusions: Patients with SAH who received acupuncture had a significantly lower incidence of DIND and significantly improved function at discharge, suggesting that acupuncture is effective in preventing cerebral vasospasm. In light of these promising results, a randomized controlled trial is warranted to determine the efficacy of acupuncture in a clinical setting. [ABSTRACT FROM AUTHOR]

An abstract of the article "Integrative Treatment Modalities for Stroke Victims in Korea" by Seong-Uk Park, Seung-Yeon Cho, Jung-Mi Park, Chang-Nam Ko, Hi-Joon Park, Ann C. Cotter and Jongbae J. Park is presented.