Index de l'article

Conclusion

Les travaux de physiologie et d’imagerie concernant l’électroacupuncture dans les algies donnent une idée de plus en plus précise de la nature de ses mécanismes neurophysiologiques. Les données récentes suggèrent fortement l’implication de la libération des neuropeptides opioïdes (endorphines, enképhalines, dynorphine etc..), mais aussi l’action inhibitrice des récepteurs ionotropiques glutaminiques (en particulier NMDA), sans oublier la modulation de la douleur par le système inhibiteur descendant sérotoninergique et catécholaminergique. L’EA semble donc moduler le message nociceptif par de multiples mécanismes tout le long de sa transmission. L’imagerie démontre de manière formelle que les systèmes limbique, hypothalamique et le tronc cérébral sont activés par l’EA. Nous verrons dans un prochain article les modalités techniques de l’électroacupuncture et ses implications pratiques. 

  

Références

 

[1]. Stéphan JM. Acupuncture expérimentale, stress et molécules informationnelles. Acupuncture & Moxibustion. 2006;5(2):162-170.

[2]. Stéphan JM. Acupuncture, récepteurs transmembranaires à tyrosine-kinases, à cytokines et transduction. Acupuncture & Moxibustion. 2007 Mars;6(1):79-86.

[3]. Zadina JE. Isolation and distribution of endomorphins in the central nervous system. Jpn J Pharmacol. 2002 Jul;89(3):203-8.

[4]. Stéphan JM. Acupuncture, récepteurs couplés aux protéines G et transduction. Acupuncture & Moxibustion. In press 2008.

[5]. Research Group of Acupuncture Anesthesia, P.M.C. The effect of acupuncture on the human skin pain threshold. Chin Med J. 1973;3:151-157.

[6]. Research Group of Acupuncture Anesthesia, P.M.C. The role of some neurotransmitters of brain in finger-acupuncture analgesia. Scientia Sinica. 1974;117:112-130. 

[7]. Pomeranz B, Chiu D. Naloxone blockade of acupuncture analgesia : endorphin implicated.Life Sci.1976;19(11):1757-62.

[8]. Sjolund B, Terenius L, Eriksson M. Increased cerebrospinal fluid levels of endorphins after electro-acupuncture. Acta Physiol Scand. 1977;100(3):382-4.

[9]. Mayer DJ, Price DD, Rafii A. Antagonism of acupuncture analgesia in man by the narcotic antagonist naloxone. Brain Res.1977;121(2):368-72.

[10]. Clement-Jones V, McLoughlin L, Tomlin S, Besser GM, Rees LH, Wen HL. Increased beta-endorphin but not met-enkephalin levels in human cerebrospinal fluid after acupuncture for recurrent pain. Lancet. 1980;2(8201):946-9.

[11]. Chen XH, Han JS. Analgesia induced by electroacupuncture of different frequencies is mediated by different types of opioid receptors: another cross-tolerance study. Behav Brain Res. 1992;47(2):143-9.

[12]. Chen XH, Han JS. All three types of opioid receptors in the spinal cord are important for 2/15 Hz electroacupuncture analgesia. Eur J Pharmacol. 1992;211(2):203-10.

[13]. Han JS. Acupuncture and endorphins. Neurosci Lett. 2004;361(1-3):258-61. 

[14]. Pan B, Castro-Lopes JM, Coimbra A. C-fos expression in the hypothalamo-pituitary system induced by electroacupuncture or noxious stimulation. Neuroreport. 1994;5(13):1649-52.

[15]. Pan B, Castro-Lopes JM, Coimbra A. Activation of anterior lobe corticotrophs by electroacupuncture or noxious stimulation in the anaesthetized rat, as shown by colocalization of Fos protein with ACTH and beta-endorphin and increased hormone release. Brain Res Bull. 1996;40(3):175-82.

[16]. Pan B, Castro-Lopes JM, Coimbra A. Chemical sensory deafferentation abolishes hypothalamic pituitary activation induced by noxious stimulation or electroacupuncture but only decreases that caused by immobilization stress. A c-fos study. Neuroscience. 1997;78(4):1059-68.

[17]. Yang J, Yang Y, Chen JM, Liu WY, Lin BC. Effect of hypothalamic supraoptic nucleus on acupuncture analgesia in the rat. Brain Res Bull. 2008;75(5):681-6.

[18]. Xie GX, Han JS, Hollt V. Electroacupuncture analgesia blocked by microinjection of anti-beta-endorphin antiserum into periaqueductal gray of the rabbit. Int J Neurosci. 1983;18:287-292.

[19]. Chao DM, Shen LL, Tjen-Alooi S, Pitsillides KF, Li P, Longhurst JC. Naloxone reverses inhibitory effect of electroacupuncture on sympathetic cardiovascular reflex responses. Am J Physiol Heart Circ Physiol. 1999;276:H2127-H2134.

[20]. Pomeranz B, Bibic L. Naltrexone, an opiate antagonist, prevents but does not reverse the analgesia produced by electroacupuncture. Brain Res.1988;452:227-231.

[21]. Kiser RS, Khatami MJ, Gatchel RJ, Huang XY, Bhatia K, Altshuler KZ. Acupuncture relief of chronic pain syndrome correlates with increased plasma met-enkephalin concentrations. Lancet 1983;2:1394-1396.

[22]. Han JS. Neurochemical basis of acupuncture. Annu Rev Pharmacol Toxicol.1982;22:193-220. 

[23]. Jin WQ, Zhou ZF, Han JS. Electroacupuncture and morphine analgesia potentiated by bestatin and thiorphan administered to the nucleus accumbens of the rabbit. Brain Res. 1986;380:317-324.

[24].Yu LC, Han JS. Involvement of arcuate nucleus of hypothalamus in the descending pathway from nucleus accumbens to periaqueductal gray subserving an antinociceptive effect. Int J Neurosci. 1989;48:71-78.

[25].Wang Q, Mao L, Han JS. The arcuate nucleus of hypothalamus mediates low but not high frequency electroacupuncture in rats. Brain Res. 1990;513:60-66.

[26]. Takeshige C. The acupuncture point and its connecting central pathway for producing acupuncture analgesia. Brain Res Bull. 1993;30:53-67.

[27]. Chang Ht. Integrative action of thalamus in the process of acupuncture for analgesia. Scientia Sinica. 1973;16:25-60.

[28]. Gao M, Wang M, Li K, He L. Changes of mu opioid receptor binding sites in rat brain following electroacupuncture. Acupunct Electrother Res. 1997;22(3-4):161-6.

[29]. Tsai HY, Lin JG, Inoki R.Further evidence for possible analgesic mechanism of electroacupuncture:effects on neuropeptides and serotonergic neurons in rat spinal cord.Jpn J Pharmacol.1989;49(2):181-5.

[30]. Takeshige C, Sato T, Mera T, Hisamitsu T, Fang J. Descending pain inhibitory system involved in acupuncture analgesia.Brain Res Bull.1992;29(5):617-34.

[31]. Scherder EJ, Bouma A.Possible role of the nucleus raphe dorsalis in analgesia by peripheral stimulation: theoretical considerations.Acupunct Electrother Res. 1993;18(3-4):195-205.

[32]. Chang YH, Hiseh MT, Wu CR.Effects of acupuncture at pai-hui on the deficit of memory storage in rats.Am J Chin Med.1999;27(3-4):289-98. 

[33]. Takagi J, Yonehara N. Serotonin receptor subtypes involved in modulation of electrical acupuncture. Jpn J Pharmacol. 1998;78(4):511-4.

[34]. Lee CK, Bae HS, Rho SW, Choi GS, Ko EJ, Kim SK, Lee YS, Lee HJ, Hong MC, Shin MK, Min BI, Kee HJ Molecular Changes in Remote Tissues induced by Electro-Acupuncture Stimulation at Acupoint ST36. Mol Cells. 2008;25(2).

[35]. Li A, Wang Y, Xin J, Lao L, Ren K, Berman BM, et al. Electroacupuncture suppresses hyperalgesia and spinal Fos expression by activating the descending inhibitory system. Brain Res. 2007;1186:171-9.

[36]. Koo ST, Lim KS, Chung K, Ju H, Chung JM. Electroacupuncture-induced analgesia in a rat model of ankle sprain pain is mediated by spinal alpha-adrenoceptors. Pain. 2008;135(1-2):11-9.

[37]. Kim HW, Uh DK, Yoon SY, Roh DH, Kwon YB, Han HJ, et al. Low-frequency electroacupuncture suppresses carrageenan-induced paw inflammation in mice via sympathetic post-ganglionic neurons, while high-frequency EA suppression is mediated by the sympathoadrenal medullary axis. Brain Res Bull. 2008;75(5):698-705.

[38]. Choi BT, Lee JH, Wan Y, Han JS. Involvement of ionotropic glutamate receptors in low frequency electroacupuncture analgesia in rats. Neurosci Lett. 2005 Apr 4;377(3):185-8.

[39]. Choi BT, Kang J, Jo UB. Effects of electroacupuncture with different frequencies on spinal ionotropic glutamate receptor expression in complete Freund's adjuvant-injected rat. Acta Histochem. 2005;107(1):67-76. 

[40]. Wang L, Zhang Y, Dai J, Yang J, Gang S. Electroacupuncture (EA) modulates the expression of NMDA receptors in primary sensory neurons in relation to hyperalgesia in rats. Brain Res. 2006;1120(1):46-53.

[41]. Xing GG, Liu FY, Qu XX, Han JS, Wan Y. Long-term synaptic plasticity in the spinal dorsal horn and its modulation by electroacupuncture in rats with neuropathic pain. Exp Neurol. 2007;208(2):323-32.

[42]. Ryu JW, Lee JH, Choi YH, Lee YT, Choi BT. Effects of protein phosphatase inhibitors on the phosphorylation of spinal cord N-methyl-d-aspartate receptors following electroacupuncture stimulation in rats. Brain Res Bull. 2008;75(5):687-91.

[43]. Wu MT, Sheen JM, Chuang KH, Yang P, Chin SL, Tsai CY, Chen CJ, Liao JR, Lai PH, Chu KA, Pan HB, Yang CF. Neuronal specificity of acupuncture response : a fMRI study with electroacupuncture. Neuroimage. 2002;16(4):1028-37.

[44]. Zhang WT, Jin Z, Huang J, Zhang L, Zeng YW, Luo F, Chen AC, Han JS.  Modulation of cold pain in human brain by electric acupoint stimulation : evidence from fMRI. Neuroreport. 2003;14(12):1591-6.

[45]. Zhang WT, Jin Z, Cui GH, Zhang KL, Zhang L, Zeng YW, Luo F, Chen AC, Han JS. Relations between brain network activation and analgesic effect induced by low vs. high frequency electrical acupoint stimulation in different subjects: a functional magnetic resonance imaging study. Brain Res. 2003;982(2):168-78. 

[46]. Napadow V, Makris N, Liu J, Kettner NW, Kwong KK, Hui KK. Effects of electroacupuncture versus manual acupuncture on the human brain as measured by fMRI. Hum Brain Mapp. 2005;24(3):193-205.

[47]. Maenaka T, Tano K, Nakanishi S, Tsukada H, Ishida T. Positron emission tomography analysis of the analgesic effects of acupuncture in rhesus monkeys. Am J Chin Med. 2006;34(5):787-801.