Acupuncture Research from Pubmed

Interventions for alleviating cancer-related dyspnea: a systematic review.

J Clin Oncol. 2008 May 10;26(14):2396-404

Authors: Ben-Aharon I, Gafter-Gvili A, Paul M, Leibovici L, Stemmer SM

PURPOSE: Dyspnea is one of the most distressing symptoms experienced by terminally ill cancer patients. This study aimed to evaluate the role of interventions for the palliation of dyspnea. METHODS: We conducted a systematic review of randomized controlled trials assessing all pharmacologic and nonpharmacologic interventions for dyspnea palliation in cancer patients, and searched the Cochrane Library, MEDLINE, conference proceedings, and references. Two reviewers independently appraised the quality of trials and extracted data. RESULTS: Our search yielded 18 trials. Fourteen evaluated pharmacologic interventions: seven assessing opioids (a total of 256 patients), five assessing oxygen (137 patients), one assessing helium-enriched air, and one assessing furosemide. Four trials evaluated nonpharmacologic interventions (403 patients). The administration of subcutaneous morphine resulted in a significant reduction in dyspnea Visual Analog Scale (VAS) compared with placebo. No difference was observed in dyspnea VAS score when nebulized morphine was compared with subcutaneous morphine, although patients preferred the nebulized route. The addition of benzodiazepines to morphine was significantly more effective than morphine alone, without additional adverse effects. Oxygen was not superior to air for alleviating dyspnea, except for patients with hypoxemia. Nursing-led interventions improved breathlessness. Acupuncture was not beneficial. CONCLUSION: Our review supports the use of opioids for dyspnea relief in cancer patients. The use of supplemental oxygen to alleviate dyspnea can be recommended only in patients with hypoxemia. Nursing-led nonpharmacologic interventions seem valuable. Only a few studies addressing this question were performed. Thus, further studies evaluating interventions for alleviating dyspnea are warranted.

PMID: 18467732 [PubMed - in process]

Creating common ground: collaboration advances among licensed natural healthcare educators.

Explore (NY). 2008 May-Jun;4(3):221-4

Authors: Sierpina VS, Kreitzer MJ, Weeks J

Content on integrative healthcare and complementary and alternative medicine is being taught in hundreds of educational programs across the country. Nursing, medical, osteopathic, chiropractic, acupuncture, naturopathic, and other programs are finding creative and innovative ways to include these approaches in new models of education and practice. This column spotlights such innovations in integrative healthcare and CAM education and presents readers with specific educational interventions they can adapt into new or ongoing educational efforts at their institution or programs. We invite readers to submit brief descriptions of efforts in their institutions that reflect the creativity, diversity and interdisciplinary nature of the field. Please submit to Dr Sierpina at vssierpi@utmb.edu or Dr Kreitzer at kreit003@umn.edu. Submissions should be between 500-1500 words. Please include any Web site or other resource that is relevant, as well as contact information.

PMID: 18466856 [PubMed - in process]

Role of mast cells in acupuncture effect: a pilot study.

Explore (NY). 2008 May-Jun;4(3):170-7

Authors: Zhang D, Ding G, Shen X, Yao W, Zhang Z, Zhang Y, Lin J, Gu Q

To better understand the therapeutic effectiveness of acupuncture, questions about the underlying mechanisms need to be addressed. Here we describe the impact of manual stimulation by an acupuncture needle of zusanli (stomach 36 [ST36]) on analgesia in rats. The analgesic effect was more pronounced after stimulation of ST36 than after stimulation of a sham point near the acupuncture point. At the same time, we determined in tissue slices the density of mast cells in the acupuncture points and nearby points, as well as the degree of degranulation before and after stimulation. We found that the density of mast cells from the ST36 of rats was higher than that from a nearby sham point. In addition, acupuncture resulted in a remarkable increase in degranulation of the mast cells. Pretreatment of the acupuncture point with disodium chromoglycate not only counteracted the phenomenon of degranulation but also reduced analgesic effect of acupuncture. Our experiments on inhibition of degranulation of mast cells in tissue from acupuncture points demonstrates the possible role of mast cells in acupuncture effects.

PMID: 18466847 [PubMed - in process]

Evaluating the efficacy of acupuncture in defined aspects of stroke recovery : A randomised, placebo controlled single blind study.

J Neurol. 2008 May 13;

Authors: Hopwood V, Lewith G, Prescott P, Campbell MJ

OBJECTIVE : To investigate the efficacy of acupuncture on stroke recovery compared to an inert placebo. DESIGN : Placebo-controlled, randomised, clinical trial. SETTING : Post-stroke rehabilitation wards in five NHS hospitals in the UK. SUBJECTS : Patients between 4 and 10 days after their first stroke. INTERVENTIONS AND OUTCOME MEASURES : The patients received 12 acupuncture or placebo treatments over four weeks. Acupuncture with electrical stimulation was compared with mock TENS, and assessments continued for 12 months after entry. Primary outcome was the Barthel Index (BI). Secondary outcomes were muscle power, Motricity Index (MI), mood, Nottingham Health Profile (NHP) and treatment credibility. RESULTS : 92 patients completed data sets. Data were analysed using both t tests and a structural equation based on longitudinal analysis of both BI and MI, using generalised estimating equations with an exchangeable correlation structure. While both acupuncture and placebo (mock TENS) appeared to have had an equal effect on stroke recovery, there is no significant difference between the two interventions at 12 (p = 0.737, 95 % CI -2.00 to 2.81) and 52 weeks (p = 0.371, 95 % CI -3.48 to1.32). An apparently accelerated improvement in the MI scores in the acupuncture group at 3 weeks (p = 0.009, 95 % CI 1.55 to 10.77) is interesting. CONCLUSIONS : Acupuncture did not demonstrate specific efficacy over placebo and both groups did as well as normally expected with this condition.

PMID: 18465110 [PubMed - as supplied by publisher]

A 50-year-old man with chronic low back pain.

JAMA. 2008 May 7;299(17):2066-77

Authors: Rathmell JP

Mr S, a 50-year-old man, has long-standing low back pain. His pain began more than 20 years earlier with a lumbar disk herniation and has persisted despite diskectomy. He has undergone numerous treatments, but he remains disabled with ongoing pain. His treatment course is used to frame the epidemiology and pathophysiology underlying acute and chronic lumbosacral and radicular pain. The roles of neuropathic pain medications, chronic opioid therapy, physical therapy, spinal manipulation, and multidisciplinary pain treatment programs are reviewed. The indications for and outcomes associated with interventional pain treatments, including epidural steroid injection, facet blocks and radiofrequency treatment for facet-related pain, intradiskal electrothermal therapy, spinal cord stimulation, and intrathecal drug delivery, are discussed. Clinicians are given an evidence-based approach to using available treatment options for low back pain.

PMID: 18381566 [PubMed - indexed for MEDLINE]

[Current diagnosis and treatment of migraine]

Schmerz. 2008 Feb;22 Suppl 1:51-8; quiz 59-60

Authors: Diener HC, Katsarava Z, Limmroth V

Headaches are one of the most common disorders and symptoms in daily medical practice. The prevalence of migraine is 8% in men and 12-15% in women. Dramatic progress in the areas of epidemiology, pathophysiology, and acute and preventive therapy of migraine has been made over the past 100 years, with triptans being the breakthrough for treating acute migraine attacks. Beta blockers, calcium antagonists, and neuromodulators are available for preventive migraine therapy. Nonpharmacologic treatment also plays an important role in migraine prevention. New medical care structures such as integrated headache care provide better support for patients with migraine, particularly those with chronic migraine.

PMID: 18219499 [PubMed - indexed for MEDLINE]

[Alternative and complementary therapies in fibromyalgia syndrome.]

Schmerz. 2008 May 9;

Authors: Langhorst J, Häuser W, Irnich D, Speeck N, Felde E, Winkelmann A, Lucius H, Michalsen A, Musial F

INTRODUCTION: Interdisciplinary S3 level guidelines were devised in cooperation with 8 medical, 2 psychological and 2 patient support groups. Results were elaborated in a multilevel group process. METHODS: On the bases of the "Cochrane Library" (1993-2006), "Medline" (1980-2006), "PsychInfo" (2006) and "Scopus" (2006) controlled studies and meta-analyses of controlled studies were analyzed. RESULTS: Only few controlled studies were found supporting in part the effectiveness of CAM therapies in the treatment of fibromyalgia syndrome. Due to the lack of information on long term efficacy and cost-effectiveness, only limited recommendations for CAM therapies can be given. CONCLUSION: Within a multicomponent therapy setting, selective CAM therapies (acupuncture, vegetarian diet, homeopathy, Tai Chi, Qi Gong, music-oriented and body-oriented therapies) can be recommended for a limited period of time.

PMID: 18463899 [PubMed - as supplied by publisher]

The effect of electro-acupuncture stimulation on rhythm of autonomic nervous system in dogs.

J Vet Med Sci. 2008 Apr;70(4):349-52

Authors: Kimura Y, Hara S

Effects of electro-acupuncture (EA) stimulation on the rhythm of the autonomic nervous system in dogs were studied. Six healthy beagles were used in this study. Each dog was separately kept in a cage, and repeatedly exposed to light for 12 hr and dark for 12 hr alternately. Fixed subject dogs were stimulated by use of 5-V, 250-musec, 2-Hz biphasic square pulses for 15 min at the Xuan Shu (GV-5) and Bai Hui (GV-20) points on the spine. After EA stimulation, electrocardiogram was recorded for 24 hr. From the electrocardiogram data, the heart rate (HR), coefficient of variation in the R-R intervals (CVRR; index of autonomic nervous activity), power of high frequency component (HF; index of vagal nervous activity), and ratio of powers of the low and high frequency components (LF/HF; index of sympathetic nervous activity) were obtained. Cosinor analysis demonstrated that these indices exhibited a significant rhythmicity (P<0.05), irrespective of EA stimulation. In LF/HF, EA stimulation advanced the acrophase (from 22:55 to 21:33, P=0.012), and elevated the midline-estimating statistic of rhythm (from 0.653 to 0.725, P=0.006). However, there was no significant difference in HR, CVRR, or HF. In conclusion, EA stimulation markedly influenced the rhythm of sympathetic nervous system in dogs.

PMID: 18460828 [PubMed - in process]

[Effect of electroacupuncture on drug-seeking behaviors induced by heroin priming and FosB expression in relevant brain regions.]

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2008 Apr;33(4):299-304

Authors: Wang YH, Zeng LB, Liu YJ, Hao W, Zhang FQ, Zhou WH, Liu HF, Tang SE, Yang GD, Chen HX

ObjectiveTo explore the effect of electroacupuncture on heroin seeking behavior and FosB expression in relevant brain regions.Methods Rat model of heroin relapse behaviors was developed with progressive fixed ratio program,and model rats were randomly divided into 3 groups: a restraint group, a needle retention group, and a electroacupuncture group. The heroin seeking behavior was elicited by a small dose of heroin. FosB expression in relevnt brain region was assessed with immunohistochemical technique.Results Tests on reinstatement of drug seeking behavior induced by heroin priming showed that compared with the restraint group, active pokes in the electroacupuncture group decreased significantly(P<0.05). Compared with the restraint group, the expression of FosB positive nuclei in Acd, Pcg and CeA of rats brain both in the electroacupuncture group and the needle retention group (P<0.05) decreased significantly. In LC, the expression of FosB positive nuclei in the needle retention group decreased significantly compared with the restraint group (P<0.05). Conclusion Continuous acupuncture and needle retention attentuate the reinstatement of heroin-seeking behaviors induced by heroin priming, and the inhibitory effect may be mediated partially by the expression of FosB in relevant regions which are involved in the process of heroin addiction.

PMID: 18460772 [PubMed - in process]

Demystifying acupuncture.

Rheumatology (Oxford). 2008 May 6;

Authors: Pyne D, Shenker NG

Acupuncture refers to the insertion of fine needles into the body at specific points for a therapeutic effect. The term comes from the Latin words 'acus' (needle) and 'punctura' (to puncture). The technique has been practiced in the Far East for at least 3000 yrs but it is only in the last 30 yrs that interest has developed in the West underpinned by increasing scientific research. One of the main uses of acupuncture has been to treat musculoskeletal pain and this article will review the evidence base and outline the main theories of mechanisms of action.

PMID: 18460551 [PubMed - as supplied by publisher]

The benefit of nonpharmacologic therapy to treat symptomatic osteoarthritis.

Curr Rheumatol Rep. 2008 Jan;10(1):5-10

Authors: Lee YC, Shmerling RH

Osteoarthritis affects a large proportion of the population, especially the elderly, leading to pain and disability. To relieve pain, many patients are turning toward nonpharmacologic therapies. Conventional nonpharmacologic treatments such as weight loss and exercise are well accepted by the medical community, and some randomized controlled trials support the use of these treatments in patients with knee osteoarthritis. However, little information exists regarding the efficacy of these treatments for osteoarthritis at other sites. Less conventional treatments such as acupuncture and massage are emerging as promising options for osteoarthritis treatment, but the magnitude of benefit has varied between studies. More investigation is necessary to reach a conclusion regarding the efficacy of these treatments.

PMID: 18457605 [PubMed - in process]

Infrared radiation spectrum of acupuncture point on patients with coronary heart disease.

Am J Chin Med. 2008;36(2):211-8

Authors: Shen X, Ding G, Deng H, Wei J, Zhao L, Zhou Y, Lao L

The objective of this study was to compare the acupoint infrared radiation spectrums of patients and healthy volunteers to show whether those of coronary heart disease (CHD) patients carry distinctive pathological information. PHE201, using a highly sensitive infrared spectrum detection device applied to the acupoint Neiguan (PC6) and to a control point on 50 CHD patients and 47 healthy adults. A total of 73 wavelength spots were detected. The scanned wavelengths ranged from 1.5 mum to 16 mum, and the scanning spacing was 0.2 mum. The data were automatically recorded in the database of the device for statistical analysis. Infrared radiation intensities of 23 in the 73 detected wavelength spots significantly differed in the CHD patients' Neiguan as compared to those of the healthy subjects (from p = 0.048 to p = 0.002), while only 12 wavelength spots at a non-acupuncture control point showed significant differences. By the chi(2) test, these differences between Neiguan and the non-acupuncture control point are statistically significant (p = 0.033). At 2-2.5 mum, which is related to energy metabolism, the intensity at the CHD patients' Neiguan was significantly lower than that of the healthy adults (from p = 0.026 to p = 0.017). No difference was observed at the non-acupuncture control point (from p = 0.094 to p = 0.052). The data suggest that the changes of infrared spectrum at Neiguan in coronary heart disease patients may reflect the distinct pathological changes. This may be the result of hypoactive energy metabolism in the area of the acupoint.

PMID: 18457356 [PubMed - in process]

Persistent heartburn in a patient on proton-pump inhibitor.

Clin Gastroenterol Hepatol. 2008 Apr;6(4):393-400

Authors: Fass R

PMID: 18387497 [PubMed - indexed for MEDLINE]

Ear acupuncture points in neonates.

J Altern Complement Med. 2008 Jan-Feb;14(1):47-52

Authors: Van Amerongen KS, Blattmann FC, Kuhn A, Surbek D, Nelle M

OBJECTIVE: The aim of this study was to determine the presence and absence of acupuncture ear points in healthy neonates. DESIGN: This was a prospective observational study performed at a university teaching hospital. Subjects: The subjects were healthy neonates. We compared male and female neonates, right and left lobe, term and preterm deliveries, and cesarean sections versus vaginal deliveries. Examinations took place on the fifth day after delivery and were performed by a neuronal pen (SVESA 1070, SVESA GmbH, Munich, Germany). An integrated optical signal detected the ear points that were assigned to the Chinese ear map. MAIN OUTCOME MEASURES: This study looked at the presence and absence of acupuncture ear points in neonates. RESULTS: There were 27 male neonates and 23 female neonates. In 66% of neonates, no points at all were found. We detected 0-4 points on the right lobe and 0-2 points on the left lobe. The psychovegetative rim was the most common point in 26% of all children. No psychic points were detected. No significant differences were found between right and left ear lobes, male and female neonates, or term and preterm deliveries with respect to numbers of points or access of points. Moreover, there were no differences among modes of delivery. CONCLUSIONS: Some ear points in healthy neonates are detectable and not dependent on side of the ear lobe. Females had significantly more acupuncture points. There was an extremely significant difference in the group with 2 active earpoints between cesarean and vaginally delivered neonates. The most important point was the psychovegetative rim and the absence of psychic points in favor of the organ points. Possibly, ear points in neonates could be used for diagnostic and therapeutic options in neonates in the future.

PMID: 18456941 [PubMed - in process]

Auricular acupuncture versus sham acupuncture in the treatment of women who have insomnia.

J Altern Complement Med. 2008 Jan-Feb;14(1):39-46

Authors: Sjöling M, Rolleri M, Englund E

BACKGROUND: Improvement in sleep parameters in relation to acupuncture treatment is often found and referred to as being a positive side-effect in the treatment of other illnesses. There is a lack of randomized studies, which primarily study the direct effect of acupuncture on sleep. OBJECTIVES: To investigate whether or not auricular acupuncture has an effect on sleep parameters among people with insomnia. DESIGN: A single-blind, randomized pilot study where the treatment group received auricular acupuncture treatment (AAT) on active points and the control group received AAT on sham points during a 6-week treatment period. SETTING: Participants were recruited from the psychiatric outpatient clinics in the geographical area connected to a local hospital in central Sweden. SUBJECTS: In all, 28 women were included in the study, with 14 in each group. Their mean and median age was 53 years. OUTCOME MEASURES: Sleep parameters were obtained by using the Karolinska Sleep Diary. RESULTS: No statistically significant differences were observed between the groups relating to parameters associated with the definition of insomnia. The treatment group experienced that it was easier to wake up in the morning compared with the control group (repeated-measures analysis of variance, p = 0.04). Both groups showed a statistically significant recovery in subjective sleep parameters during the study period (weeks 1-6) compared with baseline values (week 0). CONCLUSIONS: Only modest evidence was found supporting the hypothesis that AAT may have an effect on insomnia. Least improvements were found in total sleep time and number of awakenings, 2 parameters directly associated with the definition of insomnia. AAT may have a role in the treatment of insomnia, especially in combination with other treatments such as cognitive behavioral therapy. This study provides an example of how to perform studies using alternative therapies for sleep disorders.

PMID: 18456940 [PubMed - in process]

Complementary and alternative medicine in the treatment of bipolar disorder - A review of the evidence.

J Affect Disord. 2008 May 2;

Authors: Andreescu C, Mulsant BH, Emanuel JE

A growing number of patients with mood disorders are using complementary and alternative medicine (CAM) interventions. In this paper, we review the published scientific evidence on the benefits and risks of CAM for the treatment of patients with bipolar disorder. Since very few studies of CAM have involved patients with bipolar disorder, most available evidence is derived from trials conducted in patients with major depressive disorder. The use of omega-3 fatty acids has been studied in two controlled studies in bipolar disorder while St. John's wort (Hypericum perforatum), S-adenosyl-l-methionine (SAMe), and acupuncture have been studied in a series of randomized controlled trials in patients with major depression. Overall, the best evidence supports the use of St. John's wort for the treatment of mild to moderate depression. SAMe may also be effective for depression. However, both of these products have the potential to induce mania; the extent of this risk needs to be quantified. St. John's wort can also interact with a variety of medications. Evidence regarding the benefits of omega-3 fatty acids or acupuncture is inconsistent. Data regarding other CAM interventions (e.g., aromatherapy massage, massage therapy, yoga) are almost entirely lacking. In conclusion, better studies are needed before CAM interventions can be recommended to patients with bipolar disorder. In the meantime, patients need to be informed about the possible risks associated with the use of these interventions.

PMID: 18456339 [PubMed - as supplied by publisher]

Acupuncture-associated Listeria monocytogenes arthritis in a patient with rheumatoid arthritis.

Joint Bone Spine. 2008 May 1;

Authors: Tien CH, Huang GS, Chang CC, Chang DM, Lai JH

Septic arthritis is a rare complication of acupuncture. We present a patient with rheumatoid arthritis who developed septic arthritis of the right knee after consecutive weekly sessions of acupuncture therapy for 3 weeks. The infection was localized by musculoskeletal sonography and magnetic resonance imaging, with culture of the synovial fluid aspirated from the joint yielding Listeria monocytogenes. The patient responded well to antibiotic treatment and regained joint mobility. A high index of suspicion for an infectious process is required for prompt diagnosis and treatment of acupuncture-induced joint infections in rheumatoid arthritis patients who might have additional risk factors for infection.

PMID: 18455948 [PubMed - as supplied by publisher]

A preliminary neutron crystallographic study of thaumatin.

Acta Crystallogr Sect F Struct Biol Cryst Commun. 2008 May 1;64(Pt 5):378-81

Authors: Teixeira SC, Blakeley MP, Leal RM, Mitchell EP, Forsyth VT

A preliminary neutron crystallographic study of the sweet protein thaumatin is presented. Large hydrogenated crystals were prepared in deuterated crystallization buffer using the gel-acupuncture method. Data were collected to a resolution of 2 A on the LADI-III diffractometer at the Institut Laue Langevin (ILL). The results demonstrate the feasibility of a full neutron crystallographic analysis of this structure aimed at providing relevant information on the location of H atoms, the distribution of charge on the protein surface and localized water in the structure. This information will be of interest for understanding the specificity of thaumatin-receptor interactions and will contribute to further understanding of the molecular mechanisms underlying the perception of taste.

PMID: 18453706 [PubMed - in process]

[Research on the development of acupuncture-moxibustion in Taiwan in 1970s]

Zhonghua Yi Shi Za Zhi. 2007 Jul;37(3):157-60

Authors: Ha HC

The government has launched a program to promote the research on acupuncture and moxibustion since 1972. It was mainly through the join effort of the National Science Council and Department of health that funds were made available to major medical institutions in Taiwan for research in the theoretical and clinical application of acupuncture-moxibustion. Moreover, the emphasis has been laid on the application of modern medical knowledge and technology to traditional acupuncture-moxibustion in order to explore the mechanism of acupuncture analgesia and to determine the effectiveness of acupuncture-moxibustion in the treatment of diseases. The efforts of such studies have resulted in conferences and symposia at the national and/or international levels from 1970s to 1980s. Development and progress of acupuncture-moxibustion research in Taiwan since 1970s are reported and discussed in the article.

PMID: 18453206 [PubMed - in process]

The Effect of Acupuncture Duration on Analgesia and Peripheral Sensory Thresholds.

BMC Complement Altern Med. 2008 May 1;8(1):18

Authors: Leung AY, Kim SJ, Schulteis G, Yaksh T

ABSTRACT: BACKGROUND: Acupuncture provides a means of peripheral stimulation for pain relief. However, the detailed neuronal mechanisms by which acupuncture relieves pain are still poorly understood and information regarding optimal treatment settings is still inadequate. Previous studies with a short burst of unilateral electroacupuncture (EA)in the Tendinomuscular Meridians (TMM) treatment model for pain demonstrated a transient dermatomally correlated bilateral analgesic effect with corresponding peripheral modality-specific sensory threshold alterations. However, the impact of EA duration on the analgesic effect in this particular treatment model is unknown. To obtain mechanistically and clinically important information regarding EA analgesia, this current prospective cross-over study assesses the effects of EA duration on analgesia and thermal sensory thresholds in the TMM treatment model. METHODS: Baseline peripheral sensory thresholds were measured at pre-marked testing sites along the medial aspects (liver and spleen meridians) of bilateral lower extremities. A 5-second hot pain stimulation was delivered to the testing sites and the corresponding pain Visual Analog Scale (VAS) scores were recorded. Three different EA (5Hz) stimulation durations (5, 15 and 30 minutes) were randomly tested at least one week apart. At the last 10 seconds of each EA session, 5 seconds of subject specific HP stimulation was delivered to the testing sites. The corresponding pain and EA VAS scores of de qi sensation (tingling) during and after the EA were recorded. The measurements were repeated immediately, 30 and 60 minutes after the EA stimulation. A four-factor repeat measures ANOVA was used to assess the effect of stimulation duration, time, location (thigh vs. calf) and side (ipsilateral vs. contralateral) of EA on sensory thresholds and HP VAS scores. RESULTS: A significant (P<0.01) main effect of time and location with warm, cold and hot pain thresholds at the four testing sites without any significant difference in duration effect was observed. Similar time and location effects were observed with HP VAS with the longer durations (15 and 30 minutes) of stimulation showed a slower onset, but a more sustainable bilateral analgesic benefit than the short stimulation duration (5 minutes). The 15-minute stimulation resulted in an earlier onset of analgesic effect than the 30-minute stimulation paradigm. CONCLUSION: Longer durations of EA stimulation provide a more sustainable analgesic benefit to hot noxious stimulation than a shorter duration of stimulation. The increase of cold threshold with sustained warm threshold temperature elevation as observed in the longer durations of EA suggests that as the duration of EA lengthened, there is a gradual shifting from an initial predominantly spinally mediated analgesic effect to a supraspinally mediated modulatory mechanism of thermal pain. The 15-minute stimulation appeared to be the optimal setting for treating acute pain in the lower extremities.

PMID: 18452622 [PubMed - as supplied by publisher]