Electro-acupuncture at Zusanli(ST 36) to improve lower extremity motor function in sensory disturbance patients with cerebral stroke A randomized controlled study of 240 cases

BACKGROUND： Studies have shown that sensory transduction is a way to introduce needle sensation. OBJECTIVE： To observe the influence of electro-acupuncture at the ＂Zusanll＂ （ST 36） point on lower extremity motor function in various sensory disturbance patients with cerebral stroke. DESIGN, TIME AND SETTING： A randomized, controlled, clinical study was performed at the Department of Neurological Rehabilitation, China Rehabilitation Research Centre from September 2006 to June 2008. PARTICIPANTS： Patients with first-time cerebral infarction or hemorrhage, or with a stroke history, but no neurodysfunction （single damage）, were selected for this study. The subjects were right-handed and disease state was stable. A total of 240 inpatients were randomly assigned to the following groups： electro-acupuncture （n = 124） and control （n = 116）. The two groups were further assigned into sub-groups： no sensory disturbance, superficial sensory disturbance, deep sensory disturbance, and deep and superficial sensory disturbance. METHODS： On the basis of routine limb function training, the acupoint Zusanliwas utilized in all patients from the electro-acupuncture group. Perpendicular acupuncture was 3.0-4.0 cm deep. An electric acupuncture instrument was connected when patients developed the needle sensation, deqi. A stimulation pattern consisting of distant and dense waves of 50 Hz was used to elicit slight dorsal foot extension. Acupuncture was administered 5 times per week, 30 minutes per session, for 6 weeks in total. MAIN OUTCOME MEASURES： FugI-Meyer assessment （FMA） was used to evaluate lower extremity motor function; Ver.1.0 gait analysis to estimate gait （step frequency, step speed, and step scope）; lower extremity Composite Spasticity Scale （CSS） to estimate muscle spastic degree. RESULTS： Following treatment, motor function improved in both groups. Compared with the control group, FMA score, step speed, step frequency, and step scope were increased in the electro-acupuncture group, but there was no difference in lower extremity CSS scores between the electro-acupuncture and the control groups （P 〉 0.05）. Compared with the control group, Zusanli （ST 36） electro-acupuncture improved motor function indices as follows： FMA score, step frequency, step speed, and step scope of patients with no sensory disturbance （P 〈 0.05-0.01）, step frequency of patients with superficial sensory disturbance （P 〈 0.05）, and step frequency and step speed of patients with deep sensory disturbance （P 〈 0.05）. CONCLUSION： Zusanfi （ST 36） electro-acupuncture effects on lower extremity motor function in stroke patients were improved with no muscle tone rise. Therefore, this form of treatment can be used in convalescent treatment, Moreover, effects were different according to various sensory disturbance types, which suggested that sensory input influenced acupuncture effects.

Sensory Disturbance as a Characteristic Symptoms of Methylmercury Poisoning in Niigata, Japan

Fifty years have passed from the first official recognition of the methylmercury （MeHg） poisoning in Niigata （so called the second Minamata disease）, Japan in 2015. The first case of MeHg poisoning was found in January 1965, when two surveys were carried out for 20,000 inhabitants lived within 15 km from the mouth of the Agano river. From these surveys, 26 cases （including 5 cases of death） were officially recognized as MeHg poisoning. Moreover, 9 cases who had no symptoms but whose hair mercury concentration were over 200 ppm were found. Within 20 cases, 15 cases are among 26 cases officially recognized as having MeHg poisoning and 5 cases are among 9 cases who had no symptoms but whose hair mercury concentration were over 200 ppm in 1965. The distal dominant sensory disturbances of the extremities lasted for more than several decades among 20 cases. The sensory disturbance of the bilateral distal extremities could be used as the gold standard for the diagnosis of MeHg poisoning in the exposed areas. The distal dominant sensory disturbance of the extremities is a typical characteristic and important sign of the MeHg poisoning.