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Sunday, January 22, 2012

Acupuncture and Autism


Autism or Autistic Spectrum Disorder (ASD) is a behaviorally defined, lifelong disorder of the brain. Although it is one of the most common neurodevelopmental disorders in children, its cause is still a mystery, and no cure is currently available. Autism is characterized by deficits in language, social communication and cognition. The basis of the disorder may be neurochemical (serotonin or dopamine neuronal dysfunction), neurobiological (genetic basis), or neuropsychological (dysfunction of complex information processing or theory of mind). Children with autism usually have secondary problems in behavior including aggression, irritability, stereotypies, hyperactivity, negativism, volatile emotions, temper tantrums, short attention span and obsessive-compulsive behavior. Direct and indirect evidence suggests that neurochemical systems might be relevant in understanding the pathogenesis of autism.
How Traditional Chinese Medicine (TCM) views Autism
TCM doctors approach health and disease according to the philosophy of Yin-Yang, which encompasses balance and the homeostasis of the universe and the 5 elements (gold, wood, water, fire and soil).They also believe in the phenomenological and empirical observations of Qi, Blood and the 8 Principles. 

TCM practitioners differentiate syndrome according to 8 principles; Qi and Blood or according to the theory of Zang-Fu organs. The pathogenesis of disease is based on disharmony of Yin and Yang, conflicts between antipathogenic Qi and Pathogenic Qi; or the abnormal descending or ascending Qi. Qi is the life energy that flows through the entire body. The 8 principles involve Exterior/Interior, cold/heat, deficiency/excess, and yin-yang. This philosophy is based on more than 5,000 years of cumulative experience of human physiology and pathophysiology.  The etiology of disease, in TCM concept, can include 6 exogenous factors (wind, cold, summer heat, dampness, dryness, fire) and 7 emotions (joy, anger, melancholy, worry, grief, fear and fright), together with improper diet, overstrain, lack of physical exercise, stagnated blood and phlegm fluid. In the western concept, this may affect the body's immune defense system.

Acupuncture
Acupuncture has been practiced in Traditional Chinese Medicine (TCM) for over 2,000 years.In 1997, the Food & Drug Administration (FDA) in the USA recognized the legal status of acupuncture as a treatment technique, and since that time several other countries including Canada, the United Kingdom and several in Europe, have also done so. Research studies have now proven the benefits of acupuncture in treating pain and disorders of the brain. There are more than 400 acupoints in the body, linked through a system of 14 meridians, or pathways.

Acupoints are rich in nerve terminals, and when stimulated, result in activation of both the local point and other, more distant points in the body that fall along the same meridian. Their stimulation may result in neural signaling, electromagnetic energy enhancement, neuro-immunomodulatory and neurochemical-hormonal effects. The therapeutic effect of acupuncture depends on the acupoint(s) selected and the type of stimulation used. Body acupuncture, electrical acupuncture, laser acupuncture, and even acupressure have been practiced. Traditional acupoints on the scalp and body (by manipulation and electrical) have been found effective for treating children with brain dysfunction, resulting in improvement in the patient's overall functional abilities.

Tongue Acupuncture
Tongue diagnosis is an important part of the clinical diagnostic examination in Traditional Chinese Medicine for a syndromal approach such as autism. The tongue is the only body organ which can be exposed and seen externally. By looking at its color, thickness, dryness, superficial growth, and smell, TCM doctors can determine a treatment based on the eight principles. Moreover, according to TCM, the tongue reflects the condition of the heart, which is the master organ, controlling all the other internal organs. Thus indirectly, the tongue is linked by meridians to all the organs of the body. Tongue Acupuncture (TAC) is an innovative acupuncture technique invented by Dr. Sun JG from China. It is based on one of the most ancient medical books in China, Wang Di's Internal Medicine, and the idea that the tongue is the intersection site of all 14 meridians in the human body. Dr. Sun discovered that the tongue contains more than 40 acupoints. We hypothesize that there is a Human Map in our tongue, which is connected via rich neural-vascular pathways inside the tongue to different regions of the brain, especially the cerebellum. Neuroimaging with PET and functional MRI has demonstrated the possible role of the cerebellum and other brain region dysfunction with ASD. The cerebellum can be viewed as having its own internal topography, one that is directly linked to the modulation of emotions and social behavior, thought, language and the ability to plan. Is autism part of the system dysfunction of the cerebellum and its connecting pathways? The positive results in two normal subjects in the areas of language and visual processing, after a short course of TAC.

We decided to conduct further research to test how TAC might affect the cerebellum [cognition], temporal lobe [language], frontal lobe [executive function and affect] and basal ganglia [ritualistic/stereotypic mannerisms]. This was done through monitoring changes in glucose metabolism, via a PET scan. The use of Brain FDG-PET in the integration of Western-Chinese Medicine is essential to scientifically assess Alternative Medicine strategy for neurobiological diseases from a functional outcome perspective.
What's Unique About Tongue Acupuncture and Autism?

In a revolutionary new treatment for the first time in a clinical trial how acupuncture can successfully improve the dysfunction related to autism, by activating vital connections in the brain. We hypothesize that repetitive stimulation of specific tongue acupoints can reconnect the neural circuit through its rich neural network to the cerebellum. Improvement may result through the resignaling of the neural circuits via neurotransmitters, like serotonin/5-HT, dopamine and neurochemicals like cortisol. This reconnection of the cerebellar-frontal-temporal circuits may reverse the basic dysfunctional pathways in autism, including attention, emotion, or hyperactivity, and open up a positive road for learning communicative or cognitive skills. Once the “latent” brain is reactivated again, the use of intensive therapeutic interventions (such as speech, occupational therapy and behavioral therapy) and education can help children process information in a more efficient way. 

Future Direction
Many questions remain yet unanswered. Alternative treatment strategies, such as TAC, should be viewed as a complementary approach in neurological disabilities. However, an interdisciplinary approach involving Western and Chinese medicine provides an innovative starting point for a new conceptual treatment framework for autism. TAC can be viewed as a START-UP program or adjunctive therapy for autism. We hope that we can use a simple, relatively non-invasive quick treatment strategy to benefit families with autism worldwide.

We decided to conduct further research to test how TAC might affect the cerebellum [cognition], temporal lobe [language], frontal lobe [executive function and affect] and basal ganglia [ritualistic/stereotypic mannerisms]. This was done through monitoring changes in glucose metabolism, via a PET scan. The use of Brain FDG-PET in the integration of Western-Chinese Medicine is essential to scientifically assess Alternative Medicine strategy for neurobiological diseases from a functional outcome perspective.

What's Unique About Tongue Acupuncture and Autism?
In a revolutionary new treatment for the first time in a clinical trial how acupuncture can successfully improve the dysfunction related to autism, by activating vital connections in the brain. We hypothesize that repetitive stimulation of specific tongue acupoints can reconnect the neural circuit through its rich neural network to the cerebellum. Improvement may result through the resignaling of the neural circuits via neurotransmitters, like serotonin/5-HT, dopamine and neurochemicals like cortisol. This reconnection of the cerebellar-frontal-temporal circuits may reverse the basic dysfunctional pathways in autism, including attention, emotion, or hyperactivity, and open up a positive road for learning communicative or cognitive skills. Once the “latent” brain is reactivated again, the use of intensive therapeutic interventions (such as speech, occupational therapy and behavioral therapy) and education can help children process information in a more efficient way.

Future Direction
Many questions remain yet unanswered. Alternative treatment strategies, such as TAC, should be viewed as a complementary approach in neurological disabilities. However, an interdisciplinary approach involving Western and Chinese medicine provides an innovative starting point for a new conceptual treatment framework for autism. TAC can be viewed as a START-UP program or adjunctive therapy for autism. We hope that we can use a simple, relatively non-invasive quick treatment strategy to benefit families with autism worldwide.

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