Effect of sensory stimulation (acupuncture) on sympathetic and parasympathetic activities in healthy subjects. Intradermal acupuncture on shen-men and nei-kuan acupoints improves insomnia in stroke patients by reducing the sympathetic nervous activity: a randomized clinical trial. Atropine-induced HRV alteration is not amended by electroacupuncture on Zusanli. Effects of electrical acupuncture on acupoint BL15 evaluated in terms of heart rate variability, pulse rate variability and skin conductance response. Effects of verum acupuncture compared to placebo acupuncture on quantitative EEG and heart rate variability in healthy volunteers. An alternative method to enhance vagal activities and suppress sympathetic activities in humans Effects of acupuncture on heart rate variability in normal subjects under fatigue and non-fatigue state Increase in the vagal modulation by acupuncture at neiguan point in the healthy subjects. Effect of acupuncture on heart rate variability in primary dysmenorrheic women. Transcontinental and translational high-tech acupuncture research using computer-based heart rate and "Fire of Life" heart rate variability analysis. Sympathetic nerve activity after acupuncture in humans
UNLABELLED It has been postulated that sensory stimulation ( acupuncture ) affects the cardiovascular system via the autonomic nervous system . Previously , skin temperature , thermography , plethysmography and blood pressure changes have been used in evaluation of sympathetic nerve activity following acupuncture . By using power spectral analysis , the low frequency and high frequency components of heart rate variability can be calculated reflecting the sympathetic and parasympathetic activity . The purpose of this study was to investigate to what extent acupuncture applied into the thenar muscle and into the cavum concha of the ear induced changes in the sympathetic and /or parasympathetic nervous system in healthy subjects . MATERIAL S AND METHODS Twelve healthy volunteers , six men and six women , mean age 34.4 ( range 23 - 48 ) participated in three balanced , r and omly distributed sessions . At an individual initial visit the 12 volunteers were introduced to the needle sensation by having a needle inserted into the point LI 11 . The needle sensation was evoked and the subject was trained to identify the characteristic needle sensation . The introduction was followed by three test sessions . SESSION A A short acupuncture needle , ( Seirin no 3 , ∅0.20x15 mm ) was inserted perpendicular into the earpoint , Lu 1 , in the left inferior hemi-conchae . SESSION B An acupuncture needle ( Hwato , ∅0.30x30 mm ) was inserted perpendicular into the Hegu point ( LI 4 ) in the middle of the right dorsal thenar muscle . SESSION C An acupuncture needle ( Hwato , ∅0.30x30 mm ) was inserted perpendicular superficially into the skin overlying the Hegu point on the left h and . Results . Stimulation of the ear induced a significant increase in the parasympathetic activity during the stimulation period of 25 min ( P<0.05 ) and during the post-stimulation period of 60 min ( P<0.05 ) . No significant changes were observed in either the sympathetic activity , blood pressure or heart rate . Stimulation of the thenar muscle result ed in a significant increase in the sympathetic and the parasympathetic activity during the stimulation period ( P<0.01 ) and during the post-stimulation period ( P<0.01 and P<0.001 , respectively ) . A significant decrease in the heart rate frequency ( P<0.05 ) at the end of the post-stimulation period was also demonstrated . The superficial needle insertion into the skin overlaying the right thenar muscle caused a pronounced balanced increase in both the sympathetic and parasympathetic activity during the post stimulation period of 60 min ( P<0.01 ) while no changes were observed during the stimulation period . CONCLUSION It is indicated that sensory stimulation ( acupunctura ) in healthy persons is associated with changed activity in the sympathetic and parasympathetic nervous system depending on site of stimulation and period of observation This study is a double-blind r and omized controlled trial on the effect of intradermal acupuncture on insomnia after stroke . Hospitalized stroke patients with insomnia were enrolled in the study and were r and omly assigned to either a real intradermal acupuncture group ( RA group ) or a sham acupuncture group ( SA group ) . The RA group received intradermal acupuncture on Shen-Men ( He-7 ) and Nei-Kuan ( EH-6 ) for three days , and the SA group received sham acupuncture on the same points . The effect of acupuncture on insomnia was measured using Insomnia Severity Index ( ISI ) and Athens Insomnia Scale ( AIS ) at baseline and three days after treatment . To assess the effect of acupuncture on the autonomic nervous function , the subjects ' blood pressure and heart rate variability were monitored . Fifty-two subjects ( 27 in the RA group and 25 in the SA group ) were included in the final analysis . The insomnia-related scales ISI and AIS showed greater improvement of insomnia in the RA group than in the SA group . Moreover , there is a greater reduction of the number of non-dippers and a greater decrease of the LF/HF ratio ( heart rate variability ) in the RA group than in the SA group . These results indicate that sympathetic hyperactivities were stabilized in the RA group . It can thus be concluded that intradermal acupuncture on Shen-Men and Nei-Kuan is a useful therapeutic method for post stroke-onset insomnia as it reduces sympathetic hyperactivities Acupuncture is known to influence autonomic nervous activity . Acupuncture on Zusanli points has been shown to enhance the regularity of gastric myoelectrical activity and accelerate gastric emptying , partly through the vagal pathway , in dogs . The aim of this study was to evaluate whether atropine-induced autonomic nervous alteration , measured by heart rate variability ( HRV ) , could be amended by electroacupuncture on Zusanli points . HRV measurements were recorded in 15 healthy volunteers before , during and after electroacupuncture . Each subject was studied for three sessions in a r and omized sequence , which included electroacupuncture on the Zusanli ( St 36 ) points with or without premedication of atropine and placebo stimulation on a non-acupoint . The analysis of low frequency ( LF ) , high frequency ( HF ) and LF/HF ratios were compared between different sessions . Serum levels of gastrin , motilin and pancreatic polypeptide ( PP ) levels were also measured . There was an increase in the LF/HF ratio ( indicating increased sympathetic activity ) during the post-acupuncture period with 2 Hz of electrical stimulation on the Zusanli acupoints . When IV atropine was used immediately before the electroacupuncture , there was a decrease in the LF power and HF power during the acupuncture and post-acupuncture periods . In addition , there was a significant increase in the LF/HF ratio during the acupuncture and post-acupuncture periods . There was a significant decrease in serum PP in the post-acupuncture period after premedication with IV atropine . In conclusion , atropine-induced HRV change might be mediated via the vagal pathway . However , atropine-induced HRV alteration is not amended by electroacupuncture on Zusanli points In this research , heart rate variability ( HRV ) , pulse rate variability ( PRV ) and human skin conductance ( SC ) of all acupoints on Heart Meridian were used to evaluate the effects of electrical acupuncture ( EA ) on acupoint BL15 ( Bladder Meridian ) . Ten healthy volunteers ( aged 23 + /- 6 ) were selected as the control group on the first day , and then used again as the experimental group on the second day . The control group received sham EA during the study , while subjects of the experimental group were stimulated by 2 Hz EA on acupoint BL15 for 10 minutes .  Electrocardiogram ( ECG ) , wrist blood pressure pulse meter and skin conductance response ( SCR ) device were used to measure and analyze HRV , PRV and SCR for the two groups before and after stimulation . From the spectrum analysis of ECG and pulse pressure graph , we found that the EA applied on BL15 could induce a significant increase in the normalized high frequency power ( nHFP ) component of HRV and PRV , as well as a significant decrease in the normalized low frequency power ( nLFP ) part ( p < 0.05 ) . Moreover , both the heart rate and pulse rate were reduced in the analysis of the time domain of ECG and PRV . Furthermore , most of the SCR values at acupoints were decreased after stimulation . These results also indicate that the stimulation of BL15 by EA could cause relaxation , calmness and reduce feeling of tension or distress OBJECTIVES The aim of this single-blind r and omized crossover study was to evaluate specific effects of manual acupuncture on central and vegetative nervous system activity measured by quantitative electroencephalography ( qEEG ) and heart rate variability ( HRV ) . DESIGN Twenty ( 20 ) healthy volunteers ( mean : 25.2 + /- 3.6 years ) were monitored simultaneously using a qEEG system and a 12-channel electrocardiogram recorder during verum acupuncture ( VA ) at acupuncture point Large Intestine 4 ( Hegu ) ( LI4 ) or placebo acupuncture ( PA ) at a sham point . RESULTS In the EEG conduction of the occipital area , needle stimulation in VA increased alpha1-frequency significantly , and the ratio alpha1/theta was shifted to the benefit of alpha1 over all electrodes . The HRV parameters showed a significant increase of the low frequency/high frequency ( HF ) ratio during the first minute of stimulation in VA , indicating an initial increase of sympathetic activation . However , an increase of HF power in the minute after stimulation followed by a decrease in heart rate suggests delayed vagal activation . De qi ( a sensation that is typical of acupuncture needling ) occurred in 16 subjects during VA and in 9 volunteers during PA ( 80 % versus 45 % ) . CONCLUSIONS Manual stimulation on LI4 seems to lead to specific changes in alpha EEG-frequency and in HRV parameters . A linear relationship between the HRV parameters and the alpha EEG b and might point to a specific modulation of cerebral function by vegetative effects during acupuncture Vagal withdrawal and /or sympathetic overactivity is always accompanied by various kinds of stress and is dangerous to the body . We proposed that mild acupuncture on the Sishencong points may effectively enhance vagal activities but suppress sympathetic regulations of the heart in humans . Experiments were carried out on nine healthy male volunteers , while they were lying in a quiet room during 2 - 4 P.M.  Acupuncture was applied 2 mm deep into the skin using st and ard stainless acupuncture needles at the Sishencong points , which are located on the vertex of the head , each 1 cm away from Baihui ( GV 20 ) in four directions . Four points around the temporal area were selected as control points . Forty minutes of precordial ECG signals before , during , and after acupuncture were recorded continuously . Frequency-domain analysis of the stationary RR intervals was performed to evaluate the total variance , high-frequency power ( HF , 0.15 - 0.40 Hz ) and low-frequency power ( LF , 0.04 - 0.15 Hz ) in normalized units ( LF% ) . Acupuncture on the Sishencong points result ed in an increased HF but a decreased LF% compared with the before acupuncture stage . Such effects did not occur when manual acupuncture was applied to the control points . The differences in the heart rate dynamics between Sishencong and the control groups took place 10 min after initiation of acupuncture and persisted even after the removal of the needles . Based on these results , we concluded that manual acupuncture on the Sishencong points enhanced cardiac vagal and suppressed sympathetic activities in humans . The underlying mechanisms and potential applications warrant further investigations The objective of this study was to assess the effects of acupuncture applied at Hegu ( LI 4 ) points and Neiguan ( PC6 ) points on heart rate variability ( HRV ) in normal subjects under fatigue and non-fatigue states using power spectral analysis . Twenty-nine normal male subjects were r and omly divided into three groups . Subjects in Group A and Group B performed a simulated driving task for 3 h and acupuncture needles were then inserted perpendicularly into the LI 4 points in the middle of the dorsal thenar muscle and PC 6 points situated between the tendons of the palmaris longus and carpi radialis muscles for 15 min for Group A but inserted subcutaneously to the acupuncture points for Group B as a control . Acupuncture needles were directly inserted perpendicularly into the LI 4 points and PC 6 points for 15 min for Group C. Stimulations of the acupuncture points induced a significant decrease in heart rate ( HR ) , HRV total power ( TP ) , low frequency ( LF ) power and ratio of low frequency to high frequency ( LF/HF ) , and a significant increase in the HF power in normalized units ( NU ) during the post stimulation period in fatigue state ( P<0.05 ) . Stimulation of acupuncture points result ed in a significant increase both in the LF power and HF power in absolute units ( AU ) ( P<0.05 ) but no significant change in NU was found during the post stimulation period in non-fatigue state . It was concluded that the modulating effect of acupuncture on heart rate variability not only depended on the points of stimulation such as acupuncture or non-acupuncture points but also on the functional state of the subject , namely whether the subjects are in a state of fatigue or not Acupuncture at the Neiguan ( P6 ) point has been shown to lessen nausea and vomiting which are related to vagal modulation . This study investigated whether acupuncture at the P6 point could improve vagal modulation by using heart rate variability analysis . We compared the heart rate variability measures of 39 subjects receiving acupuncture at the P6 point , 38 subjects receiving sham acupuncture , and 34 subjects receiving no treatment at all .  The normalized high-frequency power was used as the index of vagal modulation , and the low-/high-frequency power ratio was used as the index of sympathovagal balance . The normalized high-frequency power after acupuncture  increased significantly from 28.1 + /- 12.6 nu ( mean + /- SD ) to 30.7 + /- 14.1 nu in the P6 acupuncture group , but not in the sham acupuncture ( 30.6 + /- 13.7 nu versus 31.8 + /- 13.8 nu ) or no-treatment group ( 30.1 + /- 15.0 nu versus 30.1 + /- 15.7 nu ) . In both the P6 and sham acupuncture groups , the mean RR interval ( the intervals between consecutive R waves in the electrocardiogram ) increased significantly after acupuncture . In the no-treatment group , there was no statistical difference in all heart rate variability measures in the initial and later sessions . In conclusion , acupuncture at the P6 point can increase vagal modulation of the subjects . This result may be helpful in the underst and ing of the mechanism underlying the effect of acupuncture or acupressure at P6 on the lessening of nausea and vomiting in clinic Primary dysmenorrhea is a common gynecological complaint among young women that is related to an autonomic nervous system ( ANS ) disturbance . Acupuncture is one of several therapeutic approaches for primary dysmenorrhea , since it can modulate ANS function . The heart rate variability ( HRV ) parameters such as high frequency ( HF ) , low frequency ( LF ) and LF/HF ratio are generally accepted tools to assess ANS activity . The purpose of this study was to investigate the effects of acupuncture applied at Hegu ( LI4 ) and Sanyinjiao ( SP6 ) points on HRV of women with primary dysmenorrhea during the late luteal phase . The experimental design was a crossover and patient-blinded procedure . All subjects participated in Sham ( SA ) and Real Acupuncture ( RA ) procedure , separated by one month , in a crossover sequence . The participants included 38 women ( mean age 22.3 years ; weight 53.8 kg ; height 162.6 cm ) .  HRV measurement was 15 min before and 15 min after an acupuncture procedure . The RA procedure was performed at two bilateral acupoints , but needles were inserted subcutaneously to the acupuncture points for the SA procedure . The RA induced a significant decrease in LF/HF ratio and a significant increase in the HF power , while SA treatment caused a significant increase only in the HF power .  Manual acupuncture at bilateral acupoints of LI4 and SP6 may play a role in dysmenorrhea treatment with autonomic nervous system involvement A variable heartbeat was considered a sign of good health by ancient Asian physicians . Today , new computer-based methods ( e.g. , " Fire of Life " analysis ) allow quantification of heart rate and heart rate variability during acupuncture . The objective of this article is to compare different acupuncture methods to evaluate the influence of acupuncture on heart rhythm in short-term and long-term measurements . There were four main sections in this study : ( A ) a r and omized controlled study using needle acupuncture and acupressure at Yintang ( Ex1 ) ; ( B ) an innovative blue ( violet ) laser acupuncture r and omized controlled study in Asian volunteers ; ( C ) a comparative study using moxibustion methods ; and ( D ) teleacupuncture .  A total of 72 patients ( mean age ± SD : 27.9 ± 8.6 years ) were monitored over periods of 20 minutes to 24 hours in Asia and Austria .  Acupuncture was performed with metal needles ( in sections A , C and D ) or blue laser ( in section B ) on Yintang , Neiguan , Guanyuan or a special acupuncture regimen for stress disorders ( in sections A , B , C and D , respectively ) . Significant decreases in heart rate after verum intervention at Yintang , Neiguan and Guanyuan were found . Improvements in state of health following teleacupuncture were also noted . Computer-based heart rate and heart rate variability analysis was demonstrated to be effective in evaluating the status of health during acupuncture & NA ; The aim of the present study was to determine if acupuncture stimulation inhibits sympathetic nerve activity in humans . Multiunit efferent postganglionic sympathetic activity was recorded with a tungsten microelectrode inserted in a muscle fascicle of the peroneal nerve . Mean arterial pressure , heart rate and skin blood flow were also monitored . Pain thresholds were measured by electrical tooth pain stimulation . After a 30 min rest , acupuncture needles were inserted bilaterally into the Li 11 and the Li 4 acupuncture points , and manipulated until ‘ chi ’ cramp‐like sensation was reported . Electrical stimulation ( 2 Hz , 0.6–0.8 ms duration , maximal tolerated stimulation without discomfort ) was delivered for 30 min and the physiological recordings were continued for 90 min after the end of acupuncture . In a placebo control experiment , the same procedure was followed , except that acupuncture needles were inserted subcutaneously and no manipulation or stimulation was given . The stimulator delivered pulses to an unconnected channel , hence , the same audiovisual stimuli were experienced as with acupuncture , and care was taken to ask the same questions about sensations in the placebo and the acupuncture groups . Electroacupuncture produced an increase in pain threshold which was paralleled by a transient increase in muscle sympathetic nerve activity .  During acupuncture , there was a small increase in heart rate and mean arterial pressure , but there was no post‐acupuncture hypotension . The placebo control procedure did not change pain threshold or sympathetic nerve traffic . The findings suggest that electroacupuncture produces  moderate hypoalgesia in humans paralleled by a significant increase in muscle sympathetic nerve activity
To summarize all relevant trials and critically evaluate the effect of  acupuncture on heart rate variability ( HRV ) .