This week is the
World Autism
Awareness Week. It's estimated about 1 in every 100
people in the UK is autistic. More boys and men are diagnosed with autism than
girls and women.
There is currently no effective medication to treat
autism. Applied Behaviour
Analysis (ABA) is often used in schools and clinics to help autistic
children. In recent years stem cell therapy is applied to autism
treatment, but its effect is still uncertain according to the latest report. [1]
Can
acupuncture help autism patients? How can it help? What is the best treatment
approach for autism? The following evidence based research reports will answer
these questions.
Does
it work?
Chen WX[2] reported 2 cases of child autism spectrum disorder (ASD) treated with electro acupuncture. After 24 sessions over 8 weeks treatment positive changes in "irritability" and "stereotypy" were noted in case 1, and positive changes were found for both cases in "sensory motor," "sensory response".The positive changes in case 1 included much improved "social relatedness, communication, and stereotypy behaviour"; Allam H[3] used scalp acupuncture to treat 20 ASD children.The results showed a significant improvement in cognitive and expressive language skills after treatment; Chan AS[4] reported a randomized clinical trial (RCT). They applied seven-star needletotreat 32 children with ASD and the results showed that the treatment group demonstrated significant improvement in language and social interaction, but not in stereotyped behaviour or motor function, compared to the control group.
Chen WX[2] reported 2 cases of child autism spectrum disorder (ASD) treated with electro acupuncture. After 24 sessions over 8 weeks treatment positive changes in "irritability" and "stereotypy" were noted in case 1, and positive changes were found for both cases in "sensory motor," "sensory response".The positive changes in case 1 included much improved "social relatedness, communication, and stereotypy behaviour"; Allam H[3] used scalp acupuncture to treat 20 ASD children.The results showed a significant improvement in cognitive and expressive language skills after treatment; Chan AS[4] reported a randomized clinical trial (RCT). They applied seven-star needletotreat 32 children with ASD and the results showed that the treatment group demonstrated significant improvement in language and social interaction, but not in stereotyped behaviour or motor function, compared to the control group.
Wong
VC[5] reported a randomized, double-blind, sham-controlled,
clinical trial. Children with ASD were randomly assigned to an electro-acupuncture (EA) group or a sham electro-acupuncture (SEA). After a four-week (12 sessions)
course of electro-acupuncture the results showed
there were significant improvements in the language comprehension domain,
self-care caregiver assistant domain in the EA group compared to the SEA group.
As for the parental report, the EA group also showed significantly better
social initiation, receptive language, motor skills, coordination, and
attention span.
Lee MS. [6]
aimed to assess the effectiveness of acupuncture as a treatment
for ASD.They searched 15 databases,11 RCTs. Two RCTs found
that acupuncture plus conventional language therapy was
superior to sham acupuncture plus conventional therapy. Two
other RCTs found that acupuncture produced significant effects compared
with conventional language therapy or complex interventions. Three
RCTs suggested that acupuncture plus conventional therapies had beneficial
effects compared with conventional therapy alone. Four more RCTs
reported that subjects who received acupuncture experienced
significant effects compared with subjects who were waitlisted or received no
treatment. The results of these studies provide mixed evidence
of acupuncture's effectiveness as a treatment for ASD symptoms.
Lee B[7] searched 13 databases published up
to December 2016. Twenty seven RCTs were included and 1736 participants were
investigated. The outcome measures were the overall scores on scales evaluating
the core symptoms of ASD and the scores for each symptom, such as social
communication ability and skills, stereotypies, language ability, and cognitive
function. The results showed that acupuncture complementary
to behavioural and educational intervention significantly decreased the overall
scores on the Childhood Autism Rating Scale (CARS) and
the Autism Behaviour Checklist. Acupuncture as a
monotherapy also reduced the overall CARS score.
How it works?
Zhao ZQ[8]
used electro-acupuncture to treat 55
childhood with autism (4.52±2.73 years). All
patients were examined by single photon emission computed tomography (SPECT)
before and after treatment to evaluate its effectiveness. The results showed that
intracerebral multiple focal radioactivity distribution defect areas of autism
patients were observed to be partially filled. Significant differences in the
ratios of regional cerebral blood flow and global cerebral blood flow before
and after treatment were observed. The symptoms of patients also improved.Khongrum J[9] applied laser
acupuncture at HT7 to treat the Valproic Acid-Rat Model of Autism. The
results showed that laser acupuncture HT7 decreased oxidative stress,
interleukin 6 (LI-6) gene expressions, and gamma-aminobutyric acid
transaminase T (GABA-T) activity but increased the expressions of glutamic acid
decarboxylase (GAD) proteins together with the density of Purkinje cells in the
cerebellum. Therefore, laser acupuncture at HT7 is the potential
strategy to improve the cerebellar disorders in VPA-rat model of autism.
Zhang R[10]
applied transcutaneous
electrical acupoint stimulation (TEAS) to treat 76 autistic children,
the plasma level of arginine-vasopressin (AVP) and oxytocin (OXT) were detected
before and after treatment. The result found the AVP and OXT level was
significantly higher in the TEAS group than in the control group. Li LY[11]analyzed the molecular mechanism of acupuncture treated ASD, because acupuncture can induce activation
gene expression of brain-derived neurotrophic factor (BDNF) in many
neurological disorders. In view of these findings, they hypothesise the
potential therapeutic effect of acupuncture-induced activation of BDNF in
the treatment of ASD.
What is the best protocol
?
Abo Almaali [12] analyzed acupuncture point's
combination and protocols of thirteen articles. The most frequently
used acupuncture points are EX-HN1 (5), GV-17 (4), PC-6 (4), LR-3
(3), KI-3 (3), HT-7 (3), Lu-9 (3), GV-20 (2), GV-24 (2), GV-24.5 (2), GB-13(2),
GB-19 (2), KI-4 (2), LR-4 (2), ST-36 (2), SP-3 (2), SP-6. The most frequently
used meridians are Du meridian (12), Gallbladder meridian (9), Kidney meridian
(8), Pericardium meridian (7), Extra points (7), Liver meridian (7), Heart meridian
(6), Ren meridian (6), and Bladder meridian (6).
Why
it can help?
The
clinical manifestation of autism was described in traditional Chinese medicine
classics of thousand years ago. It was called Wu Chi (five retardations). TCM
theory believes the five retardations were due to kidney essence deficiency.
Kidney essence can nourish the brain. Du meridian is an important connection
between kidney and brain. Brain development also relies on the normal function
of each organ. Acupuncture can balance yin-yang and regulate the function of
zang fu organs by stimulating certain points on certain meridians. That is why
it can give a lot of help in autism treatment.
Reference:
- Dario Siniscalco. Stem cell therapy in autism: recent insights. Stem Cells Cloning. 2018; 11: 55–67.
- Chen WX. Electroacupuncture for children with autism spectrum disorder: pilot study of 2 cases. J Altern Complement Med. 2008; 14(8):1057-65.
- Allam H. Scalp acupuncture effect on language development in children with autism: a pilot study. J Altern Complement Med. 2008; 14(2):109-14.
- Chan AS. Seven-star needle stimulation improves language and social interaction of children with autistic spectrum disorders. Am J Chin Med. 2009; 37(3):495-504.
- Wong VC. Randomized controlled trial of electro-acupuncture for autism spectrum disorder. Altern Med Rev. 2010; 15(2):136-46.
- Lee MS. Acupuncture for children with autism spectrum disorders: a systematic review of randomized clinical trials. J Autism Dev Disord. 2012 Aug; 42(8):1671-83. doi: 10.1007/s10803-011-1409-4.
- Lee B The Efficacy and Safety of Acupuncture for the Treatment of Children with Autism Spectrum Disorder: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2018 Jan 11; 2018:1057539.
- Zhao ZQ. Evaluating the effectiveness of electro-acupuncture as a treatment for childhood autism using single photon emission computed tomography. Chin J Integr Med. 2014; 20(1):19-23.
- Khongrum J. Laser Acupuncture at HT7 Improves the Cerebellar Disorders in Valproic Acid-Rat Model of Autism. J Acupunct Meridian Stud. 2017;10 (4):231-239.
- Zhang R. Transcutaneous electrical acupoint stimulation in children with autism and its impact on plasma levels of arginine-vasopressin and oxytocin: a prospective single-blinded controlled study. Res Dev Disabil. 2012; 33(4):1136-46.
- Li LY. Could acupuncture have a role in the treatment of autism spectrum disorder via modulation of BDNF expression and activation? Acupunct Med. 2014; 32(6):503-5.
- Abo Almaali. Analysis of Evidence-Based Autism Symptoms Enhancement by Acupuncture. J Acupunct Meridian Stud. 2017; 10(6):375-384.
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