Auricular acupuncture and vagal regulation

Wei He, Xiaoyu Wang, Hong Shi, Hongyan Shang, Liang Li, Xianghong Jing, Bing Zhu, Wei He, Xiaoyu Wang, Hong Shi, Hongyan Shang, Liang Li, Xianghong Jing, Bing Zhu

Abstract

Auricular acupuncture has been utilized in the treatment of diseases for thousands of years. Dr. Paul Nogier firstly originated the concept of an inverted fetus map on the external ear. In the present study, the relationship between the auricular acupuncture and the vagal regulation has been reviewed. It has been shown that auricular acupuncture plays a role in vagal activity of autonomic functions of cardiovascular, respiratory, and gastrointestinal systems. Mechanism studies suggested that afferent projections from especially the auricular branch of the vagus nerve (ABVN) to the nucleus of the solitary tract (NTS) form the anatomical basis for the vagal regulation of auricular acupuncture. Therefore, we proposed the "auriculovagal afferent pathway" (AVAP): both the autonomic and the central nervous system could be modified by auricular vagal stimulation via projections from the ABVN to the NTS. Auricular acupuncture is also proposed to prevent neurodegenerative diseases via vagal regulation. There is a controversy on the specificity and the efficacy of auricular acupoints for treating diseases. More clinical RCT trials on auricular acupuncture and experimental studies on the mechanism of auricular acupuncture should be further investigated.

Figures

Figure 1
Figure 1
The innervations of the external auricle. The innervations of the auricular branch of the vagus nerve are marked by green color. The innervations of the auriculotemporal nerve are marked by red color. The innervations of the lesser occipital nerve are marked by blue color. The innervations of the greater auricular nerve are marked by yellow color.
Figure 2
Figure 2
Auricular acupoints treating visceral diseases are mainly located at auricular concha.
Figure 3
Figure 3
“Auriculovagal afferent pathway” (AVAP): both the autonomic and the central nervous system could be modified by auricular vagal stimulation via projections from the ABVN at the auricular concha to the NTS (see Figure 3). NTS: nucleus of the solitary tract; DMN: dorsal motor nucleus of the vagus; AP: area postrema; RVM: rostral ventrolateral medulla; LC: locus coeruleus.

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