Laser Needle Acupuncture

Medical Acupuncture. 2010 March;22(1):11-17.

Clinical Equivalence of Laser Needle to Metal Acupuncture Needle in Treating Musculoskeletal Pain: A Pilot Study

Dorsher, PT

Mayo Clinic Florida, Jacksonville, FL 32224, dorsher.peter@mayo.edu

Background: Acupuncture methodology has evolved over millennia with the introduction of new technologies.  Modern laser “needle” systems can transmit light energy deep enough through the skin to influence channel acupoints and trigger points.

Objectives: To compare whether musculoskeletal pain treatment outcomes with acupuncture are clinically equivalent whether using laser or traditional metal needles; and to determine statistical power estimates of cohort size for future double-blinded studies.

Design: Prospective nonblinded cohort study using neuroanatomically based point selection in a crossover protocol alternating between laser and metal needles.

Setting: Outpatient clinic at the Mayo Clinic Florida in Jacksonville, FL.

Participants: Thirty adults with degenerative joint or spine pain whose pain did not respond to allopathic interventions and were receiving metal needle acupuncture.

Intervention: Laser stimulation at prescribed neuroanatomically based acupoints was alternated at successive treatments with metal needles at the same points for 4 treatment sessions.

Main Outcome Measures: Visual Analog Scale (VAS) (0-10) pain rating, patient preference (metal vs laser), and treatment complications.

Results: For shoulder and knee arthritis pain, metal needle treatment pain VAS was 5.9 vs laser VAS of 3.1 (mean difference, 2.8; P=.05) Ninety percent (9/10) of participants with joint arthritis pain preferred laser treatments and reported more pain relief than similar treatments using metal needles; 80% (16/20) of spine pain participants reported the laser treatments provided at least as much pain relief as similar metal needle treatments.  No laser treatment complications were noted.

Conclusions: This pilot study of participants with chronic refractory musculoskeletal pain demonstrates that when used in neuroanatomical acupuncture treatments, laser stimulation is preferred and provides superior pain relief compared with metal needle treatments of the same acupoints.  The laser “needles” appear to be clinically equivalent to metal needles.”

Lasers Med Sci.  2013 Jan 17. [Epub ahead of print]

The effects of minimally invasive laser needle system on suppression of trabecular bone loss induced by skeletal unloading.

Ko CY, Kang H, Ryu Y, Jung B, Kim H, Jeong D, Shin HI, Lim D, Kim HS.

Source

Research Team, Korea Orthopedics and Rehabilitation Engineering Center, Incheon, 403-712, Republic of Korea.

Abstract

This study was aimed to evaluate the effects of low-level laser therapy (LLLT) in the treatment of trabecular bone loss induced by skeletal unloading. Twelve mice have taken denervation operation. At 2 weeks after denervation, LLLT (wavelength, 660 nm; energy density, 3 J/cm(2)) was applied to the right tibiae of six mice (LASER) for 5 days/week over 2 weeks by using a minimally invasive laser needle system (MILNS) which consists of a 100 um optical fiber in a fine needle (diameter, 130 um). Structural parameters and histograms of bone mineralization density distribution (BMDD) were obtained before LLLT and at 2 weeks after LLLT. In addition, osteocyte, osteoblast, and osteoclast populations were counted. Two weeks after LLLT, bone volume fraction, trabeculae number, and trabeculae thickness were significantly increased and trabecular separations, trabecular bone pattern factor, and structure model index were significantly decreased in LASER than SHAM (p<0.05). BMDD in LASER was maintained while that in SHAM was shifted to lower mineralization. Osteocyte and osteoblast populations were significantly increased but osteoclast population was significantly decreased in LASER when compared with those in SHAM (p<0.05). The results indicate that LLLT with the MILNS may enhance bone quality and bone homeostasis associated with enhancement of bone formation and suppression of bone resorption.

Lasers Med Sci.  2011 Nov 9. [Epub ahead of print]

Development of a minimally invasive laser needle system: effects on cortical bone of osteoporotic mice.

Kang H, Ko CY, Ryu Y, Seo DH, Kim HS, Jung B.

Source

Department of Biomedical Engineering, Yonsei University, 234 Maeji-ri, Heungup-myun, Wonju-si, Gangwon-do, 220-710, Korea.

Abstract

Many studies have shown the positive effects of low-level laser therapy in the treatment of bone disease. However, laser radiation is scattered in the skin surface which reduces the initial photon density for tissue penetration and consequently the therapeutic efficacy. We developed a minimally invasive laser needle system (MILNS) to avoid laser scattering in tissue and investigated its stimulatory effects in the cortical bone of osteoporotic mice. The MILNS was designed to stimulate cortical bone directly by employing fine hollow needles to guide 100 um optical fibers. The study animals comprised 12 mice which were subjected to sciatic denervation of the right hind limb and were randomly divided into two groups, a sham group and a laser group which were treated using the MILNS for 2 weeks without and with laser irradiation, respectively. In vivo micro-CT images were taken to analyze the structural parameters and bone mineral density. After 2 weeks of treatment with the MILNS, the relative changes in mean polar moment inertia, cross-section thickness, and periosteal perimeter were significantly higher in the laser group than in the sham group. Moreover, the distribution of bone mineral density index was higher in the laser group. The MILNS was developed as a minimally invasive treatment modality for bone disease and resulted in positive therapeutic efficacy in the cortical bone of osteoporotic mice.

Evid Based Complement Alternat Med. 2009 Jun;6(2):153-8. Epub 2007 Nov 12.

Ten Years Evidence-based High-Tech Acupuncture–A Short Review of Peripherally Measured Effects.

Litscher G.

Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 29, A-8036 Graz/Austria. gerhard.litscher@meduni-graz.at.

Abstract

Since 1997, the Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine of Graz Medical University has been dealing with the demystification of acupuncture and examining, using non-invasive methods, how different stimulation modalities (manual needle acupuncture, laserneedle acupuncture and electro acupuncture) affect peripheral and central functions. Laser is also an important instrument for acupuncture. One only needs to mention the treatment of children or of patients with needle phobia. The laserneedle acupuncture, which was examined scientifically for the first time in Graz, represents a new painless acupuncture method for which up to ten laserneedles are glued to the skin, but not stuck into it. This first part of the short review article summarizes some of the peripherally measured effects of acupuncture obtained at the Medical University of Graz within the last 10 years.

Eur J Obstet Gynecol Reprod Biol. 2009 Jan;142(1):68-72. Epub 2008 Nov 4.

Patients’ sensation during and after laserneedle versus metal needle treatment.

van Amerongen KS, Kuhn A, Mueller M.

Department of Obstetrics and Gynaecology, Inselspital, Bern University Hospital, and University of Bern, Switzerland. k.staehler@spin.ch

Abstract

OBJECTIVES: Aim of the study was to evaluate the patients’ sensations during and after laserneedle versus metal needle acupuncture.

STUDY DESIGN: The prospective study was performed at the gynaecological outpatient department of a University Teaching Hospital of Bern, Switzerland. Thirty female patients per group were included in the study and randomized into laserneedle or metal needle group. All women visited the acupuncture out patient department because of gynaecological disorders. Age of the patients in the metal needle group was 38 years in median (range 18-73 years); mean age was 41+/-13.3. Age in the laserneedle group was 36 years in median (range 16-60 years) and mean age was 39.1+/-12.2. Interventions were laserneedle acupuncture and metal needle acupuncture. Patients answered a questionnaire before, after the first treatment and prior to the second treatment. The questionnaires asked about the patients’ knowledge of the various acupuncture methods and their health condition before treatment, their perception of pain, warmth, tiredness and relaxation during or after application of the needles or during or after the treatment. Statistics were performed by Graph Pad InStat 3 for windows.

RESULTS: The common metal needle technique was well known by the patients in comparison to the laserneedle method (p<0.0001***). Laserneedle acupuncture is a method which is painless (p<0.0001***), energy inducing and relaxing (p=0.0257*) which leads to a warming sensation (p=0.0009***) during treatment.

CONCLUSION: Both methods laserneedle and metal needle acupuncture are valuable methods in achieving relaxation and improvement of gynaecological symptoms. Laserneedle acupuncture is painless and easy to apply which is a valuable reason to support this technique in the future.

J Acupunct Meridian Stud. 2008 Dec;1(2):65-82.

Clinical effectiveness of laser acupuncture: a systematic review.

Baxter GD, Bleakley C, McDonough S.

Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand. david.baxter@otago.ac.nz

Abstract

The use of laser light as an alternative to needles to stimulate acupuncture points has been promoted for almost three decades. However, there has been no systematic assessment of the evidence to support the effectiveness of this form of acupuncture to date. A systematic review was therefore undertaken of RCTs evaluating laser acupuncture as a primary intervention. Relevant studies (n = 18) were identified using computer-based literature searches and selected hand searches. Evidence was found to support the use of laser acupuncture in the treatment of myofascial pain, postoperative nausea and vomiting and for the relief of chronic tension headache. Laser acupuncture would appear to represent an effective form of acupuncture for the management of these conditions and could be considered as a viable alternative to more traditional forms of acupuncture point stimulation.

EMLA Laser Health J 2007;2:46-67 European Medical Laser Association (EMLA)L

LaserNeedle in veterinary practice

A. Roesti.

Wimmis, Switzerland

LaserNeedle is a new non invasive optical acupuncture stimulation method. The father of the LaserNeedle technique is Prof. Dr. Dr. med G. Litscher from the biomedical technical Research institute for anaesthesia and intensive care at the University of Graz in Austria.

The utmost important advantage of the LaserNeedle System is, that you can treat 8 selected acupuncture points at the same time. LaserNeedle emits highly concentrated red and infrared coherent laser rays of 680 nm with a very high energetically density onto the acupuncture point (~4.6 kJ/cm 2 ) (Ø 20 min. of stimulation).

LaserNeedles are taped perpendicular to the acupuncture point of the skin. The red and infrared Laser light is transmitted through an optical cable to the acupuncture point. There we have very little reflection of the Laser rays. Each point to be treated is detected and selected with the RAC/VAS.

The effect of the LaserNeedle stimulation is the same as all the other conventional LLLasers. Especially the stimulation of the vegetative nerve system, with neuromodulating effect. They reduce significantly pain, resolves muscular spasms and increase post operative mobility. It stimulates the microcirculation and the immune system By means of the Laser Needle the consumption of drugs and anti-inflammatory medicaments could be reduced significantly. The indication of LaserNeedle is the same as all other LLLT.

Photomed Laser Surg. 2008 Aug;26(4):301-6.

Laser-needle therapy for spontaneous osteonecrosis of the knee.

Banzer W, Hübscher M, Schikora D.

Department of Sports Medicine, Goethe-University Frankfurt/Main, University of Paderborn, Frankfurt/Main, Germany. banzer@sport.uni-frankfurt.de

Abstract

OBJECTIVE: This case report describes the treatment of a 63-year-old patient with spontaneous osteonecrosis of the knee (SONK).

BACKGROUND DATA: SONK usually appears in the elderly patient without the typical risk factors for osteonecrosis. It is characterized by acute and sudden pain, mostly occurring at the medial side of the knee joint. Symptoms usually worsen with physical activity and improve with rest. Besides physical therapy, limited weight-bearing and the use of analgesics and nonsteroidal anti-inflammatory drugs, we propose low-level laser therapy (LLLT) as a conservative treatment option.

METHODS: LLLT was carried out using laser needles emitting radiation with wavelengths of 685 and 885 nm, and a power density of 17.8 W/cm(2). Therapy sessions lasted 60 min and were performed daily over a period of 3 mo. The total irradiation dose emitted by 8 laser needles in 60 min of treatment was 1008 J.

RESULTS: Magnetic resonance imaging revealed distinct restitution of the spongiosa edema 5 wk after treatment onset, and the final check-up at 35 wk demonstrated complete restoration of integrity.

CONCLUSION: The present case report provides the first indication that laser-needle therapy may be a promising tool for complementary and alternative therapeutic intervention for those with SONK.

Crit Rev Biomed Eng. 2007;35(3-4):183-95.

Bioengineering assessment of acupuncture, part 7: heart rate variability.

Litscher G.

Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine and Traditional Chinese Medicine (TCM Research Center), Medical University of Graz, Graz, Austria. gerhard.litscher@medunigraz.at

In the seventh part of this review article, preliminary research on the topic of acupuncture and heart rate variability is described. Heart rate variability (HRV) refers to the beat-to-beat alterations in heart rate. Under resting conditions, the electrocardiograms of healthy people exhibit periodic variations in the percentage change in sequential chamber complexes (RR-intervals). The parameter HRV is modulated by the blood-pressure control-system, influences from the hypothalamus, and, in particular, the vagal cardiovascular center in the lower brainstem. This review article contains a short summary of scientific literature on HRV and acupuncture.

EMLA Laser Health J 2007;2:46-67 European Medical Laser Association (EMLA)L

LaserNeedle in veterinary practice

A. Roesti.

Wimmis, Switzerland

LaserNeedle is a new non invasive optical acupuncture stimulation method. The father of the LaserNeedle technique is Prof. Dr. Dr. med G. Litscher from the biomedical technical Research institute for anaesthesia and intensive care at the University of Graz in Austria.

The utmost important advantage of the LaserNeedle System is, that you can treat 8 selected acupuncture points at the same time. LaserNeedle emits highly concentrated red and infrared coherent laser rays of 680 nm with a very high energetically density onto the acupuncture point (~4.6 kJ/cm 2 ) (Ø 20 min. of stimulation).

LaserNeedles are taped perpendicular to the acupuncture point of the skin. The red and infrared Laser light is transmitted through an optical cable to the acupuncture point. There we have very little reflection of the Laser rays. Each point to be treated is detected and selected with the RAC/VAS.

The effect of the LaserNeedle stimulation is the same as all the other conventional LLLasers. Especially the stimulation of the vegetative nerve system, with neuromodulating effect. They reduce significantly pain, resolves muscular spasms and increase post operative mobility. It stimulates the microcirculation and the immune system By means of the Laser Needle the consumption of drugs and anti-inflammatory medicaments could be reduced significantly. The indication of LaserNeedle is the same as all other LLLT.

Crit Rev Biomed Eng. 2007;35(1-2):1-36.

Bioengineering assessment of acupuncture, Part 6: monitoring–neurophysiology.

Litscher G.

Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, Medical University of Graz, Graz, Austria.

Neurophysiological monitoring using spontaneous and evoked bioelectrical brain activities provides functional assessment of the central nervous system. This sixth part of the review article summarizes results from electroencephalographic and evoked potential monitoring in connection with acupuncture. The article reflects the impact of new techniques on acupuncture research (e.g., 600 Hz oscillations). Although numerous questions concerning acupuncture remain still unsolved, the present findings could be a further step to discover the complex mechanisms underlying the effects of acupuncture.

Crit Rev Biomed Eng. 2006;34(6):439-57.

Bioengineering assessment of acupuncture, part 5: cerebral near-infrared spectroscopy.

Litscher G.

Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, Medical University of Graz, Graz, Austria. gerhard.litscher@meduni-graz.at

The assessment of cortical activation in the brain due to acupuncture is crucial. Thus far functional assessment of cortical responses to certain external stimuli (for examples, manual needle, optical, electrical) are very few due to the lack of suitable techniques to monitor changes of brain activities. Near-infrared spectroscopy has been found to be suitable for functional studies during acupuncture. By this neuromonitoring method, hemodynamic changes coupled to cortical activity can be monitored. Near-infrared spectroscopy is used to measure regional changes in oxyhemoglobin, deoxyhemoglobin, and cytochrome aa3 noninvasively and continuously. The studies in this fifth part of a review article, which have been carried out mainly by the research group of Biomedical Engineering in Anesthesia and Intensive Care Medicine at the Medical University of Graz, demonstrate that near-infrared spectroscopy is a suitable technique for the assessment of cortical changes in response to varying forms of acupuncture. The method is likely to play an important role in providing new insights into the effects of acupuncture on brain function.

Crit Rev Biomed Eng. 2006;34(4):327-45.

Bioengineering assessment of acupuncture, part 4: functional magnetic resonance imaging.

Litscher G.

Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz, Graz, Austria. gerhard.litscher@meduni-graz.at

In the fourth part of this review article, research on the topic of acupuncture and functional magnetic resonance imaging is described. Needle as well as painless laserneedle stimulation have led to significant changes in different areas of the brain. With the help of modern biomedical engineering equipment and neuroscience, some of acupuncture’s secrets have begun to be revealed. The neuro-modulating effects require further investigation in a larger population sample.

Crit Rev Biomed Eng. 2006;34(4):295-326.

Bioengineering assessment of acupuncture, part 3: ultrasound.

Litscher G.

Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz, Graz, Austria. gerhard.litscher@meduni-graz.at

Multidirectional transcranial ultrasound monitoring can be used to prove quantifiable effects of acupuncture stimulation in the brain. This third part of the review article gives a short introduction in monitoring cerebral blood flow velocity and summarizes the scientific results in this area of research. New constructions from the Medical University of Graz that can be used for evidence-based computer-controlled acupuncture are described. With these new methods and concepts, reproducible effects of needle and laserneedle acupuncture stimulation in cerebral blood flow velocity can be objectified for the first time.

Crit Rev Biomed Eng. 2006;34(4):273-94.

Bioengineering assessment of acupuncture, part 2: monitoring of microcirculation.

Litscher G.

Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz, Graz, Austria. gerhard.litscher@meduni-graz.at

In the second part of the review article, monitoring of microcirculation during acupuncture is described. Laser Doppler flowmetry and laser Doppler imaging provide easy-to-use, noninvasive, real-time measurements of local tissue blood flow. Using these types of biomedical equipment, it is possible to quantify and objectify peripheral changes in microcirculation during different methods of acupuncture stimulation (manual needle acupuncture and laserneedle acupuncture).

Crit Rev Biomed Eng. 2006;34(1):1-22.

Bioengineering assessment of acupuncture, part 1: thermography.

Litscher G.

Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, Medical University of Graz, Graz, Austria. gerhard.litscher@meduni-graz.at

In Western society, acupuncture is becoming a popular complementary method to medical treatment. However, a scientific understanding of acupuncture has not been completely developed but will absolutely be necessary for the increased acceptance of acupuncture by the Western medical community. This first part of the review article describes, in a general introduction, milestones of acupuncture research within the last 30 years and in a specific part the possibilities and limitations of infrared thermography, a noninvasive biomedical engineering method, within acupuncture research.

Anesth Analg. 2006 Jun;102(6):1745-51.

Electroencephalogram–entropy and acupuncture.

Litscher G.

Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, Medical University of Graz, Graz, Austria. gerhard.litscher@meduni-graz.at

Computer-based measuring of the level of sedation and hypnosis is difficult and has proven to be challenging. The electroencephalogram (EEG) has been proposed as a potential method. Response entropy (RE) and state entropy (SE) are multifactor, dimensionless parameters of a new technology of EEG monitoring, and we investigated them for the first time in acupuncture research within this study. Both parameters have been alleged to reflect changes in the clinical state of sedation. Two different acupuncture schemes were tested in a randomized crossover trial with nine healthy volunteers (mean age +/- sd, 28.8 +/- 3.6 yr; 25-36 yr). Applying and stimulating acupuncture needles or performing laserneedle acupuncture at special sedation points decreased RE and SE significantly (P < or = 0.01; paired t-test) compared with the reference interval before acupuncture. In contrast, acupuncture of points for increasing “Qi-energy” did not decrease parameters of entropy. Specific acupuncture schemes produce specific, reproducible, and quantifiable effects on entropy parameters in the EEG. Therefore, entropy measurements during acupuncture seem to be worthy of further evaluation with a larger series of subjects.

Biomed Eng Online. 2005 Jun 15;4(1):38.

Infrared thermography fails to visualize stimulation-induced meridian-like structures.

Litscher G.

Biomedical Engineering and Research in Anesthesia and Intensive Care Medicine, Medical University of Graz, Austria. gerhard.litscher@meduni-graz.at

BACKGROUND: According to Traditional Chinese Medicine (TCM) the vital energy flows through a system of channels also called meridians. Generally accepted proof for meridians cannot be considered as being given. Goal of this study was to examine whether possible stimulation-induced meridian-like structures, as recently described by other authors, can be visualized and objectified simultaneously at different infrared wavelength ranges. METHODS: The study analyses evidence for the existence of acupuncture-specific, meridian-like artifacts in 6 healthy volunteers (mean age +/- SD 28.7 +/- 3.7 years; range 25 – 35 years). Two infrared cameras at different wavelength ranges were used for thermographic control of possible stimulation effects (moxibustion-cigar, infrared warmth stimulation, needle and laserneedle stimulation). In addition to thermography, temperature and microcirculatory parameters were registered at a selected point using laser-Doppler flowmetry. RESULTS AND CONCLUSION: After moxibustion (or infrared light stimulation) of the body at 2 – 5 microm and 7.5 – 13 microm ranges, different structures appear on thermographic images of the human body which are technical artifacts and which are not identical to what are known as meridians in all textbooks of TCM. Further scientific studies are required regarding the possible visualization of meridians.

Neurol Res. 2005 Jun;27(4):423-8.

An NIRS matrix for detecting and correcting cerebral oxygen desaturation events during surgery and neuroendovascular procedures.

Schwarz G, Litscher G, Delgado PA, Klein GE.

Department of Anesthesiology and Critical Care, Medical University of Graz, Austria. gerhard.schwarz@meduni-graz.at

BACKGROUND: Transcranial cerebral oximetry was developed for early detection of cerebral hypoxia and to avoid cerebral dysfunctions. However, near infrared spectroscopy (NIRS) data obtained during surgery are subject to intrinsic and extrinsic influences that have to be accounted for when interpreting the recordings. METHODS: We developed an NIRS matrix to provide brief information for specific intervention to correct changes of cerebral oxygen saturation (COS). Selected vital data and the descriptors of cerebrovascular and neurofunctional status were linked to logistic chains. RESULTS: The matrix is horizontally and vertically grouped and contains five descriptors: 1. change of COS; 2. key variable (parameter related to the change of COS); 3. associated parameters (vital data that do not cause COS alterations); 4. interpretation of values or preconditions most probably due to COS changes; and 5. the intervention most likely to normalize the COS or return it to baseline. The descriptors are grouped horizontally to a logistics chain. CONCLUSION: The modular expandable NIRS matrix we describe has promise for clinical use in surgical, neurointerventional, and anaesthesiological contexts.

Neurol Res. 2004 Sep;26(6):698-701.

Pseudoparadoxical dissociation of cerebral oxygen saturation and cerebral blood flow velocity after acupuncture in a woman with cerebrovascular dementia: a case report.

Schwarz G, Litscher G, Sandner-Kiesling A.

Department of Anaesthesiology for Neurosurgical and Craniofacial Surgery and Intensive Care, Medical University of Graz, Austria. gerhard.schwartz@uni-graz.at

Acupuncture can increase both cerebral oxygen saturation and cerebral blood flow velocity. We describe a 77-year-old woman with cerebrovascular dementia in whom acupuncture reproducibly induced an increase of blood flow velocity but a decrease of regional oxygen saturation. At four of 11 acupuncture sessions, blood flow velocity was measured in the middle cerebral artery with transcranial Doppler sonography and cerebral regional oxygen saturation (rSO(2)) with transcranial near infrared spectroscopy. Cerebral blood flow velocity increased by an average of 20% (range: 7-27%) at all four study points whereas rSO(2) consistently decreased by an average of 7% (range: 4-13%). Clinical status and cognitive function improved. These findings in a patient with vascular dementia may suggest increased oxygen extraction by activated neuronal structures.

Lasers Med Sci. 2004;19(1):6-11. Epub 2004 Mar 31.

Acupuncture using laser needles modulates brain function: first evidence from functional transcranial Doppler sonography and functional magnetic resonance imaging.

Litscher G, Rachbauer D, Ropele S, Wang L, Schikora D, Fazekas F, Ebner F.

Department of Biomedical Engineering and Research in Anesthesia and Critical Care, Medical University of Graz, Auenbruggerplatz 29, 8036, Austria. gerhard.litscher@meduni-graz.at

Acupuncture using laser needles is a new totally painless stimulation method which has been described for the first time. This paper presents an experimental double-blind study in acupuncture research in healthy volunteers using a new optical stimulation method. We investigated 18 healthy volunteers (mean age +/- SD: 25.4 +/- 4.3 years; range: 21-30 years; 11 female, 7 male) in a randomized controlled cross-over trial using functional multidirectional transcranial ultrasound Doppler sonography (fTCD; n = 17) and performed functional magnetic resonance imaging (fMRI) in one volunteer. Stimulation of vision-related acupoints resulted in an increase of mean blood flow velocity in the posterior cerebral artery measured by fTCD [before stimulation (mean +/- SE): 42.2 +/- 2.5; during stimulation: 44.2 +/- 2.6; after stimulation: 42.3 +/- 2.4 cm/s, n.s.]. Mean blood flow velocity in the middle cerebral artery decreased insignificantly. Significant changes (p < 0.05) of brain activity were demonstrated in the occipital and frontal gyrus by fMRI. Optical stimulation using properly adjusted laser needles has the advantage that the stimulation cannot be felt by the patient (painless and no tactile stimulation) and the operator may also be unaware of whether the stimulation system is active. Therefore true double-blind studies in acupuncture research can be performed.

Biomed Tech (Berl). 2004 May;49(5):106-10.

[Quantification of gender specific thermal sensory and pain threshold before and after laser needle stimulation]

[Article in German]

Litscher G, Wang L, Huber E, Schikora D, Schwarz G.

Abteilung für Biomedizintechnische Forschung in Anästhesie und Intensivmedizin, Medizinische Universität Graz, Osterreich. gerhard.litscher@meduni-graz.at

Abstract

Quantitative thermal sensory and pain threshold testing (QST) was performed in 29 adult healthy volunteers (mean age 24.2 +/- 2.7 years; range: 18-29 years; 20 females, 9 males) using the Thermal Sensory Analyser TSA-II (Medoc Advanced Medical Systems, Ramat Yishai, Israel, and Minneapolis, Minnesota, USA) before and after laser needle acupuncture and placebo stimulation, respectively. Significant (p < or = 0,001; t-test) gender-specific differences were seen on cold pain threshold analysis. No significant changes in parameters of thermal sensory and pain thresholds were found before and after laser needle or placebo stimulation at acupuncture points for acute pain. However, a trend towards change in the median value of cold pain sensation after laser needle stimulation (p = 0.479; paired t-test; n.s.) was seen within the group of healthy females. The influence of stimulation of acupuncture points for chronic pain on the various parameters needs to be clarified in future studies.

Biomed Tech (Berl). 2004 Jan-Feb;49(1-2):2-5.

[Histological investigation of the micromorphological effects of the application of a laser needle–results of an animal experiment]

[Article in German]

Litscher G, Nemetz W, Smolle J, Schwarz G, Schikora D, Uranüs S.

Abteilung für Biomedizintechnische Forschung in Anästhesie und Intensivmedizin, Medizinische Universität Graz. gerhard.litscher@meduni-graz.at

In an experimental animal study (Sus scrofa domesticus) we investigated the effects of the new technique of laser needle stimulation (wavelength: 685 nm; energy density: 4.6 kJ/cm2 per point; application duration: 20 min). The results revealed changes in microcirculatory parameters of the skin resulting in an increase in blood flow. However, the quality and intensity of the laser light did not induce micromorphological alterations in the skin.

Eur J Anaesthesiol. 2004 Jan;21(1):13-9.

Effects of acupressure, manual acupuncture and Laserneedle acupuncture on EEG bispectral index and spectral edge frequency in healthy volunteers.

Litscher G.

University of Graz, Department of Biomedical Engineering and Research in Anesthesia and Intensive Care, Graz, Austria. gerhard.litscher@uni-graz.at

BACKGROUND AND OBJECTIVE: The main purpose of this study was to investigate the effects of sensory (acupressure and acupuncture) and optical stimulation (Laserneedle acupuncture) on electroencephalographic bispectral index, spectral edge frequency and a verbal sedation score. METHODS: Twenty-five healthy volunteers (mean age +/- SD: 25.5 +/- 4.0yr) were investigated during the awake state. The acupuncture point Yintang and a placebo control point were stimulated. The study was performed as a randomized, controlled and partly blinded cross-over trial. RESULTS: Bispectral index and spectral edge frequency values both decreased significantly (P < 0.001) during acupressure on Yintang to values of 62.9 (minimum 35) +/- 13.9 bispectral index and to 13.3 (minimum 2.9) +/- 8.1 Hz (spectral edge frequency right) and 13.8 (minimum 2.7) +/- 7.3 Hz (spectral edge frequency left), respectively. Bispectral index was also significantly (P < 0.05) affected by Laserneedle acupuncture and acupressure on the control point but the changes were not clinically relevant, 95.4 +/- 4 and 94.2 +/- 4.8, respectively. All interventions significantly (Yintang: P < 0.001; control point: P < 0.012) reduced verbal sedation score. CONCLUSIONS: The study highlights the electroencephalographic similarities of acupressure induced sedation and general anaesthesia as assessed by bispectral index and spectral edge frequency.

Neurol Res. 2003 Oct;25(7):722-8.

Cerebral and peripheral effects of laser needle-stimulation.

Litscher G.

Department of Biomedical Engineering and Research in Anesthesia and Critical Care, University of Graz, Auenbruggerplatz 29, A-8036 Graz, Austria. gerhard.litscher@uni-graz.at

This study comprises scientific-theoretic fundamental investigations of laserneedle technology, a new and painless method of acupuncture stimulation. Laserneedles are not inserted in the skin, but are merely placed on the surface of the acupuncture point. The study documents the significant changes in peripheral microcirculation (p = 0.005) and surface temperature of the skin (p = 0.02) induced by laser, in 22 healthy volunteers (mean age 24.4 +/- 2.6 years). In addition, a randomised cross-over study to characterise the specific changes in cerebral blood flow velocity with laserneedle acupuncture (p < 0.001) is presented. These results provide important information for characterising the effects of laserneedle acupuncture.

Lasers Med Sci. 2002;17(4):289-95.

Cerebral vascular effects of non-invasive laserneedles measured by transorbital and transtemporal Doppler sonography.

Litscher G, Schikora D.

Department of Biomedical Engineering and Research in Anesthesia and Critical Care, University of Graz, Austria. gerhard.litscher@uni-graz.at

Laserneedles represent a new non-invasive optical stimulation method which is described for the first time in this paper. We investigated 27 healthy volunteers (mean age+/-SD: 25.15+/-4.12 years; range: 21-38 years; 14 female, 13 male) in a randomised cross-over trial to study differences between laserneedle acupuncture and manual needle acupuncture in specific cerebral parameters. Mean blood flow velocity ( v(m)) showed specific and significant increases in the ophthalmic artery during laserneedle stimulation ( p=0.01) and during manual needle stimulation ( p<0.001) at vision-related acupoints. At the same time insignificant alterations in v(m) were found in the middle cerebral artery for both acupuncture methods. The eight laserneedles used in this study were arranged at the end of the optical fibres. Each fibre was connected to a semiconductor laser diode emitting at 685 nm with a primary output power of about 55 mW. Optical stimulation using properly adjusted laserneedles has the advantage that the stimulation can hardly be felt by the patient and the operator may also be unaware of whether the laserneedle system is active, and therefore true double blind studies in acupuncture research can be performed.