This work was supported with funds from the National Natural Science Foundation of China (NSFC) Nos. 82374564 (to YJD) and Nos. 82074566 (to YJD) and from Sun Guojie Inheritance Base for TCM Acupuncture-Moxibustion of World Federation of Acupuncture-Moxibustion Societies in Wuhan, China (World Federation of Acupuncture-Moxibustion Societies [2019] No. 26) (to YJD) and the National Famous TCM Inheritance Studio construction project of the National Administration of Traditional Chinese Medicine, China (the National Administration of Traditional Chinese Medicine [2022] No. 5) (to YJD).

All experiments were carried out following the National Institutes of Health Guide for the Care and Use of Laboratory Animals and were approved by the Hubei Provincial Center for Disease Control and Prevention Laboratory Animal Management and Use Committee. A total of 18 3-month-old female Sprague-Dawley (SD) rats weighing 220-250 g were used for the test. All rats were maintained on a 12 h light/dark cycle at 23 &#177; 1 &#176;C and 40%-50% humidity, with free access to food and water. Following a one-week acclimatizati...

Improving Cognitive Functions in Rats via Thread-Embedding Acupuncture Therapy

The authors declare that they have nothing to disclose.

Intervention time 
The etiology of AD is complex, and its pathogenesis remains uncertain. Currently, there is no effective treatment for the disease, and its course is irreversible. Therefore, the academic community has reached a consensus on the importance of focusing on the prevention and treatment of AD. The prevention and treatment strategies for AD emphasize early intervention, following the TCM concept of treating conditions before they occur, emphasizing treatment before its onset, transmissi...

Thread-embedding acupuncture (TEA) involves embedding catgut or absorbable sutures into acupoints using a special needle. This technique has a prolonged effect until the sutures are absorbed and degraded. It provides continuous and sustained stimulation to the acupoints for a week or longer1, achieving a comparable outcome without the necessity for daily repetitive procedures2. This reduces the number of patients seeking medical treatment, thus conserving medical resources to some extent. In recent years, TEAT has been increasingly used in various medical fields in China, including internal medicine, external medicine, dermatology, facial features, gynecology, and pediatrics3. Studies have shown that it is effective in producing long-term and reliable effects for certain chronic and complex diseases, such as epilepsy4 and facial nerve paralysis5. It has the advantages of minimal trauma and simple operation6. Additionally, the treatment costs of TEAT have been reported to be lower than those of electroacupuncture (EA)7. Therefore, TEAT is increasingly valued in clinical and scientific research.
Alzheimer's disease (AD) is a neurodegenerative condition that progresses over time. Its pathophysiological process begins to accumulate approximately 20 years before clinical symptoms appear, but its mechanism is still not fully understood8. Given the limited availability of effective drugs for AD, research is increasingly focusing on the prodromal and preclinical stages of the disease9. Prevention is a crucial strategy for addressing the development and progression of AD9,10. In recent years, traditional Chinese medicine (TCM) has made significant progress, and it is expected to offer new possibilities for preventing and treating AD11,12. As a subtype of acupuncture, TEAT is preferred over other therapies due to its wide treatment range, minimal trauma, simple operation, low treatment frequency, and long-lasting efficacy6. Emerging literature suggests that TEAT may benefit individuals with obesity13,14, diabetes15, insomnia16, postmenopausal osteoporosis17, and depression18, all of which are risk factors for AD. It also improves senescence in aging rats by regulating mitophagy2, improves spatial learning and memory impairment, alleviates pathological damage of the hippocampus, and inhibits inflammation response in vascular dementia (VD) rats19. It appeared attractive to figure out whether TEAT could also act on pathological processes during AD.
The current research lacks uniformity and standardization in several critical elements of TEAT operation, including the embedding method, embedding tool, thread, and embedding interval period. This lack of standardization affects the evaluation of the therapy's effect and the exploration of related mechanisms and restricts external promotion and communication. Prior research20,21 has demonstrated that intraperitoneal administration of D-galactose (D-gal) can induce Alzheimer's disease-like pathological changes in rats, including neuronal degeneration and cognitive impairments. Furthermore, electroacupuncture at the Baihui(GV20) and Shenshu(BL23) has been shown to effectively ameliorate cognitive decline, mitigate neuroinflammation, and reduce neuronal damage. This study takes Alzheimer's disease-like model rats as an example to introduce the selection of acupoints and the operation process and precautions of TEAT under this model. It discusses the critical operational elements of TEAT in experimental research to provide a reference for future studies.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>0.9% saline, 4% paraformaldehyde, Hematoxylin, Eosin Y (water-soluble), absolute ethanol, 0.01M PBS powder, xylene, hydrochloric acid, embedded paraffin, neutral gum</td>
			<td>sinopharm (www.sinopharm.com)</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>5-0 absorbable surgical suture</td>
			<td>bodamedical (www.bodamedical.com)</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>70% alcohol, iodophor, cotton ball</td>
			<td></td>
			<td></td>
			<td>Used for disinfection.</td>
		</tr>
		<tr>
			<td>chloral hydrate</td>
			<td>sigma</td>
			<td>C8383</td>
			<td></td>
		</tr>
		<tr>
			<td>coverslips, glass slides</td>
			<td>Guangzhou Wuqiang Experimental Equipment Co., Ltd</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Dehydrator</td>
			<td>Wuhan Junjie JT-12J Computerized Biological Tissue Dehydrator</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>DELUXE THERMOSTAT HEAT MAT</td>
			<td>Zhenhua Instruments</td>
			<td></td>
			<td>For maintaining the body temperature of rats.</td>
		</tr>
		<tr>
			<td>D-galactose</td>
			<td>sigma</td>
			<td>G0750</td>
			<td></td>
		</tr>
		<tr>
			<td>electric men&#39;s beard trimmer</td>
			<td></td>
			<td></td>
			<td>Used for shaving rats.</td>
		</tr>
		<tr>
			<td>Electronic scale for small animals (ZK-DST)</td>
			<td>Henan Zhike Information Technology Co., Ltd</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>erythromycin ointment</td>
			<td>frontpharm</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>glass dish</td>
			<td></td>
			<td></td>
			<td>Used to place cut absorbable sutures.</td>
		</tr>
		<tr>
			<td>High-Pressure Steam Sterilization Pot (YM100Z)</td>
			<td>Shanghai Sanshen medical equipment factory</td>
			<td></td>
			<td>For sterilization of surgical instruments.</td>
		</tr>
		<tr>
			<td>Ice Maker (CMB40)</td>
			<td>Shanghai Sheyan Instrument Co., Ltd.</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Microscope (BX-53)</td>
			<td>OLYMPUS</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>milk powder</td>
			<td></td>
			<td></td>
			<td>Used for the MWM test.</td>
		</tr>
		<tr>
			<td>Morris Water Maze Video Tracking System &#38; Data Analysis Software (Version: Watermaze 2.0)</td>
			<td>Chengdu Taimeng Technology Co., Ltd</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>No.6 thread-embedding needle</td>
			<td>bodamedical (www.bodamedical.com)</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>ophthalmic scissors, trays, tweezers</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Pathology Microtome&#160; (RM 2016)</td>
			<td>LEICA, Germany</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>pentobarbital</td>
			<td>Germany</td>
			<td>P11011</td>
			<td></td>
		</tr>
		<tr>
			<td>permanent marker</td>
			<td></td>
			<td></td>
			<td>Used to mark the acupoint.</td>
		</tr>
		<tr>
			<td>Slicing knives (R35)</td>
			<td>Feathers, Japanese</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>soap</td>
			<td></td>
			<td></td>
			<td>Used to wash hands.</td>
		</tr>
		<tr>
			<td>sterile gloves</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
	</tbody>
</table>

operation procedure and precautions of thread-embedding acupuncture therapy in alzheimer

Thread-embedding therapy (TEAT) is a treatment that prevents and manages diseases by inserting a biodegradable suture into an acupoint, providing long-lasting stimulation. TEAT is a simple approach that avoids the discomfort of regular acupuncture and provides sustained therapeutic effects. This article discusses the potential impact of TEAT on the learning and memory abilities of rats with Alzheimer&#39;s disease-like symptoms. Since chemically induced neuronal degeneration and cognitive impairments in rats does not entirely reflect the true pathological changes observed in Alzheimer&#39;s disease. Consequently, our research group has designated these manifestations as Alzheimer&#39;s disease-like symptoms. A protocol has been established to outline the selection of acupoints, the operation process, and necessary precautions for the head and lower back. The experiment was conducted on three groups: a control group, a model group, and a TEAT group, each containing 6 rats. To induce Alzheimer&#39;s disease-like symptoms, rats were intraperitoneally injected with D-galactose for 7 weeks (49 days). The rats in the TEAT group received acupoint catgut embedding treatment. Following the intervention period, a Morris Water Maze (MWM) was conducted to evaluate the rats&#39; learning and memory. Subsequently, the rats were sacrificed, and their brain tissue was examined. A histological examination was performed to understand the effects of TEAT on the pathology of rats exhibiting symptoms of Alzheimer&#39;s disease. This study suggests that TEAT may improve learning and memory in rats with Alzheimer&#39;s disease-like symptoms, indicating a potentially promising new treatment approach for this neurodegenerative condition.

Author Spotlight: Exploring Acupuncture in Alzheimer&#039;s Research from Thread-Embedding Techniques to Clinical Trials

Operation Procedure and Precautions of Thread-Embedding Acupuncture Therapy in Alzheimer

In this study we're teaching into high acupuncture can help with Alzheimer's, especially memory issues. We've got some promising results with a technique called thread-embedding that seems to help rats with Alzheimer's like symptoms. Remember better, it could be a promising way to tackle this disease.Technologies currently used to advance research in this file encompassed advanced imaging techniques like MRI and the PET scans to visualize brain changes, molecular biology tools for genetic and protein expression analysis, and the sophisticated animal models that replicate human AD pathology. The biggest lab hurdles are nailing the mimicry of human Alzheimer's in animals. Making sure discoveries can move to people and keeping competitor methods consistent for reliable results.This approach seeks to provide less invasive option, potentially delivering a cost effective and accessible methods with reduced that effects. In the future our laboratory aims to explore the molecule mechanisms of acupuncture, evaluate its capability with additional treatments, and assess its safety and efficacy in Alzheimer's patients where clinical trials.

This article introduces the specific operation method of TEAT in Alzheimer&#39;s disease-like rats. It discusses the critical operational elements of TEAT in experimental research to provide a reference for future studies.
TEAT improves learning in Alzheimer&#39;s disease-like rats 
As illustrated in the flowchart (Figure 5), during the adaptive training period, it was observed that rats in each group were observing the surrounding environmen...

Read this Scientific Article Protocol about Author Spotlight: Exploring Acupuncture in Alzheimer's Research from Thread-Embedding Techniques to Clinical Trials at JoVE.com

This study presents a protocol for thread-embedding acupuncture therapy in Alzheimer's disease-like rats.

Thread-embedding therapy (TEAT) is a treatment that prevents and manages diseases by inserting a biodegradable suture into an acupoint, providing ...

operation-procedure-precautions-thread-embedding-acupuncture-therapy

Research

JoVE Journal

Neuroscience

Thread-Embedding Therapy &#40;TEAT&#41; for Acupoint Stimulation in Rats

Begin by arranging the sterile surgical instruments, including a number six disposable thread-embedding needle and a 5-0 absorbable suture on the surgical platform. Using ophthalmic scissors, cut the surgical suture into 0.5 and 0.2 centimeter pieces. Soak the cut thread pieces in 0.9%saline.Locate the acupoint Baihui GV 20 in an anesthetized rat at the right midpoint of the parietal bone and mark it using a marker. Shave the head area around the acupoint with a trimmer. Prior to surgery, apply 0.5%iodine solution in circular motions to disinfect the acupoints and surrounding skin.Then disinfect the area three times with iodophor, each followed by an application of alcohol. Use forceps to clamp out the 0.2 centimeter absorbable surgical suture soaked in saline, and place it in the front end of the needle tube. Then connect the suture to the needle core.Pinch the area around Baihui GV 20 with the thumb and index finger of one hand. Holding the needle with the other hand, insert it horizontally and quickly at a 15-degree angle to the skin surface, and 0.1 centimeters below the point. Once the needle tip reaches 0.1 centimeters above the Baihui GV 20 point, push the needle core while retracting the needle tube to implant the suture into the subcutaneous tissue of the acupoint.Slowly remove the needle, ensuring no suture is exposed. Press the needle hole with sterile dry cotton for 10 seconds to prevent bleeding. Locate the sixth lumbar vertebra based on the hip tubercle of the rat, then count four vertebral bodies upward to locate the second lumbar vertebra.Using a marker, mark the Shenshu BL 23 5 millimeters lateral to the second vertebra. Shave the back and waist area around the acupoint with a trimmer. Apply 0.5%iodine solution in a circular motion to disinfect the acupoints and surrounding skin.Clamp out the 0.5 centimeter absorbable surgical suture soaked in saline with forceps and connect it to the needle core. Stretch the skin with the index and middle fingers of the pressing hand, or the thumb and index fingers. Holding the needle with the other hand, quickly insert it perpendicularly into the point 0.25 centimeter below the Shenshu BL 23 point.Once the needle tip reaches 0.5 centimeters under the skin, adjust the tip to make the direction of insertion centripetal, forming a 45-degree angle with the skin surface, and obliquely insert 0.5 centimeters. Push the needle core while retracting the tube to implant the 0.5 centimeter suture into the muscle tissue of the acupoint. Slowly remove the needle, ensuring no suture is exposed.Then press the needle hole with sterile dry cotton for 10 seconds to prevent bleeding. The analysis of swimming speed showed no significant difference among the groups, indicating consistent baseline levels of movement, speed, and visual perception. Post five-day platform search training, movement trajectories, and escape latency analysis revealed that the thread-embedding therapy group significantly improved in spatial reference memory compared to the control and model groups.Probe trials showed that the control group used linear and directional strategies, suggesting strong memory. The model group's edge-based strategy indicated a significant decline in memory, while the thread-embedding therapy group's trend-based strategy showed memory improvement. The duration of stay and the number of platform crossings revealed that the thread-embedding therapy groups significantly outperformed the model group, indicating enhanced spatial learning and memory.

307 Views.  Hubei University of Chinese Medicine.  This study presents a protocol for thread-embedding acupuncture therapy in Alzheimer's disease-like rats.

Improving Cognitive Functions in Rats via Thread-Embedding Acupuncture Therapy

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