XinYan GAO * * Bing ZHU * ShiPing ZHANG *

2. Neurons in the Nucleus Tractus Solitary (NTS) Involved in Mediating Autonomic Changes Evoked by Auricular Acupuncture (AA) XinYan GAO** Bing ZHU* ShiPing ZHANG* * Hong Kong Baptist University *China Academy of Chinese Medical Sciences

3. BACKGROUND

4. Auriculotherapy is largely the result of the work of Dr. Paul Nogier of France. The ear represents the body in an upside down fetal orientation.

5. ? heart The outer ear acts like a switchboard to the brain, and when each point on the ear treated, triggers electrical impulses, from the ear, via the brain, to the specific area of the body that is being treated.

6. output input But how AA works ? ? brain

7. Auricular innervations Oleson, 2003

8. Others work • Retrograde neuronal tracing or anatomic study showed that auricular branch of vagus projects to NTS. • --Tekdemir, 1998; Folan-Curran, 1994

9. Clinic reports revealedthat stimulation on auricle may excite vagal reflexes leading to cardiac arrest and chronic cough. • -- Prasad, 1984; Moorthy, 1985

10. Acupuncture practitioners use AA for autonomic disorders as hypertension and hypotonia in gastrointestinal tract. • --Gaponiuk, 1988; Jiang, 1986

11. OBJECTIVE Neurons in the NTS are known to be involved in modulation of autonomic changes. It has been hypothesized that AA influences autonomic functions via neurons in the NTS through afferent input of the vagus nerve innervating the ear. The objective of the current research is to study such hypothesis by investigating the discharge pattern of NTS during AA and examining the effect of NTS blockade on AA evoked autonomic changes.

12. NTS recording Autonomic function --MAP; HR; IGP AA Stim. 2%Lignocaine Microinjection -5℃Cold block 0.2% atropine infusion

13. Preliminary test To find the best point and stimulus for AA Changes of MAP (mmHg) A: 4Hz, 100µs, 0.4mA; B: 4Hz, 100µs, 1.0mA; C: 100Hz, 300µs, 0.4mA; D: 100Hz, 300µs, 1.0mA *P<0.05, **P<0.01, ***P<0.001 (the same as following)

14. RESULTS

15. Responses of NTS neurons, mean arterial blood pressure (MAP), heart rate (HR) and intragastric pressure (IGP) to AA

16. The effect of AA and body acupuncture on MAP

17. The effect of AA and body acupuncture on HR

18. The effect of AA and body acupuncture on IGP

19. The effect of AA and body acupuncture on MAP after atropine

20. The effect of AA and body acupuncture on HR after atropine

21. The effect of AA and body acupuncture on IGP after atropine

22. The effect of AA and body acupuncture on MAP pre-post atropine

23. The effect of AA and body acupuncture on HR pre-post atropine

24. The effect of AA and body acupuncture on IGP pre-post atropine

25. The effect of AA and body acupuncture on HR-related NTS neurons

26. The effect of AA and body acupuncture on non HR-related NTS neurons

27. The effect of AA and body acupuncture on HR-related NTS neurons after atropine

28. The effect of AA and body acupuncture on non HR-related NTS neurons after atropine

29. Responses of MAP, HR and IGP to AA and body acupuncture with NTS region cold -block

30. Comparison of changes of MAP, HR and IGP evoked by AA and body acupuncture during NTS region cold-block

31. Responses of MAP, HR and IGP to AA and body acupuncture after lignocaine microinjection

32. CONCLUSION

33. brain parasympathetic spinal auricular acupuncture visceral function sympathetic sympathetic somatic Auriculo-vagal reflex evoked by AA vagus

34. Auriculo-vagal reflex

35. Acknowledgements Bing ZHU Pei Jing RONG Shi Ping ZHANG Hui BEN Wai Kei CHAN Yan Hua LI

36. QUESTIONS & ANSWERS

37. Thank you for your attention!