Acupuncture Proves to be Integrative Therapy for Bell’s Palsy

Jongbae Jay Park, PhD, LAcBell’s palsy is a nerve disorder that causes sudden paralysis of unilateral facial muscles. Studies show that 70 percent of those affected will completely recover, but 15 percent will go on to experience permanent damage. This prolonged paralysis and asymmetry can affect psychological and social behaviors which can undermine patients’ quality of life.

Duke Anesthesiology’s Dr. Jongbae Jay Park is a co-author of a newly published study in the February 2017 issue of Complementary Therapies in Clinical Practice, titled “A close look at an integrative treatment package for Bell’s palsy in Korea.”

As the study notes, Bell’s palsy patients experience significantly higher degrees of distress and report that they feel helpless when doctors don’t acknowledge problems other than facial disfigurement. While clinical guidelines in conventional medicine don’t yet recommend acupuncture treatment for Bell’s palsy due to poor study design and reporting, acupuncture is one of the most sought after treatments for this condition in many Asian countries.

The authors conclude that the lack of awareness, dearth of knowledge in patient needs, and shortage of treatment options available during the recuperation months increase the need and significance of an integrative treatment program for a well-rounded overall recovery. While rigorous research is warranted, they highly suggest that it is worth applying integrative medicine, such as acupuncture, to Bell’s palsy patients.

Dr. Park is the director of acupuncture and Asian medicine for Duke Anesthesiology’s Center for Translational Pain Medicine and a pain specialist at Duke Innovative Pain Therapies, located in Raleigh, North Carolina. Learn more about this first-of-its-kind pain practice in Duke Anesthesiology’s 2016 edition of BluePrint magazine.

Chris KeithAcupuncture Proves to be Integrative Therapy for Bell’s Palsy
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Pediatric Anesthesia Chief Comments on Alarming Statistic

Allison Ross, MDDuke Anesthesiology’s Dr. Allison Ross weighs-in on a new study that reveals a startling statistic – more than 10 million children in the United States don’t live near a pediatric anesthesiologist, a physician who specializes in sedating children and caring for them during surgery and other procedures.

While not involved in the study, Dr. Ross, chief of the department’s Pediatric Anesthesia Division at Duke University Medical Center, was featured in articles published by Reuters, FOX News and Yahoo! News on January 3 for her insight about its findings that show nearly 15 percent of children in the nation live more than 50 miles from a pediatric anesthesiologist. That number includes more than 2.7 million children under the age of five – the group that needs these specialists the most, according to the American College of Surgeons.

“Younger children have physical and emotional needs that obviously differ from adults. Their anatomy and physiology, particularly under anesthesia, change in ways that are unlike anesthetized adult patients,” says Dr. Ross, a professor of anesthesiology and pediatrics who cares for patients at Duke Children’s Hospital and Health Center and is actively involved in research regarding the sedation of children who are mentally challenged.

The study also shows that 90 percent of pediatric anesthesiologists work in urban areas (defined by the study’s authors as counties with more than 50,000 young children). And, that 71 percent of children live within 25 miles of a pediatric anesthesiologist.

New guidelines from the American College of Surgeons state that small children who need more serious medical care should be treated by pediatric anesthesiologists who have a special certification to work with children. Pediatric anesthesiologists not only sedate children for surgery, but also for procedures like body scans to help young children stay still. They also monitor the heart rates and other health measures of sedated children.

While Dr. Ross stresses the importance of specialized training, she notes that in areas without trained pediatric anesthesiologists, medical facilities are likely to have staff with a lot of experience treating children.

“It is important to realize that it is often more important in an emergency to be taken to the nearest facility for care rather than to delay care due to a desire to be in a pediatric facility, depending on the nature of the event or the medical condition of the child,” notes Dr. Ross.

Chris KeithPediatric Anesthesia Chief Comments on Alarming Statistic
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Dr. Ji’s Lab Makes Local Headlines for Autism-Pain Discovery

Ru-Rong Ji, PhDAbnormal pain sensitivity is often associated with autism spectrum disorders which can affect the quality of life of those individuals. New research from two Duke University labs, Dr. Ru-Rong Ji’s Pain Signaling and Plasticity Laboratory and Dr. Yong-Hui Jiang’s autism research lab, reveals a potential mechanism underlying pain insensitivity in autism. According to an article published by Duke Today on December 1 titled, “Autism-Linked Protein Crucial for Feeling Pain,” this finding is the first to connect autism to one of the most well-studied pain receptors, TRPV1 (transient receptor potential ion channel subtype V1).

This research was published in the December 2016 issue of the journal, Neuron, in an article titled, “SHANK3 Deficiency Impairs Heat Hyperalgesia and TRPV1 Signaling in Primary Sensory Neurons.” The manuscript describes how SHANK3 (a prominent autism gene), expressed by peripheral primary sensory neurons, regulates TRPV1 function and heat hyperalgesia after inflammation and nerve injury, offering a mechanistic insight into pain dysregulation in autism. The co-first authors of this paper are Qingjian Han, PhD, Yong-Ho Kim, PhD (both with Dr. Ji’s lab), and Xiaoming Wang, PhD. Co-investigators with Duke Anesthesiology include Dr. Ji, Zhi-Jun Zhang, Di Liu, Mark Lay, Wonseok Chang, Temugin Berta and Yan Zhang.

As explained in the Duke Today article, Dr. Ji’s lab put SHANK3-dificient mice through several sensory tests which found that animals had lower sensitivity than normal mice to heat and heat-related pain, similar to that of a sunburn. Their research found 1) that not only is the SHANK3 protein present in the brain, but also in a cluster of pain-sensing neurons called the dorsal root ganglion in mice, 2) SHANK3 in the same types of cells from human donors who did not have autism, 3) that SHANK3 is expressed on the sending sides of the synapse. Dr. Ji was surprised to find that SHANK3 is expressed in the peripheral nervous system and notes that this is the first study where researchers looked for it outside of the brain – a study that could shape how effective treatments for autism are developed.

Co-expression of SHANK3 (red) and TRPV1 (green) in primary sensory neurons in mouse dorsal root ganglion in the peripheral nervous system.

Co-expression of SHANK3 (red) and TRPV1 (green) in primary sensory neurons in mouse dorsal root ganglion in the peripheral nervous system.

Dr. Ji is the chief of pain research at Duke Anesthesiology, a distinguished professor of anesthesiology in the Duke University School of Medicine, a faculty member of Duke Anesthesiology’s Center for Translational Pain Medicine, and a member of the Duke Institute for Brain Sciences. His lab focuses on identifying molecular and cellular mechanisms that underlie the genesis of chronic pain and developing novel pain therapies that can target those mechanisms.

Chris KeithDr. Ji’s Lab Makes Local Headlines for Autism-Pain Discovery
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