Acupuncture for Refractory Epilepsy: Role of Thalamus

Figure 1

Schematic of neural substrates for VNS and acupuncture. (1) The vagus nerve carries information to the nodose ganglion (NG) and then relay mainly to bilateral nucleus tractus solitarius (NTS) via solitary tract (ST); thereby, the vagal afferents project densely to the parabrachial nucleus (PB) in the pons and other regions of the brainstem like medullary reticular formation (MRF) and numerous forebrain sites including limbic and olfactory cortices, hypothalamus (not specified), and the thalamus. (2) Acupuncture signals are generated from activation of skin receptors at acupoints and nearby tissues and then conveyed by , , and fibers to the dorsal horn (DH) of the spinal cord or trigeminal spinal nucleus (TSN) of the medulla. Then, they project to the thalamus via trigeminothalamic tract (TTT), spinothalamic tract (STT), and spinoreticulothalamic tract (SRT).