Aldo Liguori’s research while affiliated with Sapienza University of Rome and other places

Background Although innovative pharmacological therapies for migraine prevention are now available, they may not be suitable or effective for all patients due to concerns about tolerability and the varying complexity of the underlying condition. This study systematically reviewed and meta‐analyzed acupuncture's effects on migraine prophylaxis compared to standard medical care, focusing on study heterogeneity and issues related to sham interventions. Methods Following the PRISMA guidelines and using the PICO model, the study searched PubMed, Scopus, CNKI, and VIP database from December 1965 to September 2024. Studies evaluating acupuncture's clinical efficacy for migraine prophylaxis, including clinical trials, observational studies, case series, and case reports, were considered. An additional search was conducted on the clinicaltrials.gov database from the beginning of indexing up to September 2024 to include ongoing studies. Quality control and bias assessment were performed. Primary outcomes focused on acupuncture's efficacy and safety versus pharmacological treatments in reducing migraine frequency and intensity. The impact on patients' quality of life was also evaluated. Results At the end of the selection process, 15 studies were eligible. Acupuncture showed no statistically significant difference as a prophylactic treatment for migraine in reducing the frequency of migraine days or pain intensity but did reduce the use of analgesics while improving patients' quality of life. Conclusion Current evidence supports acupuncture as an adjunctive therapy in migraine prophylaxis, but challenges such as protocol heterogeneity, dropout biases, the complexities of sham‐controlled trials, and the lack of comparison data with newer innovative treatments not yet considered warrant further research.

In order to test the theory of Brizhik et al. about the dynamic allocation of acupuncture meridians on human body and their role as hydric paths for solitons, we tested the effect of both acupuncture and exposure to extremely low frequencies (ELF) tuned with suitable ion cyclotron frequencies. The similarity of the effects, inducing variations of body impedance measured in well-known acupuncture points, up to the interchangeability and the synergy of the two treatments, the mechanic and the electromagnetic ones, turns to be evidence of the validity of the theory. Resistance and reactance variations have been detected in a group of 31 healthy volunteers before and after stimulation with a standard sequence of cyclotron frequencies, emitted from an innovative electromagnetic therapy (EMT) device. These variations were then compared with the variations produced by the well-known percutaneous stimuli of mechanical and piezoelectric nature, and, in particular in this work, acupuncture. Our results show that the observed variations can be considered as significant in both groups: cyclotron and acupuncture. The greater variations brought about by the cyclotron treatment stand out clearly.

Background The neural mechanism underlying the analgesic effect of acupuncture is largely unknown. We aimed at investigating the effect of abdominal acupuncture (AA) on the laser‐evoked potential (LEP) amplitude and laser‐pain rating to stimulation of body parts either homotopic or heterotopic to the treated acupoint. Methods Laser‐evoked potentials were recorded from 13 healthy subjects to stimulation of the right wrist (RW), left wrist (LW) and right foot (RF). LEPs were obtained before, during and after the AA stimulation of an abdominal area corresponding to the representation of the RW. Subjective laser‐pain rating was collected after each LEP recording. Results The amplitude of the N2/P2 LEP component was significantly reduced during AA and 15 min after needle removal to both RW (F = 4.14, p = .02) and LW (F = 5.48, p = .008) stimulation, while the N2/P2 amplitude to RF stimulation (F = 0.94, p = .4) remained unchanged. Laser‐pain rating was reduced during AA and 15 min after needle removal only to RW stimulation (F = 5.67, p = .007). Conclusion Our findings showing an AA effect on LEP components to both the ipsilateral and contralateral region homotopic to the treated area, without any LEP change to stimulation of a heterotopic region, suggest that the AA analgesia is mediated by a segmental spinal mechanism. Significance Although abdominal acupuncture has demonstrated to be effective in the reduction in laser‐evoked potential (LEP) amplitude and laser‐pain rating, the exact mechanism of this analgesic effect is not known. In the current study, we found that treatment of an area in the “turtle representation” of the body led to a topographical pattern of LEP amplitude inhibition that can be mediated by a segmental spinal mechanism.

Background Lateral elbow pain (LEP) due to tendinosis is one of the most common musculoskeletal pains of the upper limbs, yet there is no satisfactory treatment. This study was an international, prospective, multi‐center, randomized, controlled, clinical trial to evaluate the efficacy of acupuncture compared to sham laser in the treatment of LEP. Methods The study used a parallel and stratified design (1:1 allocation using a computer‐generated sequence) and was participant‐, outcome assessor‐ and statistician blinded. Subjects from 18 to 80 years with unilateral chronic LEP (minimum three months) were recruited at four centers in Australia, China, Hong Kong and Italy. The treatment group received manual acupuncture at acupoints LI 10 and LI 11 on the affected side whereas the control group received sham‐laser acupuncture at the same acupoints. The primary endpoint was the disabilities of the arm, shoulder, and hand (DASH) questionnaire score at the three‐week post‐treatment follow‐up visit. Three VAS scales (pain at rest, pain on motion and pain during exertion were secondary outcomes. Ninety‐six subjects were allocated to either the treatment group (n = 47) or control group (n = 49) and were all included in the analysis. Results At the follow‐up visit, we found significant differences in DASH score between the two groups (P = 0.015). The median change to baseline for the treatment group was ‐11.7 (interval: ‐50.83 to 23.33), and for the control group ‐7.50 (interval: ‐36.67 to 29.10). The estimated effect size was 0.47, indicating a medium effect. Significant differences were also found for secondary outcome measures for VAS pain. There were no severe adverse events. Our findings suggest that acupuncture has a moderate efficacy in the treatment of LEP. Conclusions Acupuncture was shown to be efficacious in improving the function of the arm associated with lateral elbow tendinosis. Both the DASH score and the VAS pain on two occasions (at rest and during motion) showed a significant change over time indicating acupuncture as a potential treatment for LEP due to tendinosis.

Objectives: Many patients with painful chronic pancreatitis (CP) have insufficient effect of treatment, and the prevalence of adverse effects is high. Consequently, alternatives to conventional management are needed. We aimed to study the effect of acupuncture in painful CP. Methods: This was a prospective, single-blinded, randomized crossover trial. Fifteen patients with CP were assigned to a session of acupuncture followed by sham stimulation or vice versa. Patients rated clinical pain scores daily on a 0 to 10 visual analogue scale (VAS) and completed the Patient Global Impression of Change. For mechanistic linkage, resting state electroencephalograms were recorded and quantified by spectral power analysis to explore effects on central pain processing. Results: Acupuncture, compared with sham stimulation, caused more pain relief (2.0 ± 1.5 VAS vs 0.7 ± 0.8 VAS; P = 0.009). The effect, however, was short, and after 1-week follow-up, there was no difference in clinical pain scores between groups (P = 1.0) or the rating of Patient Global Impression of Change (P = 0.8). Electroencephalogram spectral power distributions between sham and acupuncture were comparable between groups (all P > 0.6). Conclusions: The study presents proof-of-concept for the analgesic effect of acupuncture in pancreatic pain. Although the effect was short lasting, the framework may be used to conceptualize future trials of acupuncture in visceral pain.

Objective: To compare the effects of a basic traditional Chinese diet with a Western standard diet on body mass index (BMI), lean body mass (LBD), and eating and hunger behaviours. Methods: A sample of 284 patients were randomized into 2 groups: group A (n = 142) followed a basic traditional Chinese diet (BCTD) and group B (n = 142) followed a Western standard diet (WSD). Both diets were set at approximately 1200 calories. The patients enrolled were compared before treatment and 6 weeks after treatment, and then follow-ups were made at 1 year and 5 years. Results: In the BCTD group, BMI decreased by 0.46 kg/m2 and LBM by 0.25 kg, versus respectively 0.28 kg/m2 and 0.41 kg in the WSD group. Findings of eating self-assessment, hunger measurement and psychophysical indices of health were also in favour of the BCTD. Conclusion: Outcomes show that the BCTD has a better effect on BMI and LBM, as well as over the medium/long term, and provides stronger psychophysical support to obese patients.

Objective Acupuncture is increasingly used as an alternative to medical therapy for various pain conditions. To study the effect of acupuncture in experimental and clinical studies, a control condition with sham acupuncture is needed. However, as such models have not been established in assessment of acupunctures effect against visceral pain, this study aimed to validate a new method for blinded sham acupuncture in experimental rectal pain.Methods Fifteen subjects underwent a sequence of either sham or real acupuncture in randomized order. In the sham arm, a hollow inner tube with a sharp tip was fitted into an outer tube and subjects were blinded to the stimulations. Before and after the intervention, pain was induced by rectal stimulation with an inflatable balloon distended until the subjects' pain threshold was reached. The resting electroencephalogram (EEG) was quantified by spectral power analysis to explore the central nervous system effects objectively. Additionally, after the second study day, the subject was asked to indicate the sequence of interventions.ResultsA significant increase in rectal balloon volume was observed after sham 12 ± 21 mL (P = 0.049) and acupuncture 17 ± 30 mL (P = 0.046). However, the change in volume was not different between groups (P = 0.6). No differences in EEG spectral power distributions between sham and acupuncture were seen (all P > 0.6). The correct sequence of sham and acupuncture was indicated by 36% of the subjects (P = 0.4).Conclusions The presented sham procedure provides a valid method for blinding of “sham acupuncture” and may be used in future blinded controlled trials of acupuncture for visceral pain.

Following a long debate, during last 20 years, regarding the genetics field of human common traits, we can underline the presence of a wide expression of gene variability, adding a large environment influence, we'll keep the concept that genes will hold our species traits unaltered during the millennia. Although, obesity is the result of an interaction between genetic factors and individual environment. The genetic contribution to interindividual variation in common obesity has been estimated at 40-70%. Yet despite a relatively high heritability, the search for obesity susceptibility genes has been an arduous task. The goal of this review is to check the published works on this matter (genetics and epigenetics influence on gene expression) and underline that according to the recent evident bases the genes associated with risk of obesity are susceptible to epigenetic mutations; the epigenetic markers influence the expression of genes associated with obesity.