Arousal effect and potential mechanism of dopamine-mediated acupuncture on traumatic brain injury

Abstract Traumatic brain injury (TBI) is a brain injury caused by direct external forces, and its prognosis depends on the extent of the damage and the changes in level of consciousness. Timely awakening from a coma is the first thorny problem to be solved in TBI treatment. Therefore, there is a need for the development of safe and effective methods for timely awakening after TBI coma. Dopamine (DA) and its receptors in the nervous system are involved in the regulation of wakefulness. The amount and activity of dopaminergic neurons can affect cellular function and neuroinflammatory response, and are also significant for the awakening process after TBI. The current common awakening therapy for TBI may also be related to the activation of dopaminergic neurons. Acupuncture plays a beneficial role in timely awakening, recovery of conscious level, and functional rehabilitation after TBI. The mechanism may be related to the targeted regulation of DA and its receptors via acupuncture. Among acupuncture first aid therapies, acupuncture at hand 12 Jing-Well points, with its advantages of simple operation and ultra-early intervention, has shown great promise in timely awakening following TBI and triggering a series of subsequent nerve repair effects in the treatment of TBI. We here present a review that provides a new perspective for the timely awakening from TBI-induced coma, with a focus on the role of DA in the regulation of wakefulness and the efficacy and potential mechanism of DA systems in the treatment of TBI by acupuncture.