{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:50:08Z","timestamp":1791352208002,"version":"4.3.1"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"\n Background<\/jats:title>\n Propagated sensation along meridians (PSM) refers to the radiation of needling sensation beyond the needling site along meridian pathways. In traditional acupuncture theory, PSM has long been considered an important factor associated with clinical efficacy, particularly in conditions like lumbar disc herniation where pain radiates along the lower limb. However, this phenomenon has not been well characterized by modern neurobiological methods. Whether patients who report PSM show distinct autonomic, sensory, or motor responses, and whether this relates to better outcomes, remains unclear. In this study, we aim to explore the clinical and physiological correlates of patient-reported PSM in a cohort of LDH patients receiving standardized acupuncture.<\/jats:p>\n <\/jats:sec>\n \n Methods and analysis<\/jats:title>\n \n This single-center, prospective, observational cohort study will enroll 204 LDH patients with radicular pain. Participants will be classified into three groups based on PSM reporting across three treatment sessions corroborated by assessor-documented needle-evoked muscle twitches: PSM-positive, PSM-negative, and indeterminate. The primary endpoint is the clinical improvement rate based on Japanese Orthopaedic Association (JOA) scores. Secondary endpoints include pain intensity (VAS), functional status (JOA), multimodal neurophysiological parameters (EEG, sEMG, EDA, EOG), serological cytokine profiles (IL-1\n \u03b2<\/jats:italic>\n , IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17, IFN-\u03b3, TNF-\n \u03b1<\/jats:italic>\n , and IFN-\n \u03b1<\/jats:italic>\n ), and the Massachusetts General Hospital Acupuncture Sensation Scale (MASS) administered post-session to quantify PSM intensity and spreading. Data will be analyzed using linear mixed-effects models, with results reported as effect estimates with 95% confidence intervals and false discovery rate correction within signal families; exploratory multimodal analyses will be used to identify physiological features associated with PSM.\n <\/jats:p>\n <\/jats:sec>\n \n Expected results<\/jats:title>\n We hypothesize that the PSM-positive cohort will show greater clinical improvement than the PSM-negative cohort, with larger reductions in radicular pain and better functional recovery following standardized acupuncture.<\/jats:p>\n <\/jats:sec>\n \n Clinical trial registration<\/jats:title>\n \n ITMCTR2025001534,\n https:\/\/itmctr.ccebtcm.org.cn<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fneur.2026.1935793","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:53:26Z","timestamp":1791348806000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Patient-reported propagated sensation along meridians during acupuncture for lumbar disc herniation: protocol for an exploratory prospective cohort study with multimodal neurophysiological and immune measurements"],"prefix":"10.3389","volume":"17","author":[{"given":"Jianhao","family":"Huang","sequence":"first","affiliation":[{"name":"Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine","place":["Shenzhen, China"]},{"name":"Macao Polytechnic University","place":["Macau, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Chen","sequence":"additional","affiliation":[{"name":"Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiling","family":"Zheng","sequence":"additional","affiliation":[{"name":"Shenzhen University","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinjing","family":"Yang","sequence":"additional","affiliation":[{"name":"Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaopian","family":"Guo","sequence":"additional","affiliation":[{"name":"Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawei","family":"Si","sequence":"additional","affiliation":[{"name":"Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufeng","family":"Xie","sequence":"additional","affiliation":[{"name":"Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2633","DOI":"10.3969\/j.issn.1673-5374.2013.28.005","article-title":"The existence of propagated sensation along the meridian proved by neuroelectrophysiology","volume":"8","author":"Xu","year":"2013","journal-title":"Neural Regen Res"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1007\/s11655-013-1456-0","article-title":"Understanding propagated sensation along meridians by volume transmission in peripheral tissue","volume":"19","author":"Zhang","year":"2013","journal-title":"Chin J Integr Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"197","DOI":"10.13703\/j.0255-2930.2019.02.023","article-title":"Talking about the key factors to improve the therapeutic effect of acupuncture from \u201cthe arrival of qi ensures curative effect\u201d (in Chinese)","volume":"39","author":"Song","year":"2019","journal-title":"Chinese Acupuncture & Moxibustion"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2015\/635089","article-title":"Deqi is double-faced: the acupuncture practitioner\u2019s and the subject\u2019s perspective","volume":"2015","author":"Yin","year":"2015","journal-title":"Evid Based Complement Alternat Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"430851","DOI":"10.1155\/2013\/430851","article-title":"An exploratory survey of Deqi sensation from the views and experiences of Chinese patients and acupuncturists","volume":"2013","author":"Yuan","year":"2013","journal-title":"Evid Based Complement Alternat Med"},{"key":"ref6","first-page":"570","article-title":"Origin and development of Hua Tuo's acupuncturing sensation technique (in Chinese)","volume":"41","author":"Xu","year":"2021","journal-title":"Chin Acupunct Moxibustion"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1089\/acm.2007.0524","article-title":"Acupuncture de qi, from qualitative history to quantitative measurement","volume":"13","author":"Kong","year":"2007","journal-title":"J Altern Complement Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.13193\/j.issn.1673-7717.2026.06.001","article-title":"Applying artificial intelligence technology to analyze objective manifestations of propagated sensation along meridians (in Chinese)","volume":"44","author":"Xu","year":"2026","journal-title":"Chin Arch Tradit Chin Med"},{"key":"ref9","first-page":"325","article-title":"The main characteristics of infrared radiant track along meridian courses over human body surface and the condition of its appearance","volume":"20","author":"Hu","year":"2001","journal-title":"J Infrared Millim Waves"},{"key":"ref10","first-page":"1856","article-title":"Effect of acupuncture on partial oxygen pressure in different depths of tissues along governor vessel in 61 normal volunteer subjects","volume":"26","author":"Chen","year":"2011","journal-title":"China J Tradit Chin Med Pharm"},{"key":"ref11","first-page":"258","article-title":"Investigation on the thermal-source of infrared radiant track along meridian course over the human body surface and the mechanism of its formation","volume":"27","author":"Hu","year":"2002","journal-title":"Acupunct Res"},{"key":"ref12","first-page":"175","article-title":"Preliminary exploration on the mechanism underlying the formation of infrared radiant track along meridian courses over the human body surface","volume":"22","author":"Hu","year":"2003","journal-title":"J Infrared Millim Waves"},{"key":"ref13","first-page":"321","article-title":"Comparison between governor Meridian and its bilateral control points in microcirculatory blood perfusion in 53 volunteer subjects (in Chinese)","volume":"33","author":"Xu","year":"2008","journal-title":"Zhen Ci Yan Jiu"},{"key":"ref14","first-page":"477","article-title":"Comparison of the thermal conductivity of the related tissues along the meridian and the non-meridian (in Chinese)","volume":"25","author":"Xu","year":"2005","journal-title":"Zhongguo Zhen Jiu"},{"key":"ref15","first-page":"255","article-title":"Effect of acupuncture on infrared radiant track along meridians over the human body surface (in Chinese)","volume":"27","author":"Xu","year":"2002","journal-title":"Zhen Ci Yan Jiu"},{"key":"ref16","first-page":"4","article-title":"Comparison of topographical mapping of cortical somatosensory evoked response during propagated sensation along Meridian and imitating propagated sensation along Meridian (in Chinese)","volume":"20","author":"Xu","year":"2010","journal-title":"Fujian Zhong Yi Xue Yuan Xue Bao"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1016\/j.jtcme.2023.01.004","article-title":"Analysis of the mechanism of propagated sensation along meridians based on gene expression profiles","volume":"13","author":"Zhu","year":"2023","journal-title":"J Tradit Complement Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1142\/S0192415X07005247","article-title":"Quantification of DeQi sensation by visual analog scales in healthy humans after immunostimulating acupuncture treatment","volume":"35","author":"Kou","year":"2007","journal-title":"Am J Chin Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"13","DOI":"10.13193\/j.issn.1673-7717.2026.05.003","article-title":"Targets,Mechanisms,Techniques and clinical significance of twitch-eliciting acupuncture (in Chinese)","volume":"44","author":"Jin","year":"2026","journal-title":"Chin Arch Tradit Chin Med"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1576","DOI":"10.1016\/j.apmr.2011.05.005","article-title":"Detecting local twitch responses of myofascial trigger points in the lower-back muscles using ultrasonography","volume":"92","author":"Rha","year":"2011","journal-title":"Arch Phys Med Rehabil"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1313","DOI":"10.1136\/bmj.39223.428495.BE","article-title":"Diagnosis and treatment of sciatica","volume":"334","author":"Koes","year":"2007","journal-title":"BMJ"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"125","DOI":"10.7507\/1672-2531.202309143","article-title":"Non-operative treatments for lumbar disc herniation: an evidence-based practice guideline","volume":"24","author":"Ge","year":"2024","journal-title":"Chin J Evid Based Med"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"514","DOI":"10.7326\/M16-2367","article-title":"Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians","volume":"166","author":"Qaseem","year":"2017","journal-title":"Ann Intern Med"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1630736","DOI":"10.3389\/fneur.2025.1630736","article-title":"Exploring potential mechanistic aspects of \"Biaoben acupoint\" acupuncture for lumbar disc herniation using 4D proteomics","volume":"16","author":"Shi","year":"2025","journal-title":"Front Neurol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"104645","DOI":"10.1016\/j.jpain.2024.104645","article-title":"Acupuncture modulation of chronic neuropathic pain and its association with brain functional properties","volume":"25","author":"Wei","year":"2024","journal-title":"J Pain"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1269","DOI":"10.1002\/ejp.1947","article-title":"Mechanism underlying painful radiculopathy in patients with lumbar disc herniation","volume":"26","author":"Samuelly-Leichtag","year":"2022","journal-title":"Eur J Pain"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1097\/01.brs.0000160987.66563.ca","article-title":"Effect of noxious electrical stimulation of the peroneal nerve on stretch reflex activity of the hamstring muscle in rats: possible implications of neuronal mechanisms in the development of tight hamstrings in lumbar disc herniation","volume":"30","author":"Hirayama","year":"2005","journal-title":"Spine"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"866","DOI":"10.16466\/j.issn1005-5509.2021.08.009","article-title":"Clinical application of Feng Jun's Shuji acupuncture","volume":"45","author":"Huang","year":"2021","journal-title":"J Zhejiang Chin Med Univ"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1097\/00007632-198107000-00005","article-title":"Operative results and postoperative progression of ossification among patients with ossification of cervical posterior longitudinal ligament","volume":"6","author":"Hirabayashi","year":"1981","journal-title":"Spine"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.1111\/j.1553-2712.2001.tb01132.x","article-title":"Reliability of the visual analog scale for measurement of acute pain","volume":"8","author":"Bijur","year":"2001","journal-title":"Acad Emerg Med"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1007\/s00776-008-1213-y","article-title":"Japanese orthopaedic association back pain evaluation questionnaire. Part 3. Validity study and establishment of the measurement scale","volume":"13","author":"Fukui","year":"2008","journal-title":"J Orthop Sci"},{"key":"ref32","first-page":"605","article-title":"Observation on the therapeutic effect of lumbar disc herniation treated with different acupuncture therapies (in Chinese)","volume":"33","author":"Wang","year":"2013","journal-title":"Zhongguo Zhen Jiu"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1524","DOI":"10.3969\/j.issn.1001-1528.2024.05.017","article-title":"Clinical effects of Lingxian Tongluo capsules combined with Wentong acupuncture method on patients with lumbar disc herniation (in Chinese)","volume":"46","author":"Xu","year":"2024","journal-title":"Chin Tradit Patent Med"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1935793\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:53:34Z","timestamp":1791348814000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1935793\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":33,"alternative-id":["10.3389\/fneur.2026.1935793"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1935793","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]},"article-number":"1935793"}}