Let me first define this "needling sensation" for non-acupuncturists.

The needling sensation is not the pain sensation felt by mere perforation of the skin (discriminative sensation), but the feeling of paresthesia-dysesthesia around the needle (secundary area), and thought to be of affective-dynamic pain nature.

I can´t ansver Your question exactly, so just a little note. Yes they play, at least in that way as they play a role in the nervous system. The malfunctions would be occurred without neuroglia cells. So the complexity of neurotransmission would be impossible without them, and there would be no needling sensation.

At peripheral level acupunture basically act through the stimulation of A1 adenosine receptor in the nerve! At this step is not reliable that glia or microglia can be involved since they are not expressed in the periphery except in the dorsal root ganglia! However, when stimulated, A1 adenosine receptor can, in turn, reduce the spinal release of prohyperalgesic/proinflammatory molecules, thus reducing the activation of glial and microglial cells

Thank you very much, Malina and Livio, your contribution is much appreciated.

A pin prick is situated within a terminal arborization of the primary sensory neuron and its localization is felt therefore within its own cutaneous sensory field. By manipulating the needle (rotation, translation in depth) the patient feels this sensory field expanding. This could be due to an Adenosine inflammatory type of secondary hyperalgesia. Similar to the inflammatory model of a capsaicine injection.

-> However might glia cells present an alternative, or complementary view?

Satellite glia cells were described in the DRG, presumed to be mere structural supportive elements, nurtering the neurons. However, very remarkebly, "sandwich synapses" are described between two neurons and their sandwiched satellite cell in between. A daisy chain clustering is described, suggesting a network within the DRG (*).

(*) Transglial transmission at the dorsal root ganglion sandwich synapse: glial cell to postsynaptic neuron communication. Rozanski GM, Li Q, Stanley EF.Eur J Neurosci. 2013 Apr;37(8):1221-8. doi: 10.1111/ejn.12132. Epub 2013 Jan 25.

Therefore, (sustained) manipulation of the needle could also set in motion a recruiting effect that exceeds the properties of the primary cutaneous sensory filed. This recruitment via satellite cells could make the needle felt within an expanding evoked sensory field. This could explain the "needling sensation" after manipulation, very different from the initial perforation prick sensation.

Would you agree with this complementary view?

I think that de qi cannot be explained by evidence base of present science. Other word I refer you to my article on the qi production and its mechanism to understand qi and de qi. Nowadays the PVS ( Primo Vascular System) is a new system where (based on my article and hypothesis) is the base of qi production and distribution and de qi. For more information please go to (Can PVs be a basic concept for qi production in my contribution in research gate)

Jean - what an intriguing thought! As you say, we have evidence for transglial transmission in the DRG. Also, as you mention ,since one neuron can be connected to several neighbours (as inferred by staining for the corresponding transmitter receptors) we hypothesize that sandwich synapse transmission in the DRG may exhibit network activity.

The one part that remains problematic is that as the sensory impulse can pass from the periphery to the CNS without entering the soma it is not clear how soma-soma communication affects sensation. However, more recent evidence of somatic membrane potential oscillations and action potentials that originate in the DRG may yet provide a link.

Thank you Majid,

coincidence or not, I was this WE on congress with Kwang-Sup Soh from Korea, who organized an International symposium in 2010 on PVS in Korea. He proposes indeed the PVS as independent anatomical entity, with electronmicroscopy. His continuous work on the claim of Bong Han started from 2002. The decisive proof on meridian identification is still in progress, his articles are in RG. For me this was new. Do you have info that supplements the data?

Hello dear Elise,

thank you for joining, I am happy to see you again.

Appearantly I had a fruitful congress: Lui Huirong (doctoral supervisor Shanghai Univ. of TCM) made following statement in a rat model of Irritable Bowel Syndrome with visceral hypersensitivity (colorectal distension). "Increased intracellular [Ca++]i concentration caused by P2Y1 receptor signal transduction of DRG neurons can be inhibited by electroacupuncture (EA)." I signalled your article on sandwich synapse, As the presentation on the congress was made by a collaborator, I did not find out if this observation had anything to do with satellite glia Ca++waves. Can you make this out from the mentioned P2Y1 receptors?

Unlikely: we see the involvement of P2Y2 receptors but have no evidence for P2Y1.

Referred pain (RP).

Thank you Elise.

I have another question about referred pain. RP can be explained by the convergence of sensory input (cutaneous, visceral...) onto a Wide Dynamic Range (WDR) neuron. This secondary afferent has a larger secondary cutaneous receptive field than the individal primary neuron in the DRG. A WDR neuron can explain RP. However, if primary neurons may form a collectivity through a satellite glia group formation, could the sandwich synapse offer an alternative explanation for RP?

Thank you Jean

I am following a research line on the integrative medicine which is made of Iranian Traditional Medicine (ITM) and Traditional Chinese Medicine (TCM). In last 3 years I am writing the basic concepts of Traditional Medicine from embryologic, pathology, histology, physiology, anatomy view and up to now I wrote about 200 to 250 pages (unpublished). They are mainly focused on the basic concept of TCM and ITM. Based on this introductory to my work, I got that inhuman body there are some concepts that cannot be described by modern medicine concepts and findings. They need a new concepts, and new issue.

I have a communication with Prof Soh and he confirmed my view point and hypothesis on the mechanism of qi production. I am working in this concepts and I reached to the mental-emotional view points of Traditional and conventional concepts.

I would like to say that there may be another way to look at de qi concept and it is better do not limit every think to western medicine concepts and findings. there are many things that we dont know yet.

Dear Majid,

I regret someone downvoted you, presumably because in RG, researchers want to demystify a blind obedience to tradition and search for evidence based knowledge. But I have the conviction you are concerned as anyone about progress of knowledge with a genuine interest in experimental and statistical science. Prof. Soh uses modern technology at university level and is cautious in his conclusions. I agree with you that scoence is not about affirmation of certainties, of what we already know, but about extending knowledge beyond its current boundaries. There is a lot what we do not know: the wisdom is to find good questions, and that is what this scetion is all about. Please inform me about the progress of your work.

Dear Jean,

Thank you for your interest in my work. I had a look at your works and articles in RG and find them very interesting. You know I am working on the mental emotional state (MES) mentioned in ITM and TCM and found them that they are talking about one thing but with two language. The basic concept of MES is very similar in ITM and TCM and may be in future we can use the recommendation of ITM and TCM in addition to drug therapy for MES treatment.

If you are interested we can follow each on this subject in any way that you want.

One of the things that is non materialistic in human body is mind (JAN in ITM) and qi (ROUH in ITM) which are mutually affecting each other. All MES are dependents on the relationship between MIND and QI. and any disturbance of this relationship will lead to disorder or diseases.

The seven emotional sates of TCM are angry, joy, sadness, fear, pensiveness, timidity and mental restlessness. of course some body like maciocia believes that there are other MES like guilt and love and so on.

Based on the basic concepts of ITM and TCM each of these MES affecting the direction movement of qi ( ROUH) and Mind (JAN), and based on this theory there are treatable with acupuncture and herbal medicinal, not just maintenance therapy with drug therapy.

This is way I am saying that qi cannot be understand by neuron and biochemistry of mediators. It is a complicated non ministerial part of human body which must be discovered more and more.

convergence: spatial summation

There seem to be two convergent systems in the central nervous axis. One on the level of the dorsal horn, and one in the dorsal root ganglion. This is important for considerable exrension od additive primary cutanious sensory fields.

We postulate different characteristics for each type of convergence: the DRG will stay dipendent on its segmental entry, divergence will depend on the activation of collaterals in the Lissauer tract. Whereas the DH may have intraspinal longitudinal extensions on its own. Have thesebeen described yet?