SHEN MEN – HT7

Location
At the wrist crease, on the radial side of the flexor carpi ulnaris tendon. As seen below, with a simplified overview of biomechanics.

(Picture ref1)

Biomechanics overview

Shen Men is an important point in acupuncture and as such, has a lot of research showing an impressive array of biomechanisms, most pronounced in relation to cardiac and cognitive regulation and related functions.

 

It is worth noting another study here that on an anatomical perspective showed Co-labeled signals from the mouse ventricular wall and Shenmen (HT7) point region were found at all levels of the mouse central nervous areas, such as the cerebral cortex, hypothalamus, midbrain, pons, and medulla oblongata. Or, in other words, ‘there is a neural connection between Shenmen (HT7), the heart, and the brain, which may be most closely related to the autonomic nervous system’ (2). This may explain a lot of the biomechanisms we have discovered.

Anti-inflammatory

Electroacupuncture on insomniac rats at Shen Men, Bai Hui (DU20) and San Yin Jiao (SP6), which stimulates the dorsal horn, was able to reduce inflammation by regulating pro and anti-inflammatory compounds. Interleukin-1β, prostaglandin-D2, melatonin, IL-10 are upregulated and IL-6, TNF-α, IFN-γ and corticosterone in rats could be downregulated. Apoptotic function is reduced by upregulating PI3k/AKT pathway (This pathway is involved in many physiological and pathological processes, including cancer, metabolism, and cardiovascular diseases) and the CAMP/CREB pathway (Dysregulation of the cAMP/CREB pathway has been implicated in neurodegenerative diseases like Alzheimer’s and Huntington’s disease, where impaired CREB activity may contribute to neuronal loss and cognitive decline.) And BCL-2 is increased whilst BAX, BAD and Caspase-3 are reduced, these, again, are important for reducing apoptosis. It can reduce the release of excitement monoclonal neurotransmitters domaine, norepinephrine and epinephrine and increase the release of serotonin, a key mood stabilizer, amongst its other functions (3).

Cardiovascular regulation

Electroacupuncture at HT7  increased HR, +dp/dt max (a key measure in the heart ventricles ability to contract and increase pressure) and cardiac sympathetic discharge and -dp/dt max (the ability for the ventricle to relax and drop pressure quickly), the opposite of responses observed in acute myocardial ischemic rabbits (4)

Acupuncture at Baihui (GV20), Neiguan (PC6), Shenmen (HT7) and Taichong (LR3) regulates blood oxygen metabolism in rats with insomnia (5).

Electroacupuncture at HT7 can significantly decrease the ST segment on an ECG, the arrangement of cardiomyocytes, the breakage of myocardial fibers, the interstitial hemorrhage decreased, the mitochondrial atrophy decreased, the membrane density increased, the content of Fe2+ decreased and the activity of GSH increased. The expression level of GPX4, FTH1 mRNA and protein in myocardial tissue increased, while the expression level of TFR1 and ACSL4 and the expression of protein decreased. Thus, it was theorised that, ‘protective effect of acupuncture on the myocardium of AMI rats may be related to the inhibition of “ferroptosis”’). Interestingly ferroptosis also plays a role in cancer, neurodegenerative diseases and organ damage. (6).

Acupuncture at HT7 reduces systolic and diastolic blood pressure in spontaneous hypertension rats as well as reducing plasma angiotensin (which regulates blood pressure via vasoconstriction), aldosterone (which regulates blood presssure via sodium levels, too much leads to hypertension) and increasing atrial natriuretic peptide, which inhibits sodium reabsorption in the kidneys and acts in the heart to prevent cardiac hypertrophy and to regulate vascular remodeling and energy metabolism (7). It also improves heart rate variability (8) a marker of health and longevity.

Central nervous system regulation

Acupuncture at HT7 cause blood oxygen level dependent responses mainly in right postcentral gyrus of frontal lobe (BA 2, BA 1, BA 43), left inferior frontal gyrus (BA 47), secondarily, in the right inferior parietal lobule (BA 40), right inferior frontal gyrus (BA 44), left superior temporal gyrus (BA 22) and right insula (BA 40 (9).

Another study found HT7 activating BA2 and BA1 of the gyrus postcentralis in right-sided frontal lobe, BA47 of left-sided inferior frontal gyrus and BA43 of left-sided gyrus postcentralis, and also activated BA40 of inferior parietal lobule in right-sided parietal lobe, BA22 of gyrus temporalis superior in left-sided lobus temporalis, and BA40 of right-sided insula (10)

A further one showing Shenmen (HT 7) were mainly BA10 BA13, BA47, BA22 on the left side and BA40 BA44 on the right side which it equated to language, cognitive function and emotional control (11).

Electroacupuncture at  Baihui (DU20), Shuigou (DU26) and Shenmen (HT7) exerted a synergistic effect, improving spatial learning and memory impairment in rats with insomnia by upregulating the hippocampal PKA/CREB and BDNF/TrkB signaling, facilitating neurogenesis, and inhibiting neuronal apoptosis (12).

Electroacupuncture at HT7 can increase 5-HT release from the hypothalamic PVN region, this may help with acute myocardial ischemia (13). 

Acupuncture at Shenmen (HT 7), Zusanli (ST 36), Fenglong (ST 40) and Taixi (KI 3) activated right hemisphere regions (temporal lobe, such as hippocampal gyrus, insula, and some area of parietal lobe) and left regions (temporal lobe, parietal lobule, some regions of cerebellum). The activated regions were consistent with impaired areas in the brain for Alzheimer’s disease patients, and are closely correlated with cognitive function; memory, reason, language, executive (14).

Acupuncture at HT7 also increased hypothalamic GABA and GABA(A)R in rats with insomnia (15). As well as inhibiting ethanol-induced dopamine release by modulating GABA(B) activity (16)

Metabolism

Acupuncture at shen men, as well as bai hui and shui gou increases glucose metabolism in the lentiform nucleus (part of the basal ganglia), as shown on PET scan, in dementia patients. It is known that the aging brain has poorer glucose metabolism and particulatly so in the posterior brain of dementia patients (20).

Mental health conditions

Electroacupuncture at Shen Men (in combination with San Yin Jiao, for better effects) helps to reduce anxiety and depression by reducing serum contents of norepinephrine and dopamine, sleep was also improved (17).

Acupuncture at HT7, significantly decreased both dopamine release in the nucleus accumbens and behavioural hyperactivity induced by a systemic morphine challenge, suggesting that the therapeutic effect of acupuncture on morphine addiction occurs through inhibition of neurochemical and behavioural sensitization to morphine (18).

One of the most interesting studies i’ve come across, mainly for how unique it is and the potential benefits it could show, was considering the impacts of shen men on maternally separated rats. 32 rat pups were separated from their mothers at 14 days. 8 were control, 8 separated, 8 separated and given daily shen men for a week and 8 separated and given daily zu san li for 7 days. Those in the separated group and zu san li group showed behavioural changes consistent with maternal separation, retreating to the darker corners of the cage and becoming quiescent, whereas those of the shen men group did not. Their brains were then checked for changes and it was noted that cell proliferation in the dentate gyrus of the hippocampus was significantly decreased in the separated and zu san li group whereas it was increased in the shen men group. Cell proliferation in the dentate gyrus is crucial for continuous neurogenesis, which plays a central role in learning, memory, and mood regulation (19). 

In other words acupuncture at shen men can prevent the negative behaviors and impacts on neuronal development in early life of those separated from their families. We know in humans this can lead to anxiety, depression, addiction and other psychiatric diseases. 

The question is, would this effect carry over to human studies and could it be applied retrospectively to help those who have lost or been separated from their families in early life. 

Sleep conditions

Electroacupuncture at HT7 and SP6 has a positive effect in improving insomnia and insomnia-induced fatigue in insomnia rats, which may be associated with its effects regulating energy metabolism in the hypothalamus and thus its regulation on circadian rhythm. This was seen in EA’s effect of restraining the expression of adenosine 5′-monophosphate (AMP)-activated protein kinase, and up-regulating the contents of Ac-CoA and Na＋-K＋-ATPase (sodium/potassium pump) in paraventricular nucleus and corticosterone in plasma (21).

Acupuncture at HT 7 can effectively improve the cognitive abilities and brain waves in sleep deprived rats by; the EEG of δ (delta/sleep) waves of rats in the acupuncture group was significantly increased and the β (beta/wakeful) waves was significantly decreased (22).

Another study found HT7 and SP6 has a synergism effect on the improvement of night sleep quality and daytime fatigue and sleepiness of insomnia patients, the mechanism may be related with its function in down-regulating the serum adrenocorticotrophic hormone, cortisol levels and increasing the serum melatonin content (23).

References

  1. Son, C.-G. (2019) “Clinical application of single acupoint (HT7),” Integrative Medicine Research, 8(4), pp. 227–228. Available at: https://doi.org/10.1016/j.imr.2019.08.005.
  2. Wu, L.-B. et al. (2023) “Study on reverse transsynaptic virus tracing targeting Shenmen (HT7) and heart in mice,” Journal of Acupuncture and Tuina Science, 21(2), pp. 109–120. Available at: https://doi.org/10.1007/s11726-023-1367-3.
  3. Cao, F. et al. (2022) “Baihui (DU20), Shenmen (HT7) and Sanyinjiao (SP6) target the cAMP/CREB/BDNF and PI3K/Akt pathways to reduce central nervous system apoptosis in rats with insomnia,” Heliyon, 8(12), p. e12574. Available at: https://doi.org/10.1016/j.heliyon.2022.e12574.
  4. Cai RL, Hu L, Zhou YP, et al. [Effects of electroacupuncture of “Shenmen” (HT 7) and “Zhizheng” (SI 7) on cardiac function and electrical activities of cardiac sympathetic nerve in acute myocardial ischemia rabbits]. Zhen ci yan jiu = Acupuncture Research. 2007 Aug;32(4):243-246. Available at: https://europepmc.org/article/med/17907386
  5. Yujuan, Y.E. et al. (2023) “Efficacy of needling Baihui (GV20), Neiguan (PC6), Shenmen (HT7) and Taichong (LR3) on cerebral cortical blood oxygen level in rats with insomnia.,” PubMed, 43(3), pp. 523–532. Available at: https://doi.org/10.19852/j.cnki.jtcm.20230404.005.
  6. Jiang, Z. et al. (2020) “Effect of electroacupuncture ‘Shenmen’HT7 on the expression of ferroptosis related proteins GPX4, FTH1, TfR1 and ACSL4 in Acute Myocardial Ischemia Model Rats,” Revista Argentina De Clinica Psicologica, 29(3), pp. 1214–1222. Available at: https://dialnet.unirioja.es/servlet/articulo?codigo=7827774.
  7. Liu, W.-N. et al. (2009) “[Effect of electroacupuncture of different acupoints on blood pressure, plasma angiotensin II, aldosterone and atrial natriuretic peptide in spontaneous hypertension rats].,” PubMed, 34(6), pp. 393–7. Available at: https://pubmed.ncbi.nlm.nih.gov/20209975.
  8. Yang, Y, F. et al. (2009) “DIFFERENT EFFECTS OF ACUPUNCTURE AT SHENMEN (HT7)-TONGLI (HT5) AND SHENMEN-NEIGUAN (PC6) POINTS ON HEART RATE VARIABILITY IN HEALTHY SUBJECTS,” J Chin Med, 20(3,4): 97-106. Available at: https://www.nricm.edu.tw/var/file/0/1000/attach/26/pta_2471_6537897_11272.pdf
  9. Chen, S. et al. (2008) “[A fMRI observation on different cererbral regions activated by acupuncture of Shenmen (HT 7) and Yanglao (SI 6)].,” PubMed, 33(4), pp. 267–71. Available at: https://pubmed.ncbi.nlm.nih.gov/18928121.
  10. Chen, S., Liu, J., et al. (2008) “Functional magnetic resonance imaging study on acupuncturing Shenmen (HT 7) and sham acupoint,” Journal of Acupuncture and Tuina Science, 6(4), pp. 242–244. Available at: https://doi.org/10.1007/s11726-008-0242-6.
  11. Li, Z. et al. (2012) “[Study on specificity of acupuncture effect of Shenmen (HT 7) and Daling (PC 7)].,” PubMed, 32(4), pp. 325–8. Available at: https://pubmed.ncbi.nlm.nih.gov/22734382.
  12. Qiao, L. et al. (2023) “Efficacy of electroacupuncture stimulating Shenmen (HT7), Baihui (GV20), Sanyinjiao (SP6) on spatial learning and memory deficits in rats with insomnia induced by para-chlorophenylalanine: a single acupoint combined acupoints.,” PubMed, 43(4), pp. 704–714. Available at: https://doi.org/10.19852/j.cnki.jtcm.20230308.001.
  13. Wu ZJ, Cai RL, He L, et al. [Effects of electroacupuncture stimulation of “Neiguan” (PC 6) and “Shenmen” (HT7) on contents of 5-hydroxytryptamine in hypothalamic paraventricular nucleus region and serum in hyperlipidemia rats with acute myocardial infarction]. Zhen ci yan jiu = Acupuncture Research. 2013 Dec;38(6):482-487. Available at: https://europepmc.org/article/med/24579363
  14. Zhou, Y. and Jin, J.-P. (2008) “Effect of acupuncture given at the HT 7, ST 36, ST 40 and KI3 acupoints on various parts of the brains of Alzheimer’s disease patients,” Acupuncture & Electro-therapeutics Research, 33(1), pp. 9–17. Available at: https://doi.org/10.3727/036012908803861186.
  15. Zhou, Y. et al. (2012) “[Effect of acupuncture at different acupoints on expression of hypothalamic GABA and GABA(A) receptor proteins in insomnia rats].,” PubMed, 37(4), pp. 302–7. Available at: https://pubmed.ncbi.nlm.nih.gov/23140052.
  16. Yoon, S.S. et al. (2004) “Acupuncture-mediated inhibition of ethanol-induced dopamine release in the rat nucleus accumbens through the GABAB receptor,” Neuroscience Letters, 369(3), pp. 234–238. Available at: https://doi.org/10.1016/j.neulet.2004.07.095.
  17. Du, L. et al. (2022) “[Combined use of Shenmen (HT 7) and Sanyinjiao (SP 6) to improve the anxiety and depression in patients with insomnia: a randomized controlled trial].,” PubMed, 42(1), pp. 13–7. Available at: https://doi.org/10.13703/j.0255-2930.20210113-k0002.
  18. Kim, M.R. et al. (2005) “Effect of acupuncture on behavioral hyperactivity and dopamine release in the nucleus accumbens in rats sensitized to morphine,” Neuroscience Letters, 387(1), pp. 17–21. Available at: https://doi.org/10.1016/j.neulet.2005.07.007.
  19. Park, H.-J. et al. (2002) “Acupuncture enhances cell proliferation in dentate gyrus of maternally-separated rats,” Neuroscience Letters [Preprint]. Available at: https://doi.org/10.1016/s0304-3940(01)02581-2.
  20. Huang, Y. et al. (2005) “[Effects of needling in Baihui (DU20), Shuigou (DU26) and Shenmen (HT7) on glucose metabolism in the lentiform nucleus in patients with vascular dementia].,” Academic Journal of the First Medical College of PLA, 25(11), pp. 1405–1407. Available at: https://europepmc.org/abstract/MED/16305967.
  21. Zhu, Y. et al. (2019) “[Effect of electroacupuncture at ‘Shenmen’(HT7) and ‘Sanyinjiao’(SP6) on energy metabolism in paraventricular nucleus of hypothalamus of insomnia rats].,” PubMed, 44(3), pp. 170–5. Available at: https://europepmc.org/article/med/30945498 
  22. Li, J. and Liu, J. (2017) “[Effects of Acupuncture at ‘Shenmen’ (HT 7) on Brainwaves and Cognitive Ability in Rats with Sleep Deprivation].,” PubMed, 42(6), pp. 502–6. Available at: https://europepmc.org/article/med/29318855 
  23. Xia, S. et al. (2022b) “[Acupoint compatibility effect and mechanism of Shenmen (HT7) and Sanyinjiao (SP6) in improving daytime fatigue and sleepiness of insomnia].,” PubMed, 47(7), pp. 630–5. Available at: https://europepmc.org/article/med/35880281 

Joe Jennings, Bsc TCM (Hons), MBAcC

This project is sponsored by Healthy Seminars