**3. Modern adaptation of scalp acupuncture in mental disorders**

In TCM concepts, all patients can be categorized into different syndrome types despite the diagnosis of disease. Patients will then be prescribed with a unique treatment regimen, i.e., two patients suffering from the same disease might receive prescription of different acupoints since they may vary in syndrome type [12]. This individualized medicine concept has been a feature of TCM since the early establishment of the philosophy of TCM. However, there are few shortcomings for this manipulation. Firstly, the differentiation of syndrome types may not be accurate or definite as the diagnosis procedures are highly dependent to the therapists' clinical experience. Besides, since most patients with mental problems have complicated somatic problems or being masked by the side effects of psychiatric medication, diagnosis of syndrome type according to TCM theories may become exceptionally difficult. Moreover, individualized acupuncture treatment may provide inconsistent therapeutic outcomes. Objective observation and comparisons of the treatment results become impossible as the testing subjects are using different acupoints. As a result, we suggest the use of standardized, identical acupoint regimen for acupuncture treatment on psychiatric patients.

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treatment.

*Scalp Acupuncture and Mental Disorders DOI: http://dx.doi.org/10.5772/intechopen.84683*

therapeutic value to the psychiatric patients.

**4. Procedures of scalp acupuncture**

to those patients who easily feel anxious upon seeing needles.

**5. Selection of acupoints in treating mental disorders**

lateral Line of the Vertex are commonly used.

Instead of body acupuncture, scalp acupuncture has been widely used in diseases originated from the brain. The invention of scalp acupuncture has been with accordance to the neurology and reflexology knowledge of the brain and scalp structures. It is perceived that acupuncture stimulation on the subscalpular tissue may exert influences to the respective lesion in the brain [7]. A large proportion of preceding clinical trials of acupuncture on various mental illnesses such as anxiety, depression, and insomnia adopted the essential use of scalp acupuncture, while the collateral use of body acupuncture remains elective [13–15]. The sole use of scalp acupuncture in treating insomnia or other diseases such as intracerebral hemorrhage and Parkinson's disease has been endorsed in literatures [15–17]. Therefore, we are convinced that the use of scalp acupuncture will be sufficient to bring about

Besides, scalp acupuncture shows superiority over body acupuncture in clinical situations. Unlike body acupuncture, patients receiving scalp acupuncture are not required to retain on bed. They can sit on chairs or carry out static activities during treatment sessions. Another advantage of scalp acupuncture is that since textile sensitivity of the scalp is relatively low, scalp acupuncture would cause less pain and discomfort when compared with body acupuncture. Apart from diminished unpleasant sensation during needle insertion, the manipulation of scalp acupuncture cannot be easily seen by the treatment recipients. This is important especially

In practice of scalp acupuncture, sterile disposable acupuncture needles of the standard size of 0.20 × 25 mm or 0.22 × 25 mm are usually used. Acupuncture needles are obliquely inserted onto the selected acupoints with an angle of 15–30° after standard sterilization procedures. The needles should be inserted at a depth of 10 mm lying between aponeurosis layer and loose areolar connective tissue. Needles rest too deep or too shadow at the scalp structure will cause pain and diminished effect. After the insertion, mild stimulation to the needles is recommended. Needles can be swirled at time intervals. A standard session of scalp acupuncture treatment will last for at least an hour before the needles are carefully removed after the

According to TCM theories, acupoints are explicit points located at the surface of our bodies. Each acupoint serves its own function and can be joined together to form meridian lines. The selection and combination of acupoints is the most crucial component in acupuncture therapy. For example, it is understandable that the use of acupoints in treating brain diseases is definitely distinct from those for alleviating pain problems such as back pains. In the treatment of mental problems or brain organic problems, acupoints and scalp lines on the scalp including Baihui, Sishencong, midline of the forehead, lateral line 2 of the forehead and posterior

Baihui is located at the vertex of the midline of the head, which is the meeting point from apexes of ears. It is one of the acupoints on the governor vessel (GV). The governor vessel is known to have its passage running from the coccyx upward along the spine into the brain. Under the TCM theory, it is the convergence of all Yang meridians and thus stimulation at Baihui can boost the flow of Qi in all the

#### *Scalp Acupuncture and Mental Disorders DOI: http://dx.doi.org/10.5772/intechopen.84683*

*Acupuncture - Resolving Old Controversies and Pointing New Pathways*

mental illnesses.

the recent decades.

**2. History of scalp acupuncture**

scalp acupuncture. The development of scalp acupuncture has been rapid in the recent decades, and there is emerging evidence in supporting its use in patients with

The earliest medical record for the application of acupuncture on scalps can be traced back to around 5 BC [7]. Since then, experiences accumulated with the utilization of acupuncture on the scalp in treating various illnesses. Along with the establishment of TCM theories, it had been a component in traditional acupuncture system. Until the 1950s, acupuncture experts started to observe and recognize the relationship between illnesses and subscalp spots. Inspired by micropuncture systems concepts and influenced by anatomical and physiological knowledge from modern medicine, new theories and new needling techniques had been established [8]. In the 1970s, acupuncturists from different areas of China developed their own schools of theory, and several scalp acupuncture systems have been suggested. Despite variations present in theoretical concepts, sites of acupuncture (acupoints), and nomenclature among different schools, many areas such as the clinical indication and treatment procedures share common ground. Most recognized theories include the adaptation of knowledge in cerebral anatomy, physiology, neurology, and reflexology. Owing to the impressive therapeutic effect of scalp acupuncture in treating brain diseases as well as other illnesses, there was a strong urge to facilitate academic exchange and promote scalp acupuncture to wider communities. Intensive efforts had been made in standardizing the names of the scalp acupoints. By the time the World Health Organization (WHO) set up an international standard scalp acupuncture nomenclature systems in 1989, scalp acupuncture had been already extensively applied by therapists and acupuncturists around the globe [9]. Some places like the USA and Japan had even developed their own understandings in the field of scalp acupuncture [10, 11]. In short, scalp acupuncture is a technique derived from TCM, yet its theory and application involves multiplicity of systems that have been rapidly developing in

**3. Modern adaptation of scalp acupuncture in mental disorders**

In TCM concepts, all patients can be categorized into different syndrome types despite the diagnosis of disease. Patients will then be prescribed with a unique treatment regimen, i.e., two patients suffering from the same disease might receive prescription of different acupoints since they may vary in syndrome type [12]. This individualized medicine concept has been a feature of TCM since the early establishment of the philosophy of TCM. However, there are few shortcomings for this manipulation. Firstly, the differentiation of syndrome types may not be accurate or definite as the diagnosis procedures are highly dependent to the therapists' clinical experience. Besides, since most patients with mental problems have complicated somatic problems or being masked by the side effects of psychiatric medication, diagnosis of syndrome type according to TCM theories may become exceptionally difficult. Moreover, individualized acupuncture treatment may provide inconsistent therapeutic outcomes. Objective observation and comparisons of the treatment results become impossible as the testing subjects are using different acupoints. As a result, we suggest the use of standardized, identical acupoint regimen for acupunc-

**38**

ture treatment on psychiatric patients.

Instead of body acupuncture, scalp acupuncture has been widely used in diseases originated from the brain. The invention of scalp acupuncture has been with accordance to the neurology and reflexology knowledge of the brain and scalp structures. It is perceived that acupuncture stimulation on the subscalpular tissue may exert influences to the respective lesion in the brain [7]. A large proportion of preceding clinical trials of acupuncture on various mental illnesses such as anxiety, depression, and insomnia adopted the essential use of scalp acupuncture, while the collateral use of body acupuncture remains elective [13–15]. The sole use of scalp acupuncture in treating insomnia or other diseases such as intracerebral hemorrhage and Parkinson's disease has been endorsed in literatures [15–17]. Therefore, we are convinced that the use of scalp acupuncture will be sufficient to bring about therapeutic value to the psychiatric patients.

Besides, scalp acupuncture shows superiority over body acupuncture in clinical situations. Unlike body acupuncture, patients receiving scalp acupuncture are not required to retain on bed. They can sit on chairs or carry out static activities during treatment sessions. Another advantage of scalp acupuncture is that since textile sensitivity of the scalp is relatively low, scalp acupuncture would cause less pain and discomfort when compared with body acupuncture. Apart from diminished unpleasant sensation during needle insertion, the manipulation of scalp acupuncture cannot be easily seen by the treatment recipients. This is important especially to those patients who easily feel anxious upon seeing needles.
