Acupuncture’s Effects on Intracranial Pressure: From Early Observations to Modern Insights

Gerhard Litscher ^*

1. Swiss University of Traditional Chinese Medicine, High-Tech Acupuncture and Digital Chinese Medicine, Bad Zurzach, Switzerland; President of the International Society for Medical Laser Applications (ISLA transcontinental; since 2012), German Vice President of the German-Chinese Research Foundation (DCFG) for TCM (since 2014), Vice Chairperson, World Federation of Chinese Medicine Societies, Committee of Card. Rehab. (2023-2028), Honorary President of the European Federation of Acupuncture and Moxibustion Societies, Honorary President of the American Society for Laser Acupuncture Therapy (ASLAT); Honorary Professor of China Beijing International Acupuncture Training Center, China Academy of Chinese Medical Sciences, Former Head of two Research Units and the TCM Research Center at the Medical University of Graz, Austria, Europe

* Correspondence: Gerhard Litscher

Received: January 04, 2026 | Accepted: January 04, 2026 | Published: January 06, 2026

OBM Integrative and Complementary Medicine 2026, Volume 11, Issue 1, doi:10.21926/obm.icm.2601003

Recommended citation: Litscher G. Acupuncture’s Effects on Intracranial Pressure: From Early Observations to Modern Insights. OBM Integrative and Complementary Medicine 2026; 11(1): 003; doi:10.21926/obm.icm.2601003.

© 2026 by the authors. This is an open access article distributed under the conditions of the Creative Commons by Attribution License, which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is correctly cited.

1. Introduction

More than twenty years ago, pioneering experimental work by Litscher G. et al. [1] provided one of the first objective demonstrations that acupuncture can influence central cerebral parameters [1]. Utilizing transcranial Doppler sonography alongside complementary monitoring techniques, we revealed that stimulation of specific acupuncture points — through acupressure, manual needle acupuncture, electroacupuncture, and laser needle acupuncture — can induce measurable changes in cerebral blood flow velocity and reversible increases in intracranial pressure (ICP) in selected clinical contexts. At the time, these findings challenged the prevailing view that acupuncture effects were largely peripheral or subjective.

With modern neuroimaging, non-invasive ICP monitoring, and computational modeling of cerebral hemodynamics, these early observations can now be revisited under far more robust methodological conditions. What was once considered exploratory is increasingly recognized as physiologically plausible: acupuncture appears capable of modulating neurovascular coupling, cerebral perfusion, and ICP-related dynamics (Figure 1) [2,3,4,5,6].

Figure 1 Summary of acupuncture-induced modulation of cerebral blood flow and intracranial pressure (ICP). Left panel: historical context (Litscher et al. 2005 [1]) showing stimulation of acupuncture points St.7 (Xiaguan) and SJ.22 (Erheliao), with Doppler-monitored changes in blood flow velocity and ICP. Right panels: modern 2026 clinical setting with advanced non-invasive ICP monitoring, transcranial Doppler, and neuroimaging. Arrows illustrate increases and decreases in cerebral blood flow and pressure, highlighting reproducible neurovascular responses over time (CBF Cerebral Blood Flow; BBB Blood–Brain Barrier).

2. Cerebral Blood Flow Modulation by Acupuncture

Clinical studies over the past two decades have consistently demonstrated that acupuncture can influence cerebral blood flow (CBF). Randomized controlled trials involving patients with cerebrovascular disease have increases in mean blood flow velocity in the middle cerebral artery and vertebrobasilar circulation following acupuncture compared with sham or standard therapy alone [2,3]. These changes suggest a direct physiological effect on cerebrovascular tone, beyond placebo-related mechanisms.

Functional neuroimaging studies further support these findings, revealing region-specific perfusion changes after acupuncture [4]. These effects are consistent with targeted modulation of neural networks and autonomic regulation rather than global, non-specific changes in cerebral perfusion.

3. Mechanistic Insights from Experimental Research

Preclinical studies provide mechanistic explanations for these observations. Electroacupuncture in animal models of cerebral ischemia improves regional cerebral blood flow, enhances collateral circulation, and reduces neuronal damage via cholinergic and nitric oxide–dependent pathways [5]. Moreover, recent meta-analyses indicate that acupuncture can preserve blood–brain barrier integrity and reduce cerebral edema formation [6], suggesting a potential indirect influence on ICP.

4. Modern ICP Monitoring and Methodology

A significant limitation of early studies was the lack of sensitive, non-invasive ICP monitoring. Recent advances, including electrical impedance tomography and multimodal neurovascular monitoring, allow real-time assessment of cerebral perfusion and ICP surrogates without invasive probes [7]. Additionally, computational models integrating arterial pressure, cerebral blood flow, and ICP dynamics now permit sophisticated simulations of subtle neuromodulatory effects [8]. These methodological innovations make it possible to revisit the early findings of Litscher et al. [1] with contemporary rigor.

5. Clinical Implications and Future Directions

The evidence accumulated until 2026 suggests that acupuncture induces reproducible functional changes in cerebral hemodynamics. While large-scale clinical data confirming clinically meaningful ICP modulation in humans are still limited, the physiological plausibility and safety considerations warrant renewed attention, particularly for patients with impaired autoregulation or reduced intracranial compliance, such as those with traumatic brain injury, hydrocephalus, or post-stroke edema.

Future studies should focus on:

• Prospective, sham-controlled designs incorporating multimodal cerebral monitoring, including non-invasive ICP surrogates.
• Standardized acupuncture protocols with clearly defined points and stimulation parameters.
• Translational approaches linking physiological endpoints to clinically meaningful outcomes.

Revisiting the pioneering work of Litscher et al. [1] with modern technology and neurovascular understanding may clarify both safety considerations and potential therapeutic implications, positioning acupuncture as a credible neuromodulatory intervention with measurable effects on cerebral physiology.

6. Conclusion

Accumulating evidence indicates that acupuncture can induce reproducible changes in cerebral blood flow and related intracranial dynamics. While definitive clinical proof of sustained intracranial pressure modulation is still limited, advances in non-invasive monitoring and neurovascular assessment now allow these effects to be evaluated with greater precision. Revisiting early experimental findings with contemporary methodologies is essential to refine safety considerations and clarify the potential role of acupuncture as a neuromodulatory approach that influences cerebral physiology.

Acknowledgments

The author gratefully acknowledges all colleagues at the Medical University of Graz who contributed to the successful execution of the early investigations more than two decades ago. Their interdisciplinary collaboration, technical expertise, and scientific commitment were essential in conducting these pioneering studies and laid the foundation for subsequent research in this field.

Author Contributions

The author did all the research work for this study.

Funding

No financial support.

Competing Interests

The author hereby declares that no conflict of interests exists in connection with the publication of this editorial.

AI-Assisted Technologies Statement

An AI tool (ChatGPT-5, OpenAI, 2025) was used for the initial translation of this contribution from German into English. The author has carefully reviewed and edited the final version, which was also polished by a native speaker. The author takes full responsibility for the content of the manuscript.