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

Understanding whether acupuncture can influence intracranial pressure (ICP) and cerebral hemodynamics remains a relevant and insufficiently explored question in contemporary neurovascular research. This editorial synthesizes early experimental observations with recent clinical and technological advances to reassess the cerebral effects of acupuncture from a modern perspective. Evidence from clinical studies indicates that acupuncture can alter cerebral blood flow velocity and regional perfusion, suggesting an interaction with cerebrovascular regulation beyond placebo-related mechanisms. Experimental models further support these findings by demonstrating improved cerebral perfusion, neuroprotection, and preservation of blood–brain barrier integrity following manual needle acupuncture or electroacupuncture stimulation. Recent advancements in non-invasive ICP monitoring, multimodal neurovascular assessment, and computational modelling enable a more precise evaluation of subtle changes in pressure and flow than was previously possible. Although definitive clinical data on sustained or therapeutic ICP modulation remain limited, the reproducibility of cerebral physiological responses highlights the importance of careful monitoring, particularly in patients with altered autoregulation or reduced intracranial compliance. Revisiting early acupuncture research with contemporary methodologies may enhance safety assessments and help define the role of acupuncture as a neuromodulatory intervention with effects on cerebral physiology.