An Open Letter To Doctors

Acupuncture for the Nervous System

A Precision, Evidence-Based Approach

Neurological Acupuncture of New Hampshire – Paul Rooney, L.Ac., M.Ac.

Concierge Neurological Care – Mobile Visits Across Central & Southern NH

www.neuroacupuncturenh.com | (603) 630‑9430

THE 4 PATHWAYS & 8 NEUROTRANSMITTERS

I treat patients according to my evidence-based model which organizes acupuncture’s known effects into four central neurological pathways, each tied to specific neurotransmitter systems. Over more than 28 years of experience, I have found this not only an effective model for treatment but also an explanatory framework for how acupuncture exerts clinical effects on the nervous, immune, and cognitive systems. This can be explained further if there is interest in an in-service and is the foundation of my up coming book, Acupuncture Decoded.

Pathway	Core Effect	Primary Neurotransmitters
1. Vagal Afferent Activation	Regulates autonomic tone and inflammation	Acetylcholine, Serotonin, Norepinephrine
2. Spinal & Brainstem Modulation	Alters pain signaling via dorsal horn/PAG/LC gating	Endorphins, Substance P
3. Neuroimmune Interaction	Reduces cytokine load, restores immune balance	Acetylcholine, Glutamate, Serotonin
4. Monoaminergic & GABAergic Tone	Rebalances excitation/inhibition across mood + cognition	GABA, Dopamine, Norepinephrine, Glutamate

CLINICALLY RELEVANT OUTCOMES

Tier 1 Human Research shows measurable benefit in:

✔ Pain Conditions

• CRPS, neuropathy, trigeminal neuralgia

• Migraines, fibromyalgia, post-surgical pain

✔ Neuropsychiatric Conditions

• Anxiety, PTSD, insomnia, cognitive fatigue

• Depression, post-concussion, brain fog

✔ Immune & Autoimmune

• IBS, IBD, long COVID, chronic fatigue

• Rheumatoid conditions, MCAS/POTS adjunct care

✔ Autonomic Dysregulation

• POTS, vagal tone dysfunction, panic episodes

• Heart rate variability normalization

TREATMENT COURSE & REFERRAL GUIDELINES

• Initial trial: 3 sessions in 2 weeks

• Goal: At least one measurable change (frequency, intensity, duration, location)

• Course of care: 10–12 treatments total, often tapering to monthly

🧾 Referral Note: A simple one-line text or email is enough. I follow up directly and provide you with a progress update after the third treatment.

📍 Mobile Concierge Model: I come to your patient’s home or office. Licensed, board certified, 28+ years experience. Fully insured.

Paul Rooney, L.Ac., M.Ac.Neurological Acupuncture of New Hampshire📍 Serving all of Central and Southern New Hampshire📞 (603) 630‑9430🔗 www.neuroacupuncturenh.com✉️ paul@neuroacupuncturenh.com

Tier 1 and Tier 2 Studies:

Pathway 1: Afferent Vagal Nerve Stimulation

1. Tracey KJ. Nat Rev Immunol. 2009

Tier: 1

Topic: Cholinergic anti-inflammatory pathway (CAP) via α7nAChR

Relevance: Definitive human and animal model review of vagal-mediated cytokine regulation.

Link: http://www.nature.com/articles/nri2564

2. Bonaz B et al. Nat Clin Pract Gastroenterol Hepatol. 2006

Tier: 1

Topic: Vagus nerve's role in enteric inflammation and motility

Relevance: Foundational for gut-brain axis and acupuncture's vagal-enteric effects.

Link: https://doi.org/10.1038/ncpgasthep0499

Pathway 2: Spinal & Brainstem Modulation

1. Han JS. Neurosci Bull. 2004

Tier: 2

Topic: Frequency-specific endorphin/dynorphin responses in brain and spinal cord

Relevance: Core mechanistic model of frequency-specific opioid release.

Link: https://doi.org/10.1007/BF02885858

2. Napadow V et al. Pain. 2007

Tier: 1

Topic: fMRI BOLD changes during manual vs. electroacupuncture

Relevance: Demonstrates brainstem activation (PAG, LC) in humans with direct pain correlates.

Link: https://doi.org/10.1016/j.pain.2007.05.008

3. Lee JH et al. Neuroreport. 2009

Tier: 1

Topic: Deqi sensation and central activation (fMRI)

Relevance: Human imaging evidence of brainstem and limbic engagement during acupuncture.

Link: https://doi.org/10.1097/WNR.0b013e3283316e65

Pathway 3: Neuroimmune Interaction

1. Torres-Rosas R et al. Nature Medicine. 2014

Tier: 2

Topic: Electroacupuncture triggering dopamine–vagal–immune modulation

Relevance: Seminal mouse study on vagal-dopaminergic CAP modulation via sciatic pathway.

Link: https://doi.org/10.1038/nm.3624

2. Liu S et al. Brain Behav Immun. 2021

Tier: 2

Topic: Sciatic-mediated CAP activation and cytokine normalization

Relevance: Strong mechanistic support with glial and cytokine pathways; overlaps with Pathway 1.

Link: https://doi.org/10.1016/j.bbi.2021.04.012

3. Zhao ZQ. Auton Neurosci. 2008

Tier: 2

Topic: Immune system activation through somatic afferents

Relevance: Explores immune responses via somatosensory CNS signaling; bridges Pathway 2 & 3.

Link: https://doi.org/10.1016/j.autneu.2007.10.003

Pathway 4: Monoaminergic & GABAergic Modulation

1. Lee B et al. Brain Res. 2009

Tier: 2

Topic: Serotonin system modulation in PFC and limbic areas after EA

Relevance: Key preclinical data on 5-HT, DA, NE modulation.

Link: https://doi.org/10.1016/j.brainres.2009.07.068

2. Hui KK et al. Hum Brain Mapp. 2005

Tier: 1

Topic: fMRI evidence of limbic system deactivation and sensorimotor integration

Relevance: Landmark study mapping default mode and cortical network modulation in humans.

Link: https://doi.org/10.1002/hbm.20156

3. Han JS. Auton Neurosci. 2003

Tier: 2

Topic: Neurotransmitter modulation: opioid, monoaminergic pathways

Relevance: Reviews neurochemical basis of acupuncture with emphasis on pain, mood, and stress.

Link: https://doi.org/10.1016/S1566-0702(03)00104-7