Modulation of Functional Gastrointestinal Disorders by Paraventricular Nucleus and The Effect of Acupuncture

Functional gastrointestinal disorders (FGIDs) refer to gastrointestinal motility disorders and irritable bowel syndrome (IBS). Its characteristics are abdominal pain, diarrhea and constipation. These multifactorial conditions often have limited treatment efficacy, prompting ~50% of patients to seek alternatives like acupuncture, which has shown promising therapeutic effects recently. The paraventricular nucleus (PVN) is a multifunctional neuroendocrine nucleus located in the medial thalamus. It contains large cell neurons that synthesize oxytocin (OXT) and vasopressin (VP), and small cell neurons, including corticotropin-releasing hormone (CRH) neurons. The PVN regulates cardiovascular and electrolyte homeostasis and is crucial in FGIDs' pathogenesis. It affects gastrointestinal diseases via mechanisms like visceral pain, motility disorders, nausea, vomiting, and gastric mucosal damage. Neural circuits such as BNST-PVN, PVN-LSV, and PVN-DMV are also involved in this regulationAcupuncture, a traditional Chinese medical treatment, shows promise for FGIDs by modulating visceral pain and gastrointestinal motility via effects on CRH receptors in the PVN. This provides a novel treatment approach. Future studies should focus on clarifying the exact mechanism of acupuncture in the PVN and exploring the effects of different acupoints on the PVN., stimulation frequencies, and intensities affect the PVN.In summary, the PVN is a key brain center whose dysfunction or changes in hormone/receptor expression are linked to FGIDs. Acupuncture's regulation of the PVN offers a potential therapy. This review highlights the PVN's role in FGIDs, acupuncture's effects, and future research directions.