Beyond Remyelination: Acupuncture-Associated Glial Network Modulation as a Testable Hypothesis for White Matter Resilience During Aging

Age-associated white matter decline reflects changes in myelin, axons, vascular support and multiple glial populations rather than a single cell-autonomous failure. Microglia, astrocytes and oligodendrocyte-lineage cells undergo heterogeneous, region- and context-dependent shifts during aging, and oligodendrocyte precursor cell (OPC) recruitment, differentiation and myelin-support functions can become less efficient. Manual acupuncture can elicit a local extracellular purine and adenosine response, whereas electroacupuncture can recruit site- and intensity-dependent somatosensory-autonomic reflexes in defined experimental domains. Preclinical disease and injury models have also associated electroacupuncture with oligodendrocyte regeneration or remyelination-related outcomes. However, no study has demonstrated that either modality preserves glial network function, myelin maintenance or white matter resilience during normative aging. We therefore propose a bounded, falsifiable hypothesis: manual acupuncture and electroacupuncture may generate partially independent peripheral inputs that converge, through an unresolved peripheral-to-central nervous system (CNS) bridge, on age-associated microglial, astrocytic and oligodendrocyte-lineage states. Glial network modulation is operationally defined here as coordinated, time-dependent change in microglial surveillance and lipid handling, astrocytic metabolic and extracellular support, neuroimmune signaling and oligodendrocyte-lineage competence that collectively alters the capacity of white matter to maintain structure and function under aging-related stress. The model distinguishes myelin maintenance, myelin preservation, adaptive myelination and remyelination, and does not assume that a normal aging brain contains a focal demyelinated lesion. It predicts separable upstream responses, a measurable peripheral-to-CNS intermediate, causal interdependence among glial populations, and concordance between lineage, ultrastructural, quantitative imaging, conduction and behavioral outcomes. A staged experimental program is proposed using young and aged reference groups, modality-specific controls, causal perturbation, lineage tracing, electron microscopy, quantitative myelin imaging and blinded functional assessment. This article is a preclinical hypothesis and does not establish that acupuncture promotes healthy aging, prevents age-related disease or preserves human white matter.