Neuroanatomical organization of electroacupuncture in modulating gastric function in mice and humans

Somatosensory-vagal reflexes evoked by electroacupuncture (EA) can modulate visceral functions. However, the underlying principles and neural mechanisms remain poorly understood, hindering further optimization. Here, we identified key neural components essential for EA topographically driving the somatosensory-vagal-gastric reflex in mice. EA drove this reflex via activation of a subset of transient receptor potential vanilloid-1 (TRPV1)⁺ nociceptors marked by the expression of Adra2a and located exclusively in deep fascial tissues. Through TRPV1⁺ fibers, EA activated a subtype of gastro-projecting Oxtr⁺ fibers originating from the dorsal motor nucleus of the vagus (DMV). Genetic ablation of TRPV1⁺ fibers or Oxtr⁺ DMV neurons attenuated EA-induced gastric reflexes. Conversely, optogenetic activation of these neurons was sufficient to drive gastric motility in mice. Using similar stimulation parameters, we demonstrated that EA successfully improved gastric functions in patients with dysmotility-like functional dyspepsia (chictr.org.cn: ChiCTR2300072636). Our findings thus provide a neural anatomical basis for EA topographically to promote and treat gastric motility disorders.