The Mechanisms and Research Progress of Electroacupuncture Modulation of the Anterior Cingulate Cortex in Alleviating Paclitaxel-induced Pain and Cognitive Impairment

Paclitaxel is a widely used chemotherapeutic agent, but its administration is frequently ac-companied by neuropathic pain and cognitive impairment, which together profoundly diminish the quality of life in cancer patients. Unfortunately, existing therapeutic strategies for PTX-induced ab-normalities remain inadequate, with limited efficacy and significant adverse effects. Central to the per-ception of pain and the regulation of cognitive function is the Anterior Cingulate Cortex (ACC). The integrative role of the ACC depends on tightly regulated neuronal activity, neurotransmitter homeosta-sis, and neuroplasticity-defined as the ability of the brain to reorganize and form new neural connec-tions-all of which may be disrupted by PTX. Electroacupuncture (EA), a non-pharmacological inter-vention with an excellent safety profile, has emerged as a promising therapy capable of relieving pain and ameliorating cognitive impairment in this context. This review first outlines the pathophysiological mechanisms of PTX-induced pain and cognitive dysfunction, including both peripheral neurotoxicity and central sensitization-a heightened response of the central nervous system to stimulation. It then de-tails the neuroanatomical and functional contributions of the ACC to these processes, with special em-phasis on its influence over memory and attention. Subsequently, the article discusses the mechanisms by which EA mitigates PTX-induced symptoms, including its regulatory effects on neurotransmitter systems, modulation of microglial activity, and promotion of neuroplasticity-particularly within the ACC. The synergy between EA and other therapeutic modalities, such as pharmacological treatments and cognitive rehabilitation, is also addressed. Finally, the need for future research is highlighted, in-cluding the optimization of EA parameters, a deeper exploration of ACC connectivity with other brain regions, and the development of multimodal treatment strategies. In sum, targeting the ACC with EA represents a promising approach for alleviating PTX-induced neuropathic pain and cognitive impair-ment, providing a theoretical foundation by elucidating underlying mechanisms to improve the clinical management of chemotherapy side effects.