Abstract
Dear Editor:
I enjoyed reading a recent article by Wong and Sun 1 describing the effect of tongue acupuncture in children with autism spectrum disorder, and would like to express my opinions on this topic.
In the article by Wong and Sun, the trial involved 50 children between 3 and 11 years of age; the tongue acupuncture method consisted of 40 sessions for each child subject in intervention and control groups, with 5 sessions performed on a daily basis per week over 2 months. Also, the researchers stated that the whole acupuncture procedure lasted for <15 seconds for 5 acupoints on the tongue (see page 546: last paragraph in ref. 1). However, a child's tongue is tiny, soft, sensitive, and deformable; also the shape of tongue can be affected by local muscle tension. I believe that, without grasping and pulling the tongue, the researchers could not complete the tongue acupuncture for the children; yet, the action of grasping and pulling can deform the tongue. Considering there are 40 invisible acupoints on the tongue (Fig. 1), 2,3 it would be very difficult to perform accurate needle insertions in terms of needle placement, angle, and depth over 40 sessions for each child. How did Wong and Sun 1 produce the accuracy and repeatability of the needle insertions? Was it by observation or photo or video analysis? Without the evidence, the potential advantage of tongue acupoints cannot be proven; thus, these researchers only showed preliminarily that the invasive tongue mechanical stimulation outperformed the superficial stimulation for improving the condition of the children in this trial, who had autism spectrum disorder.
Tongue acupoints.
If the researchers could insert the needle into exactly the same invisible points of the tongue 40 times over 8 weeks for each child, might the tongues be affected by hypoglossal or lingual nerve injuries? 4 Did the researchers evaluate the potential nerve damages within each child's tongue after the treatments? Given that these child subjects had autism spectrum disorder (see page 547, table 1, in ref. 1), were they able to express the potential pain, numbness, and fear that they may have experienced as a result of the tongue acupuncture treatment?
Regardless of my comments, Drs. Wong and Sun presented an interesting study.