Electroacupuncture (EA) pretreatment is a recent observation which has been shown to induce ischemic tolerance mimicking the ischemic pretreatment, suggesting that EA pretreatment may be a promising preventive strategy for the patients with high risk of acute
ischemia/reperfusion injury. It was first described in the brain, then in the heart where EA stimulation at
acupoint prior to
ischemia led to neuroprotection and myocardial protection and induced rapid and delayed ischemic tolerance. Then the optimal parameters and
acupoint specificity of EA pretreatment to induce protective effect were proved. Many studies have shown that protective mechanisms of EA pretreatment may involve a series of regulatory molecular pathways including activity enhancement of
antioxidant, regulation of the
endocannabinoid system, involvement of
beta-adrenergic receptor, and postreceptor signaling pathway, inhibition of apoptosis. Recently, the neuroprotective and cardioprotective effect of EA pretreatment had been demonstrated in patients undergoing craniocerebral
tumor resection or heart valve replacement surgery. Thus, the purpose of this paper is to collect the evidence for the
neuroprotective effect of EA pretreatment, to summarize the proposed protective mechanisms of EA pretreatment, and to discuss the possibility of EA pretreatment as a new preventive strategy for patients with high risk of
ischemia in clinic.