Effect of opposing needling on motor cortex excitability in healthy participants and in patients with post-stroke hemiplegia: study protocol for a single-blind, randomised controlled trial

Abstract

Background Opposing needling has an obvious curative effect in the treatment of post-stroke hemiplegia; however, the mechanism of the opposing needling in the treatment of post-stroke hemiplegia is still not clear. The purpose of this study is to investigate the effect of opposing needling on the excitability of primary motor cortex (M1) of healthy participants and patients with post-stroke hemiplegia, which may provide insight into the mechanisms of opposing needling in treating post-stroke hemiplegia. Methods This will be a single-blind, randomised, sham-controlled trial in which 80 healthy participants and 40 patients with post-stroke hemiplegia will be recruited. Healthy participants will be randomised 1:1:1:1 to the 2-Hz, 50-Hz, 100-Hz, and sham electroacupuncture groups. Patients with post-stroke hemiplegia will be randomised 1:1 to the opposing needling or conventional treatment groups. The M1 will be located in all groups by using neuroimaging-based navigation. The stimulator coil of transcranial magnetic stimulation (TMS) will be moved over the left and right M1 in order to identify the TMS hotspot, followed by a recording of resting motor thresholds (RMTs) and motor-evoked potentials (MEPs) of the thenar muscles induced by TMS before and after the intervention. The primary outcome measure will be the percent change in the RMTs of the thenar muscles at baseline and after the intervention. The secondary outcome measures will be the amplitude (μV) and latency (ms) of the MEPs of the thenar muscles at baseline and after the intervention. Discussion The aim of this trial is to explore the effect of opposing needling on the excitability of M1 of healthy participants and patients with post-stroke hemiplegia. Trial registration Chinese Clinical Trial Registry ChiCTR1900028138. Registered on 13 December 2019.

Acupuncture for stroke: A bibliometric analysis of global research from 2000 to 2022

“…Subsequently, cortical stimulation was directed at the left and right M1 regions in hemiplegic stroke patients prior to the application of EA at this optimal frequency. RMTs and MEPs of the bilateral thenar muscles were further evaluated in these patients to investigate the therapeutic effects of acupuncture on motor cortex recovery [ 88 ]. Therefore, future studies should focus on combining acupuncture with other nonpharmaceutical therapies to provide better treatment effects for patients with stroke.…”

Effects of scalp acupuncture combined with repetitive transcranial magnetic stimulation on post-stroke cognitive impairment at different time intervals

“…ii) We estimated the patients' exposure to clear consciousness (i.e., no serious aphasia or significant cognitive dysfunction [MoCA score >24]) before the stroke onset to identify those with no significant cognitive dysfunction before the onset. iii) All participants were received rTMS stimulation and acupunc-ture treatment, The acupoints included Baihui, Shenting, Yintang, Sishencong, and bilateral Fengchi [8][9][10]. Stimulation parameters: site, the unaffected M1 region; stimulation frequency, 1 Hz; intensity, 120% of the motor threshold; stimulation time, 2 seconds; interval time, 20 seconds [11][12][13][14].…”