Evaluating the Effects of 5-Hz Repetitive Transcranial Magnetic Stimulation With and Without Wrist-Ankle Acupuncture on Improving Spasticity and Motor Function in Children With Cerebral Palsy: A Randomized Controlled Trial

Abstract

Objective: The goal of this study is to explore the effect of wrist-ankle acupuncture combined with 5-Hz repetitive transcranial magnetic stimulation (rTMS) on improving spastic state and motor function of children with spastic cerebral palsy by measuring electrophysiological parameters and behaviors.Methods: Twenty-five children with spastic cerebral palsy were enrolled in a single-blind and randomized controlled trial. The control group received 20 sessions of 5-Hz rTMS over the affected hemisphere with 1,000 pulses. The experimental group was given wrist-ankle acupuncture on the basis of the control group. Gross motor function measure (GMFM-66), muscle tension, and electrophysiological parameters of the two groups were assessed at baseline and after intervention.Results: After treatment, the GMFM-66 scores in the same groups were significantly improved (p < 0.001). Besides, the R-value of soleus, gastrocnemius, and hamstring muscle decreased (p < 0.05), and the results showed a trend of shortening MEP latency, increasing amplitude and duration (p < 0.05). Compared to the controlled group, the experimental group displayed more excellent changes in the GMFM-66 scores and motor evoked potential (MEP) latency. The statistical results showed that the increase of GMFM-66 score and the shortening of MEP latency in the experimental group were greater than that in the control group (p < 0.05). However, no significant differences were found in the assessment of muscle tension, amplitude, and duration of MEPs between two groups (p > 0.05).Conclusion: Wrist-ankle acupuncture combined with 5-Hz rTMS is optimal to improve gross motor function and enhance the conductivity of corticospinal tract in children with cerebral palsy but cannot highlight its clinical superiority in improving spasticity.Clinical Trial Registration: [http://www.chictr.org.cn/index.aspx], identifier [chictr2000039495].

Effects of traditional Chinese medicine combined with modern rehabilitation therapies on motor function in children with cerebral palsy: A systematic review and meta-analysis

“…Especially in scalp acupuncture, some special acupoints, such as DU-20 and X-HN1, may expand the blood vessels of the corresponding brain areas or promote collateral circulation ( Chinese Association of Rehabilitation Medicine Pediatric Rehabilitation Committee et al, 2022b ). Expression of endothelin receptor type A, which was associated with vasoconstriction, decreased in mice after being treated with acupuncture ( Li J. et al, 2021 ). Some studies demonstrated that another mechanism of TCM in improving motor development might be the mediation of neurotransmitters, such as gamma-aminobutyric acid, an inhibitory neurotransmitter for motoneurons to improve motor development ( Shorter and Segesser, 2013 ).…”

Effects of auricular acupuncture stimulation on healthy adults’ upper limb motor-evoked potentials: A randomized, crossover, double-blind study

“…Variations in the amplitude of motor-evoked potentials (MEP) induced by TMS are frequently used to detect differences in cortical excitability ( Du et al, 2018 ). Numerous recent studies have reported MEP changes in response to acupuncture, but the findings have been inconsistent ( Sun et al, 2019 ; Li et al, 2021 ). Furthermore, it is unknown whether auricular acupuncture regulates the motor cortex.…”