Meta-analysis on randomized controlled trials for scalp acupuncture treatment of stroke: A systematic review

You, Young-Nim; Park, Gwang-Cheon; Cho, Myung-Rae; Song, Min-Yeong; Na, Chang-Su; Han, Jia; Kim, Jae-Hong

doi:10.1016/s0254-6272(18)30879-3

Cited by 13 publications

(16 citation statements)

References 10 publications

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“…In this study, we compared the NIHSS scores between the scalp acupuncture group and the control group and found a significant difference in the NIHSS scores after ISSA treatment between the two groups. This indicated that scalp acupuncture may have an ameliorative effect on the global neurological impairment in stroke patients, which is consistent with the results of previous studies (Wang et al, 2012 ; You et al, 2018 ). However, no statistically significant difference in the SFMA scores was observed between the two groups.…”

Section: Discussionsupporting

confidence: 92%

“…The ISSA is developed based on the traditional acupuncture science, modern anatomy, neurophysiology and bioholographic theory (Liu et al, 2012 ). Two systematic reviews have confirmed a significant improvement in the neurological symptoms such as, motor dysfunction in patients with acute ischemic stroke (AIS) after scalp acupuncture treatment (Wang et al, 2012 ; You et al, 2018 ). Moreover, scalp acupuncture has also been demonstrated to have a lasting therapeutic effect on the recovery of sensory and motor functions in stroke patients (Hegyi & Szigeti, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

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Scalp acupuncture enhances local brain regions functional activities and functional connections between cerebral hemispheres in acute ischemic stroke patients

Liu

Jiang

Wang³

et al. 2021

The Anatomical Record

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This study aimed to explore the changes in functional connections between cerebral hemispheres and local brain regions functional activities in patients with acute ischemic stroke (AIS) treated with International Standard Scalp Acupuncture (ISSA). Thirty patients with middle cerebral artery AIS in the dominant hemisphere were selected and randomly divided into two groups such as the control group and the scalp acupuncture group, with 15 patients in each group. Patients in the control group were treated with conventional Western medicine, while patients in the scalp acupuncture group received ISSA (acupuncture at the parietal midline [MS5], acupuncture at the left anterior parietotemporal oblique line [MS6] and acupuncture at the left posterior parietotemporal oblique line [MS7]) for one course of treatment. All patients were evaluated for treatment efficacy and received whole brain resting state functional magnetic resonance imaging (Rs‐fMRI) scan before and after treatment. The observational indicators included: (a) the National Institutes of Health Stroke Scale (NIHSS) scores and the simplified Fugl‐Meyer Assessment (SFMA) scores; (b) analyses of the amplitude of low‐frequency fluctuation (ALFF), regional homogeneity (ReHo) and voxel‐mirrored homotopic connectivity (VMHC). The results showed a significant difference in the NIHSS scores before and after treatment in the scalp acupuncture group compared with the control group ( p < .05), indicating that patients improved better after scalp acupuncture treatment. Compared with the control group, the VMHC, ALFF and ReHo values in the scalp acupuncture group increased after treatment. The VMHC values increased in the brain regions dominated by bilateral BA6 and BA8; the ALFF values increased in the left BA39 and the adjacent superior temporal gyrus and middle temporal gyrus; and the ReHo values increased in the brain regions extending from left middle temporal gyrus (including BA21) to BA37, and the brain regions extending from the left BA40 and angular gyrus to BA7. The present study indicated that scalp acupuncture can specifically strengthen the functional activities of the brain regions related to sensory integration, language processing and motor coordination in the middle aged and elderly patients with AIS of the dominant cerebral hemisphere, and can strengthen bilateral frontal lobe motor control. This study may provide a scientific basis for the clinical application of ISSA treatment in patients with AIS, and may also provide a preliminary research basis for further animal experiments.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Scalp acupuncture enhances local brain regions functional activities and functional connections between cerebral hemispheres in acute ischemic stroke patients

Liu

Jiang

Wang³

et al. 2021

The Anatomical Record

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“…The observation validated the efficacy of ISSA in the treatment of AIS patients, confirming that the ISSA combined with routine treatment could improve the neurological deficits and motor dysfunction in patients with AIS in the trial, which was consistent with those by Wang et al [ 5 ]. Based on the effectiveness, we explored the specific effect of the ISSA on brain function networks in patients with dysfunction after AIS.…”

Section: Discussionsupporting

confidence: 89%

“…A relevant meta-analysis found that acupuncture can improve the motor function of the defect in acute stroke patients without obvious serious adverse events [ 4 ]. Among them, the ISSA therapy has been used in the clinical treatment of AIS by stimulating specific areas of the scalp [ 5 ]. However, modern medicine and rehabilitation training are mainly used in the acute stage of ischemic stroke at present.…”

Section: Introductionmentioning

confidence: 99%

Scalp Acupuncture Enhances the Functional Connectivity of Visual and Cognitive‐Motor Function Network of Patients with Acute Ischemic Stroke

Liu

Chen

Zhang

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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Object. To explore the specific effect of the international standard scalp acupuncture (ISSA) on patients with brain dysfunction after acute ischemic stroke (AIS) based on resting-state functional magnetic resonance imaging (Rs-fMRI). Design. A parallel-group randomized controlled trial. Participants. 30 hemiplegic patients with middle cerebral artery acute infarction of the dominant hemisphere. Interventions. 30 patients were divided into 2 groups randomly. 15 patients in the treatment group (TG) were treated with ISSA, needling at the parietal midline (MS5) and left anterior/posterior parietal-temporal oblique lines (MS6 and MS7), combined with western routine treatment. While another 15 patients in the control group (CG) received routine treatment only. Main Outcome Measures. (1) Functional connectivity (FC): patients received brain scan using 3.0 T MRI after the treatment for 1 week. Based on the Matlab2012a platform, SPM12 software and DPABI software were used to process the scanning data and finally the functional connectivity of the brain was obtained. (2) National Institute of Health Stroke Scale (NIHSS) score. Results. The difference in the NIHSS score between the two groups of patients before and after treatment was statistically significant (tNIHSS = 2.225; PNIHSS = 0.038), indicating that TG had a better effect. Centered to the seed region of the left supplementary motor area (SMA) (−5.32, 4.85, 61.38), FC increased at the left middle cerebellar peduncle, left cerebellum posterior lobe (uvula and declive), vermis, fusiform gyrus, lingual gyrus, inferior occipital gyrus, calcarine, cuneus, precuneus, BA7, BA18 and BA19, etc. Centered to the seed region of the left parahippocampal gyrus (PG) (−21.17, −15.95, −20.70), FC increased at the left precuneus, inside-paracingulate, inferior parietal gyrus, paracentral lobule, BA5, BA6, BA7, and BA40, right median cingulate, precuneus, BA19, BA23, and BA31, etc. Conclusions. It is indicated that ISSA can regulate the brain functional connection in patients with middle cerebral artery acute infarction in the dominant hemisphere and specifically strengthen the connections between visual, cognitive, motor control, and planning-related brain regions, which may be related to the recovery of movement in the mechanism. This trial is registered with ChiCTR-IOR-15007672.

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“…In addition, a meta-analysis of animal studies reported promising results, finding that SA improved infarct volume and neurological function score (10). Moreover, in Young-Nim et al (11) obtained similar results in their metaanalysis; however, the intervention methods were mixed (SA and body acupuncture). Therefore, we decided to investigate whether additional SA has benefits for patients with stroke.…”

Section: Introductionmentioning

confidence: 94%

Efficacy of Scalp Acupuncture in Patients With Post-stroke Hemiparesis: Meta-Analysis of Randomized Controlled Trials

Huang

Leng

et al. 2021

Front. Neurol.

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Objectives: To conduct a meta-analysis to assess the efficacy of scalp acupuncture (SA) in patients with stroke and consequent hemiparesis regardless of brain infarction or intracerebral hemorrhage.Methods: A literature search of randomized controlled trials (RCTs) on SA for stroke was performed in five databases up to May 10, 2021. We investigated three types of outcome: motor function, sequelae of poststroke hemiparesis, and adverse effects. Methodological quality was assessed using the revised Cochrane risk of bias tool version 2.0.Results: Of 1,063 papers, 30 RCTs involving Fugl–Meyer Assessment were selected, among which 10 and four RCTs were selected for evaluation of courses lasting of 1 and 3 months, respectively. The meta-analysis of 1- and 3-month courses revealed significant differences in the motor function of the SA plus Western standard treatment group vs. Western standard treatment only (medication plus rehabilitation; P < 0.001). A 3-month course tended to result in better outcomes than a 1-month course.Conclusions: Our meta-analysis results reveal that SA improves motor function in patients with acute to chronic stroke, regardless of brain infarction or intracerebral hemorrhage. However, because of a lack of methodological quality, thoroughly planned clinical studies are still required.

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Meta-analysis on randomized controlled trials for scalp acupuncture treatment of stroke: A systematic review

Cited by 13 publications

References 10 publications

Scalp acupuncture enhances local brain regions functional activities and functional connections between cerebral hemispheres in acute ischemic stroke patients

Scalp acupuncture enhances local brain regions functional activities and functional connections between cerebral hemispheres in acute ischemic stroke patients

Scalp Acupuncture Enhances the Functional Connectivity of Visual and Cognitive‐Motor Function Network of Patients with Acute Ischemic Stroke

Efficacy of Scalp Acupuncture in Patients With Post-stroke Hemiparesis: Meta-Analysis of Randomized Controlled Trials

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