Neuroimaging mechanisms of acupuncture on functional reorganization for post-stroke motor improvement: a machine learning-based functional magnetic resonance imaging study

Abstract

ObjectiveMotor recovery is crucial in stroke rehabilitation, and acupuncture can influence recovery. Neuroimaging and machine learning approaches provide new research directions to explore the brain functional reorganization and acupuncture mechanisms after stroke. We applied machine learning to predict the classification of the minimal clinically important differences (MCID) for motor improvement and identify the neuroimaging features, in order to explore brain functional reorganization and acupuncture mechanisms for motor recovery after stroke.MethodsIn this study, 49 patients with unilateral motor pathway injury (basal ganglia and/or corona radiata) after ischemic stroke were included and evaluated the motor function by Fugl–Meyer Assessment scores (FMA) at baseline and at 2-week follow-up sessions. Patients were divided by the difference between the twice FMA scores into one group showing minimal clinically important difference (MCID group, n = 28) and the other group with no minimal clinically important difference (N-MCID, n = 21). Machine learning was performed by PRoNTo software to predict the classification of the patients and identify the feature brain regions of interest (ROIs). In addition, a matched group of healthy controls (HC, n = 26) was enrolled. Patients and HC underwent magnetic resonance imaging examination in the resting state and in the acupuncture state (acupuncture at the Yanglingquan point on one side) to compare the differences in brain functional connectivity (FC) and acupuncture effects.ResultsThrough machine learning, we obtained a balance accuracy rate of 75.51% and eight feature ROIs. Compared to HC, we found that the stroke patients with lower FC between these feature ROIs with other brain regions, while patients in the MCID group exhibited a wider range of lower FC. When acupuncture was applied to Yanglingquan (GB 34), the abnormal FC of patients was decreased, with different targets of effects in different groups.ConclusionFeature ROIs identified by machine learning can predict the classification of stroke patients with different motor improvements, and the FC between these ROIs with other brain regions is decreased. Acupuncture can modulate the bilateral cerebral hemispheres to restore abnormal FC via different targets, thereby promoting motor recovery after stroke.Clinical trial registrationhttps://www.chictr.org.cn/showproj.html?proj=37359, ChiCTR1900022220.

Research trends and hotspots of post-stroke dysphagia rehabilitation: a bibliometric study and visualization analysis

“…Acupuncture affects the bilateral cerebral hemispheres via feature brain areas of interest (ROIs), reduces aberrant functional connectivity, and enhances motor cortex recovery after stroke. By combining intervention with swallowing training, acupuncture can significantly boost the rehabilitative result ( 79 , 80 ). Although evidence for the potential therapeutic alternatives and efficacy of acupuncture continues to emerge, international standards to assist clinical practice and treatment have yet to be produced ( 81 ).…”

Bilateral effect of acupuncture on cerebrum and cerebellum in ischaemic stroke patients with hemiparesis: a randomised clinical and neuroimaging trial

“… 9 Recent studies have investigated acupuncture improving limbs dysfunction from neuroplasticity reorganisation, particularly the excitability of intracortical neuronal circuits involved interhemispheric inhibition (IHI) and cerebellar brain inhibition (CBI). 10 11 Although our previous studies reported the bilateral modulations of acupuncture contributed to motor recovery from a single acupoint of Yanglingquan (GB34) to acupoints formula, 12 13 neuroimaging outcomes supporting the maximum applicability of acupuncture have been insufficient so far.…”

Effect of auricular acupressure combined with acupuncture for juvenile pseudomyopia

“…[8][9][10] Stimulation at acupoints can locally or distantly modulate organ physiology. [11][12][13][14][15][16][17][18][19] Acupuncture at acupoints and auricular acupressure can treat a variety of disorders, such as neck pain, neuropathic pain, stroke rehabilitation, Alzheimer disease, Parkinson disease, dysmenorrhea, depression and anxiety. [14,16,[20][21][22][23][24][25] Most importantly, they have also been reported to effectively manage myopia.…”