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

Abstract

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.

Aberrant interhemispheric functional reciprocities of the default mode network and motor network in subcortical ischemic stroke patients with motor impairment: A longitudinal study

“…For instance, previous studies have demonstrated that stroke can cause significant disturbances in the effective connectivity of motor areas (5,14,18). FC between the bilateral primary sensorimotor cortex was significantly decreased in patients with stroke (17,46). Using diffusion tensor imaging (DTI), patients with stroke also demonstrated a decrease in the interhemispheric fiber connections between the left and right motor cortex (33,47,48).…”

“…Additionally, brain function recovery after stroke is always difficult to evaluate (12). Mounting evidence has suggested that the recovery of impaired behavioral function is accompanied by brain reorganization after effective treatment (13)(14)(15)(16)(17). Identifying stroke recovery processes by neuroimaging will benefit the selection of suitable treatments for stroke.…”

“…Recently, as a conspicuous indicator of disturbed functional specialization of the brain, VMHC has been chosen in some diseases to explore the alterations of functional homotopy due to intervention or recovery ( 28 – 31 ). This method has also been used in stroke studies to investigate the changes in functional connections between cerebral hemispheres ( 10 , 17 , 28 , 31 ). After receiving scalp acupuncture, patients with acute ischemic stroke showed a significant increase in VMHC values in the bilateral BA6 and BA8 ( 17 ).…”

“…This method has also been used in stroke studies to investigate the changes in functional connections between cerebral hemispheres ( 10 , 17 , 28 , 31 ). After receiving scalp acupuncture, patients with acute ischemic stroke showed a significant increase in VMHC values in the bilateral BA6 and BA8 ( 17 ). Scalp acupuncture can specifically strengthen the functional activities of the brain regions related to motor coordination in stroke.…”

Combinations of scalp acupuncture location for the treatment of post-stroke hemiparesis: A systematic review and Apriori algorithm-based association rule analysis

“…Liu et al (2020) reported that SA (ISSA_MS5, MS6, and MS7) enhances functional connections, especially between visual, cognitive, motor control, and planning-related brain regions in acute ischemic stroke patients, by using fMRI examination. Liu H. et al (2021) also reported that SA (ISSA_MS5, MS6, and MS7) could strengthen the functional activities related to sensory integration, language processing, 10.3389/fnins.2022.956854 and motor coordination of the dominant cerebral hemisphere and the motor control bilateral frontal lobe by using the fMRI examination. This present study may provide a scientific basis that SA can modulate the functional connections of brain regions related to the recovery of voluntary movement after brain damage.…”