Sensorimotor Responses in Post-Stroke Hemiplegic Patients Modulated by Acupuncture at Yanglingquan (GB34): A fMRI Study Using Intersubject Functional Correlation (ISFC) Analysis

Abstract

Motor dysfunction is common in patients with stroke. Acupuncture has become an acceptable alternative method for stroke rehabilitation. Previous studies have shown various functional connectivity changes activated by acupuncture. We introduced intersubject correlation (ISC) and intersubject functional correlation (ISFC) analyses into the functional magnetic resonance imaging (fMRI) for ischemic stroke to seek a common activation and suppression pattern triggered by acupuncture. In this study, 63 ischemic stroke patients with motor dysfunction and 42 normal controls were analyzed. Three functional scans were conducted during the resting state, motor task, and acupuncture at Yanglingquan (GB34) task. Twenty-two sensory, motor, and movement-imagination cortices in the bilateral hemispheres were selected as the region of interest (ROI). We performed ISC and ISFC analyses among these ROIs in three fMRI runs on patients and controls. Subgroup analyses by course or severity were also conducted. The results showed that acupuncture at GB34 triggered ISFC among upper limb motor, upper limb/hand/face, lower limb, tongue/larynx sensory, and movement imagination regions in the patient group. Subgroup ISC and ISFC analyses showed that patients tended to have increasing responses in the early stage of stroke (within 1 month) and decreasing responses afterward (1–3 months). Patients with mild clinical functional damage (NIHSS 2–4) tended to generate more responses via acupuncture than those with moderate damage (NIHSS 5–15). Our findings may help understand the clinical effects and modulatory features of acupuncture based on the group-level post-stroke neuroplasticity.

Immediate neural effects of acupuncture manipulation time for stroke with motor dysfunction: a fMRI pilot study

“…Chen et al further revealed a cortico-subcortical connectivity between the cerebellum and the sensory motor network (SMN) (Chen et al, 2022). Acupuncture can regulate the SMN to relieve hemiplegia, numbness and other symptoms (Wang et al, 2022;Peng et al, 2023). Thus, we consider that 3-min acupuncture stimulation may improve motor dysfunction in stroke patients more effectively by regulating the SMN including the cerebellum compared with shorter stimulation.…”

Efficacy and cerebral mechanisms of acupuncture for chronic obstructive pulmonary disease: study protocol for a multicenter, randomized controlled neuroimaging trial

“…Acupuncture, an important facet of traditional Chinese medicine, has demonstrated clinical efficacy in many conditions, including pain, mood disorders, and stroke, by modulating neural responses in the brain (51)(52)(53). Brain activation leads to enhanced blood flow, blood volume, and oxygen saturation in the cerebrum, thereby increasing deoxyhemoglobin levels, which is proportional to the magnetic resonance signal on functional MRI.…”

Effects of acupoints-based TENS combined with tDCS on spasticity and motor function in ischemic stroke with spastic hemiplegia: study protocol for a randomized controlled trial

“…Yanglingquan (GB34), also known as “confluential point of sinews,” has the effect of relaxing and strengthening sinews, thus it is considered as a classic acupoint for relieving spasticity. A fMRI study illustrated that acupuncture at GB34 may improve the motor function recovery in post-stroke hemiplegic patients via affecting the functional connectivity of the brain ( 56 ). It was found that the anti-spastic action of acupuncture at GB34 for post-stroke spasticity was related to its alleviation of spinal hyperreflexia via KCC2-mediated spinal GABA A activation ( 57 ).…”