Acupuncture Enhances Communication between Cortices with Damaged White Matters in Poststroke Motor Impairment.

Xiao Han,Zhongjian Tan,Yanzhe Ning,Xuan Niu,Yingying Li,Lixin Tang,Zhen Chen,Zhengguang Chen,Chuanzhu Sun,Kuangshi Li,Yihuai Zou,Diyang Lyu,Lijun Bai,Caihong Fu,Fangyuan Cui

doi:10.1155/2019/4245753

Abstract

Stroke is a leading cause of motor disability. Acupuncture is an effective therapeutic strategy for poststroke motor impairment. However, its mechanism is still elusive. Twenty-two stroke patients having a right-hemispheric subcortical infarct and 22 matched healthy controls were recruited to undergo diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI) scanning. The resting-state fMRI was implemented before and after needling at GB34 (Yanglingquan). The stroke patients presented a substantially reduced fractional anisotropy value in the right superior longitudinal fasciculus (SLF), corticospinal tract, and corpus callosum. The structural integrity of the frontoparietal part of the SLF (SLF-FP) correlated with the motor scores of lower limbs in stroke patients. This corticocortical association bundle originated from the premotor cortex (PM) and the adjacent supplementary motor area (SMA), known as secondary motor areas, and terminated in the supramarginal gyrus (SMG). After acupuncture intervention, the corresponding functional connectivity between the PM/SMA and SMG was enhanced in stroke patients compared with healthy controls. These findings suggested that the integrity of the SLF is a potential neuroimaging biomarker for motor disability of lower limbs following a stroke. Acupuncture could increase the communication between the cortices connected by the impaired white matter tracts, implying the neural mechanism underlying the acupuncture intervention.

Highlights

Stroke is a critical contributor to the risk of death and a common cause of acquired disability on a global scale [1,2,3]
The results showed that all patients had motor hemiparesis with National Institute of Health Stroke Scale (NIHSS) from 1 to 14, Fugl-Meyer Assessment of the upper limbs (FMA-U) from 6 to 65, and Fugl-Meyer Assessment of the lower limbs (FMAL) from 9 to 34
The results suggested that the modulation of communication between the regions connected by the ipsilesional superior longitudinal fasciculus (SLF)-FP could be a potential mechanism underlying poststroke acupuncture intervention

Summary

Introduction

Stroke is a critical contributor to the risk of death and a common cause of acquired disability on a global scale [1,2,3]. A number of functional magnetic resonance imaging (fMRI) studies have engaged in mapping the functional alterations following a stroke and proposed that motor impairment is relevant to abnormal functional patterns [4, 5]. The structure damage played a key role in motor disability [6, 7], especially the location of the lesion [8]. Disruptive changes in structure and disorganized patterns in function are independently associated with the impaired mobility and have the reciprocal correlation [9].

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Results

Discussion

Conclusion