Kortikale Aktivierungen durch Yamamoto Neue Schädelakupunktur (YNSA) in der Behandlung von Schlaganfallpatienten: Eine Sham-kontrollierte Studie mit Hilfe der funktionellen Kernspintomographie (fMRI)

Abstract

Background Yamamoto New Scalp Acupuncture was first introduced 35 years ago. Today, it is the most often used microsystem in acupuncture next to auriculotherapy . Aims Can the efficacy of YNSA – by means of cortical activation – be visualized in fMRI? The neurological correlates of YNSA were studied with the aid of fMRI in 17 patients with ischemic stroke damage in the right hemi-sphere suffering from residual paresis of the left hand versus 19 healthy volunteers. A new acupuncture needle for magnetic resonance imaging developed by Schockert was used in this study. Methods The study was performed in a 1.5 tesla Philips MRI system (TR 3000 ms, TE 50 ms, FA 90 °) in a box-car design. Patients were instructed via video goggles to open or close their left hand for five seconds. The data were analyzed by the SPM 2 evaluation program. All patients and volunteers were first subjected to sham acupressure and then YNSA. The sham acupuncture consisted of a single application of pressure by a finger nail in the centre of an imaginary line between SJ 23 and Gb 14. In the verum YNSA, needles were applied to the yin points of the basal ganglia, cerebellum and basic point C. Results Of the 17 patients, only five measurements could be evaluated due to motion artefacts. It was not possible to make a group analysis because of the inhomogeneous lesions. The cortical activations were different in each patient. In contrast to the sham acupuncture, verum acupuncture displayed significant cortical activation in the motor, premotor and supplemental motor cortex of the patients. It was possible to evaluate the measurements of the volunteers as a group analysis. In contrast to the patients, the volunteers displayed a decrease in cortical activation during YNSA. Conclusions Eight patients in this study experienced a perceptible improvement in mobility and a reduction of spasticity as a result of stroke treatment with YNSA. These motor improvements positively correlate to cortical activity which can be visualized by functional magnetic resonance imaging. Further more extensive clinical and fMRI studies are necessary in order to investigate YNSA-induced cortical activation in stroke patients in deeper detail.