Mechanism of motor recovery in hemiplegic patients with ischemic stroke: a study of acupuncture-induced blood oxygenation level dependent functional magnetic resonance imaging and diffusion tensor imaging

Abstract

Objective To investigate the mechanism of motor recovery in hemiplegic patients after ischemic stroke using acupuncture-induced blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI) and diffusion tensor imaging (DTI). Methods A total of 20 patients with left hemiplegia after ischemic stroke were enrolled in the study. DTI raw data was used to reconstruct three dimensional image of pyramidal tract through post-processing of workstation, and the damage and recovery of the pyramidal tract were observed. SPM8 and other software were used to compare and analyze the acupuncture-induced BOLD-fMRI data, and the distribution differences in the brain activation areas were compared. Results The muscle strength grade and the Fugl-Meyer scale score at 6 months were significantly higher than those during 3-6 weeks after stroke onset. DTI showed that the right pyramidal tract had different degrees of damage, interrupt, compression, and displacement during 3-6 weeks after onset, and there were different degrees of repair, remodeling at 6 months after onset. Acupuncture-induced BOLD-fMRI showed that compared with 3-6 weeks after onset, the positive activated brain regions were mainly located in the motor related brain regions in bilateral frontal cortex and the left cerebellum, and the negative activated brain regions were mainly located in the limbic system, such as bilateral anterior cingulate cortex and parahippocampal gyrus. Conclusions The mechanism of motor recovery in hemiplegic patients after ischemic stroke may be mainly related to the regulation and compensation of motor related brain regions, as well as the regulation of muscular tension through the extrapyramidal system. The repair and reorganization of the damaged motor pathway may also be the mechanism of motor recovery in hemiplegic patients after ischemic stroke. Key words: Stroke; Brain Ischemia; Hemiplegia; Recovery of Function; Acupuncture; Diffusion Tensor Imaging; Magnetic Resonance Imaging