Abstract

BackgroundScalp acupuncture (SA) and repetitive transcranial magnetic stimulation (rTMS) are effective for treating cerebral infarction. This study aims to examine the efficacy and safety of SA and electromagnetic convergence stimulation (SAEM-CS), which was developed through collaboration between conventional medical physicians and doctors who practice traditional Korean medicine. SAEM-CS was designed to improve function in patients with cerebral infarction, compared to the improvement after conventional stroke rehabilitation, SA, and rTMS therapeutic approaches.Methods/designThis study is a prospective, outcome assessor-blinded, randomized controlled clinical trial with a 1:1:1:1 allocation ratio. Participants with motion or sensory disabilities caused by a first-time cerebral infarction (n = 60) that had occurred within 1 month of the study onset will be randomly assigned to control, SA, rTMS, or SAEM-CS groups. All groups will receive two sessions of conventional rehabilitation treatment per day. The SA group will receive SA on the upper limb area of MS6 and MS7 (at the lesional hemisphere) for 20 min, the rTMS group will receive low-frequency rTMS (LF-rTMS) treatment on the hot spot of the M1 region (motor cortex at the contralesional hemisphere) for 20 min, and the SAEM-CS group will receive LF-rTMS over the contralesional M1 region hot spot while receiving simultaneous SA stimulation on the lesional upper limb area of MS6 and MS7 for 20 min. SA, rTMS, and SAEM-CS treatments will be conducted once/day, 5 days/week (excluding Saturdays and Sundays) for 3 weeks, for a total of 15 sessions. The primary outcome will be evaluated using the Fugl‐Meyer Assessment, while other scales assessing cognitive function, activities of daily living, walking, quality of life, and stroke severity are considered secondary outcome measures. Outcome measurements will be conducted at baseline (before intervention), 3 weeks after the first intervention (end of intervention), and 4 weeks after intervention completion.DiscussionThis study aims to explore the efficacy and safety of SAEM-CS on cerebral infarction. Collaborative research combined traditional Korean and conventional medicines, which can be useful in developing new treatment technologies.Trial registration KCT0001768. Registered on 14 January 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1611-y) contains supplementary material, which is available to authorized users.

Highlights

  • Scalp acupuncture (SA) and repetitive transcranial magnetic stimulation are effective for treating cerebral infarction

  • Collaborative research combined traditional Korean and conventional medicines, which can be useful in developing new treatment technologies

  • The purpose of this study is to explore the efficacy and safety of SA and electromagnetic convergence stimulation (SAEM-CS), which was developed through a collaborative study between the Department of Physical and Rehabilitation Medicine at Chonnam National University Hospital and the Departments of Acupuncture and Moxibustion Medicine and Traditional Korean Medicine Rehabilitation at Dong-Shin University

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Summary

Introduction

Scalp acupuncture (SA) and repetitive transcranial magnetic stimulation (rTMS) are effective for treating cerebral infarction. The local application of repetitive transcranial magnetic stimulation (rTMS) influences the neural excitability of selected brain areas [9], and it has been reported that lowfrequency stimulation (1 Hz) suppresses local neural activities [10, 11], whereas high-frequency stimulation (≥5 Hz) activates local neural activities [12]. Both high-frequency rTMS (HF-rTMS) applied to the lesional hemisphere and low-frequency rTMS (LFrTMS) applied to the contralesional hemisphere are beneficial for upper limb hemiparesis in patients with chronic stroke [11, 13,14,15,16,17] and in the early phase of stroke [9, 18,19,20]

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