Abstract
Design A parallel-group randomized controlled trial. Participants. 30 hemiplegic patients with middle cerebral artery acute infarction of the dominant hemisphere. Interventions. 30 patients were divided into 2 groups randomly. 15 patients in the treatment group (TG) were treated with ISSA, needling at the parietal midline (MS5) and left anterior/posterior parietal-temporal oblique lines (MS6 and MS7), combined with western routine treatment. While another 15 patients in the control group (CG) received routine treatment only. Main Outcome Measures. (1) Functional connectivity (FC): patients received brain scan using 3.0 T MRI after the treatment for 1 week. Based on the Matlab2012a platform, SPM12 software and DPABI software were used to process the scanning data and finally the functional connectivity of the brain was obtained. (2) National Institute of Health Stroke Scale (NIHSS) score. Results The difference in the NIHSS score between the two groups of patients before and after treatment was statistically significant (tNIHSS = 2.225; PNIHSS = 0.038), indicating that TG had a better effect. Centered to the seed region of the left supplementary motor area (SMA) (−5.32, 4.85, 61.38), FC increased at the left middle cerebellar peduncle, left cerebellum posterior lobe (uvula and declive), vermis, fusiform gyrus, lingual gyrus, inferior occipital gyrus, calcarine, cuneus, precuneus, BA7, BA18 and BA19, etc. Centered to the seed region of the left parahippocampal gyrus (PG) (−21.17, −15.95, −20.70), FC increased at the left precuneus, inside-paracingulate, inferior parietal gyrus, paracentral lobule, BA5, BA6, BA7, and BA40, right median cingulate, precuneus, BA19, BA23, and BA31, etc. Conclusions It is indicated that ISSA can regulate the brain functional connection in patients with middle cerebral artery acute infarction in the dominant hemisphere and specifically strengthen the connections between visual, cognitive, motor control, and planning-related brain regions, which may be related to the recovery of movement in the mechanism. This trial is registered with ChiCTR-IOR-15007672.
Highlights
Characterized by high morbidity, disability, and mortality rate, stroke has been ranked as the leading cause of motor disability across the world
It is indicated that international standard scalp acupuncture (ISSA) can regulate the brain functional connection in patients with middle cerebral artery acute infarction in the dominant hemisphere and strengthen the connections between visual, cognitive, motor control, and planning-related brain regions, which may be related to the recovery of movement in the mechanism. is trial is registered with ChiCTR-IOR-15007672
Erefore, in order to further clarify the specific effect of ISSA on brain functional connectivity in acute ischemic stroke (AIS) patients, this study observes the specific changes of brain functional connectivity in AIS patients after ISSA intervention by RsfMRI besides the observation of its curative effect
Summary
Characterized by high morbidity, disability, and mortality rate, stroke has been ranked as the leading cause of motor disability across the world. The high disability rate of the stroke patients will still remain the same Both the stroke patients who missed the right time for thrombolysis and thrombectomy and those with contraindications need to begin rehabilitation treatment as early as possible to gain a better recovery [3]. Rs-fMRI is an important method to study the therapeutic mechanism of acupuncture in the treatment of diseases, especially to analyze the FC among different brain regions. FC obtains the changes in the overall brain functions of stroke patients, which is regarded as one of the hot spots in the study of mechanism of the therapeutic effect of acupuncture. Zhang et al [9] believed that the possible mechanism of acupuncture regulating effect on the default mode network (DMN) in stroke patients could be explained the cognitive ability and motor function recovery. Erefore, in order to further clarify the specific effect of ISSA on brain functional connectivity in AIS patients, this study observes the specific changes of brain functional connectivity in AIS patients after ISSA intervention by RsfMRI besides the observation of its curative effect
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