Motor function and fALFF modulation in convalescent-period ischemic stroke patients after scalp acupuncture therapy: a multi-centre randomized controlled trial

Yijun Zhan; Jian Pei; Jun Wang; Qinhui Fu; Jia Xu; Minghang Yan; Yiwen Cai; Xiao Cui; Wencheng Ye; Mingxia Fan; Qiurong Yu; Jie Jia

doi:10.1177/09645284221086289

Motor function and fALFF modulation in convalescent-period ischemic stroke patients after scalp acupuncture therapy: a multi-centre randomized controlled trial

Acupunct Med. 2023 Apr;41(2):86-95. doi: 10.1177/09645284221086289. Epub 2022 Jun 7.

Authors

Yijun Zhan¹, Jian Pei¹, Jun Wang², Qinhui Fu¹, Jia Xu¹, Minghang Yan¹, Yiwen Cai¹, Xiao Cui², Wencheng Ye², Mingxia Fan³, Qiurong Yu³, Jie Jia⁴

Affiliations

¹ Department of Acupuncture, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
² Department of Rehabilitation, Shanghai Changning Tianshan Traditional Chinese Medicine Hospital, Shanghai, China.
³ Department of Physics, Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China.
⁴ Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai, China.

PMID: 35673804
DOI: 10.1177/09645284221086289

Abstract

Background: Scalp acupuncture has been found to be effective at improving motor function after ischemic stroke, but few studies examining its central mechanisms of action have been carried out. The aim of this study was to investigate the clinical effects of scalp acupuncture on motor dysfunction and changes in spontaneous brain activity in patients with ischemic stroke.

Methods: This was an evaluator- and analyst-blinded, multi-center randomized controlled trial. A total of 108 convalescent-stage ischemic stroke patients with motor dysfunction were allocated to receive either scalp acupuncture combined with rehabilitation treatment (SR group) or rehabilitation treatment alone (RE group). Patients in both groups received treatment 5 times per week for 8 weeks. The primary outcome measure was the Fugl-Meyer assessment (FMA). Secondary outcome measures included the modified Barthel index (mBI), modified Rankin scale (mRS) and values of fractional amplitude of low frequency fluctuation (fALFF) acquired using a resting-state functional magnetic resonance imaging (rs-fMRI) technique.

Results: Both groups showed significant improvements in motor function, daily life ability and degree of disability, as measured by FMA, mRS and mBI (p < 0.05), and the SR group showed a significantly greater improvement (p < 0.05). Compared with the RE group, the areas where the fALFF values increased in the SR group were located in the cerebellum, praecuneus, precentral gyrus, superior frontal gyrus and parietal lobe. The improvement in FMA scores had the strongest correlation with the baseline fALFF values of the ipsilateral precentral gyrus.

Conclusion: Scalp acupuncture improved motor function in convalescent-period ischemic stroke patients, and effects were correlated with regulation of motor-relevant brain regions. The fALFF value of the ipsilateral precentral and postcentral gyri could be potential clinical indices for prognostication of motor dysfunction.

Trial registration number: NCT03120650 (http://www.clinicaltrials.gov).

Keywords: fALFF; ischemic stroke; motor dysfunction; randomized controlled trial; scalp acupuncture.

Publication types

Randomized Controlled Trial
Multicenter Study

MeSH terms

Acupuncture Therapy* / methods
Humans
Ischemic Stroke*
Scalp
Stroke Rehabilitation* / methods
Stroke* / complications
Treatment Outcome

Associated data

ClinicalTrials.gov/NCT03120650