Department of Acupuncture, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Department of Rehabilitation, Shanghai Changning Tianshan Traditional Chinese Medicine Hospital, Shanghai, China.
Acupunct Med. 2023 Apr;41(2):86-95. doi: 10.1177/09645284221086289. Epub 2022 Jun 7.
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.
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.
Both groups showed significant improvements in motor function, daily life ability and degree of disability, as measured by FMA, mRS and mBI ( < 0.05), and the SR group showed a significantly greater improvement ( < 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.
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.
NCT03120650 (http://www.clinicaltrials.gov).
头皮针刺已被证明可有效改善缺血性中风后的运动功能，但针对其作用的中枢机制的研究较少。本研究旨在探讨头皮针刺对缺血性中风后运动功能障碍和自发性脑活动变化的临床效果。
这是一项评估者和分析者双盲、多中心随机对照试验。共纳入 108 例恢复期运动功能障碍的缺血性中风患者，分为头皮针刺联合康复治疗组（SR 组）和单纯康复治疗组（RE 组）。两组患者每周接受 5 次治疗，共 8 周。主要结局指标为 Fugl-Meyer 评估（FMA）。次要结局指标包括改良巴氏指数（mBI）、改良 Rankin 量表（mRS）和使用静息态功能磁共振成像（rs-fMRI）技术获得的低频振幅（fALFF）值。
两组患者的 FMA、mRS 和 mBI 评分均显著提高（<0.05），且 SR 组的运动功能、日常生活能力和残疾程度的改善更为显著（<0.05）。与 RE 组相比，SR 组 fALFF 值增加的区域位于小脑、顶内叶、中央前回、额上回和顶叶。FMA 评分的改善与患侧中央前回的基线 fALFF 值相关性最强。
头皮针刺可改善恢复期缺血性中风患者的运动功能，其疗效与调节与运动相关的脑区有关。患侧中央后回和中央前回的 fALFF 值可能是运动功能障碍预后的潜在临床指标。
NCT03120650（http://www.clinicaltrials.gov）。
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