Zhang Junfeng, Wang Meng, Chen Hao, Fan Shiyu, Sun Rongshan, Wang Lin, Cong Shan, Yu Tao, Qian Yulin
Rehabilitation Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.
Front Neurol. 2025 Jun 2;16:1542489. doi: 10.3389/fneur.2025.1542489. eCollection 2025.
To observe the modulation and clinical efficacy of acupuncture combined with continuous theta-burst stimulation (cTBS) on cerebral cortical activity in post-stroke upper limb spasticity.
Patients with upper limb spasticity after stroke were randomly divided into two groups. The control group ( = 15) received acupuncture treatment, and the experimental group ( = 15) received cTBS treatment of the premotor cortex of the healthy side in addition to acupuncture. The efficacy was evaluated before and after the first treatment and 2 weeks after treatment. MAS, FMA, MBI, fNIRS and F wave evaluation were observed in the two groups.
After treatment, there were significant differences between the two groups in MAS, FMA-UE, MBI, F-wave amplitude, and the F/M amplitude ratio index of the experimental group ( 0.05). Comparison between groups, the MAS-elbow flexor in the experimental group decreased significantly after the first treatment and 2 weeks after treatment. After 2 weeks of treatment, the HbO concentration in the CH4 channel exercise phase in the experimental group increased compared with the control group ( <0.05). The strength of functional connection in the left primary motor area (M1)-the left primary somatosensory cortex (S1), the left S1-the right premotor cortex and supplementary motor area (PMC & SMA), and the left S1-the left PMC&SMA showed an increasing trend (0.05 < < 0.1). The F wave amplitude was significantly lower than before intervention, and the difference was significant ( < 0.05).
Acupuncture combined with cTBS can relieve upper limb spasticity, enhance motor function, improve daily living ability, and reduce excessive spinal cord excitability. It can also increase HbO concentration in the cerebral cortex. However, large-sample studies are still needed to prove the effect of this therapy on brain networks.
This study provides evidence for the potential of combined cTBS and acupuncture in stroke rehabilitation.
identifier ChiCTR2400083631.
观察针刺联合连续θ波爆发刺激（cTBS）对脑卒中后上肢痉挛患者大脑皮质活动的调节作用及临床疗效。
将脑卒中后上肢痉挛患者随机分为两组。对照组（n = 15）接受针刺治疗，试验组（n = 15）在针刺基础上接受患侧运动前区的cTBS治疗。在首次治疗前、治疗后及治疗后2周进行疗效评估。观察两组的改良Ashworth量表（MAS）、Fugl-Meyer评估量表上肢部分（FMA-UE）、改良Barthel指数（MBI）、功能性近红外光谱技术（fNIRS）及F波评估。
治疗后，两组在MAS、FMA-UE、MBI、F波幅及试验组的F/M波幅比指数方面存在显著差异（P < 0.05）。组间比较，试验组首次治疗后及治疗后2周时，MAS肘关节屈肌评分显著降低。治疗2周后，试验组CH4通道运动期的血红蛋白氧（HbO）浓度较对照组升高（P < 0.05）。左侧初级运动区（M1）-左侧初级躯体感觉皮层（S1）、左侧S1-右侧运动前区及辅助运动区（PMC & SMA）、左侧S1-左侧PMC & SMA之间的功能连接强度呈增加趋势（0.05 < P < 0.1）。F波幅显著低于干预前，差异有统计学意义（P < 0.05）。
针刺联合cTBS可缓解上肢痉挛，增强运动功能，提高日常生活能力，降低脊髓过度兴奋性，还可增加大脑皮质HbO浓度。然而，仍需大样本研究来证实该疗法对脑网络的作用。
本研究为cTBS与针刺联合应用于脑卒中康复的潜力提供了证据。
标识符ChiCTR2400083631。
