Acupuncture is used as a treatment in stroke patients with aphasia, yet the underlying neural mechanisms are unknown. This study aims to examine the relationship between changes in language function and brain activation using functional magnetic resonance imaging in chronic stroke patients with aphasia who underwent an 8-week acupuncture protocol. Seven chronic stroke patients were identified from a stroke database of a regional acute hospital in Hong Kong between January and July 2007. Patients were treated three times a week over a period of 8 weeks. Four acupoints were stimulated on the weak side of the patient's body. No other rehabilitation was given during the study period. Changes in language function were measured by aphasia quotient (AQ) of Cantonese Aphasia Battery (CAB). Functional magnetic resonance imaging blood oxygen level dependent signals were used to demonstrate the correlation between changes in AQ and brain activation after treatment. The patients were divided into well-recovered and poorly- recovered groups based on their CAB scores at entry. The well-recovered group showed significant improvement in CAB scores after receiving acupuncture treatment. A significant correlation between changes in AQ and blood oxygen level dependent activation in the lesioned Wernicke's speech area was found. These preliminary results suggest that acupuncture may be beneficial to language recovery in chronic stroke patients.

Acupuncture has historically been recommended as adjunctive treatment to patients with stroke, but its effectiveness has yet to be proven. This case series aims to report the results of using functional magnetic resonance imaging (fMRI), together with motor function evaluations, to assess the effect of acupuncture on stable patients after stroke. Eleven chronic stroke patients underwent fMRI and motor function evaluations of their impaired upper limb before and after an 8-week period of acupuncture on two acupoints (Hegu LI-4 and Quchi LI-11), without undergoing simultaneous rehabilitation. Improvements in motor functions of the impaired upper limb were found after acupuncture treatment. Changes in cortical activities were closely related to the finding of improved motor functions. A larger and stronger activation was found in the sensorimotor area of the lesioned hemisphere after receiving the acupuncture intervention. Conjunction analysis demonstrated common regions that were activated during either motor task or acupuncture stimulation. Acupuncture may improve functions of the impaired upper limb in chronic stroke patients via modulating peri-infarct regions that are responsible for plasticity of the motor cortex.

Background: Motor impairment is common after stroke. Along with classic integrated physical and occupational therapy, acupuncture is also suggested as an adjunctive therapy. Objective: To evaluate the effectiveness of acupuncture on upper limb motor recovery of patients with subacute stroke. Design, Setting, and Patients: Eighteen subacute stroke patients, transferred from a regional acute hospital to a convalescent hospital for rehabilitation in Hong Kong, from March 2005 to November 2007. Two clinical and behavioral evaluations for motor function were given to each participant along with 2 functional magnetic resonance imaging (fMRI) scans. Intervention: Patients were treated with acupuncture 3 times a week over 8 weeks. The intervention set of 3 acupoints is known to influence the motor system, while a second control set does not. Physical and occupational therapy were also used as treatment (parallel to the interventions with acupuncture). Main Outcome Measures: The primary outcome measure was fMRI, and the secondary measures were clinical and behavioral parameters, concentrating on motor function and disability using reliable and validated scales. Results: Data on hand grip demonstrated reappearance of brain activations in the motor-related areas of the lesioned hemisphere in both groups after intervention. As with clinical and behavioral evaluations, the fMRI data on hand grip demonstrated no statistically significant differences between the groups. Conclusions: These preliminary results suggest that acupuncture may be beneficial to motor recovery in subacute stroke patients. However, the application of control acupuncture points did not result in a different recovery. The supplemental effect of acupuncture to physical and occupational therapy needs to be explored in further studies.