This study aimed to explore the changes in functional connections between cerebral hemispheres and local brain regions functional activities in patients with acute ischemic stroke (AIS) treated with International Standard Scalp Acupuncture (ISSA). Thirty patients with middle cerebral artery AIS in the dominant hemisphere were selected and randomly divided into two groups such as the control group and the scalp acupuncture group, with 15 patients in each group. Patients in the control group were treated with conventional Western medicine, while patients in the scalp acupuncture group received ISSA (acupuncture at the parietal midline [MS5], acupuncture at the left anterior parietotemporal oblique line [MS6] and acupuncture at the left posterior parietotemporal oblique line [MS7]) for one course of treatment. All patients were evaluated for treatment efficacy and received whole brain resting state functional magnetic resonance imaging (Rs‐fMRI) scan before and after treatment. The observational indicators included: (a) the National Institutes of Health Stroke Scale (NIHSS) scores and the simplified Fugl‐Meyer Assessment (SFMA) scores; (b) analyses of the amplitude of low‐frequency fluctuation (ALFF), regional homogeneity (ReHo) and voxel‐mirrored homotopic connectivity (VMHC). The results showed a significant difference in the NIHSS scores before and after treatment in the scalp acupuncture group compared with the control group ( p < .05), indicating that patients improved better after scalp acupuncture treatment. Compared with the control group, the VMHC, ALFF and ReHo values in the scalp acupuncture group increased after treatment. The VMHC values increased in the brain regions dominated by bilateral BA6 and BA8; the ALFF values increased in the left BA39 and the adjacent superior temporal gyrus and middle temporal gyrus; and the ReHo values increased in the brain regions extending from left middle temporal gyrus (including BA21) to BA37, and the brain regions extending from the left BA40 and angular gyrus to BA7. The present study indicated that scalp acupuncture can specifically strengthen the functional activities of the brain regions related to sensory integration, language processing and motor coordination in the middle aged and elderly patients with AIS of the dominant cerebral hemisphere, and can strengthen bilateral frontal lobe motor control. This study may provide a scientific basis for the clinical application of ISSA treatment in patients with AIS, and may also provide a preliminary research basis for further animal experiments.

Object. To explore the specific effect of the international standard scalp acupuncture (ISSA) on patients with brain dysfunction after acute ischemic stroke (AIS) based on resting-state functional magnetic resonance imaging (Rs-fMRI). 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.

ObjectiveTo explore the different compensatory mechanisms of brain function between the patients with brain dysfunction after acute ischemic stroke (AIS) in the dominant hemisphere and the non-dominant hemisphere based on Resting-state Functional Magnetic Resonance Imaging (Rs-fMRI).MethodsIn this trial, 15 healthy subjects (HS) were used as blank controls. In total, 30 hemiplegic patients with middle cerebral artery acute infarction of different dominant hemispheres were divided into the dominant hemisphere group (DH) and the non-dominant hemisphere group (NDH), scanned by a 3.0 T MRI scanner, to obtain the amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) and compare the differences.ResultsCompared with the HS, increased ALFF values in the brain areas, such as the bilateral midbrain, were observed in DH. Meanwhile decreased ReHo values in the brain areas, such as the right postcentral gyrus (BA3), were also observed. Enhanced ALFF values in the brain areas, such as the left BA6, and enhanced ReHo values in the brain areas, such as the left precuneus, were observed in the NDH. The ALFF and ReHo values of the right BA9 and precentral gyrus were both increased. Compared with DH, the NDH group showed lower ALFF values in the left supplementary motor area and lower ReHo values in the right BA10.ConclusionAfter acute infarction in the middle cerebral artery of the dominant hemisphere, a compensation mechanism is triggered in brain areas of the ipsilateral cortex regulating motor-related pathways, while some brain areas related to cognition, sensation, and motor in the contralateral cortex are suppressed, and the connection with the peripheral brain regions is weakened. After acute infarction in the middle cerebral artery of the non-dominant hemisphere, compensatory activation appears in motor control-related brain areas of the dominant hemisphere. After acute middle cerebral artery infarction in the dominant hemisphere, compared with the non-dominant hemisphere, functional specificity in the bilateral supplementary motor area weakens. After acute middle cerebral artery infarction in different hemispheres, there are hemispheric differences in the compensatory mechanism of brain function.

Objective: Resting State Functional Magnetic Resonance Imaging (Rs-fMRI) was used to explore the changes on the functional connections between cerebral hemispheres and local functional activities in patients with acute ischemic stroke dysfunction treated by International Standard Scalp Acupuncture.Methods: 30 patients of acute ischemic stroke in the middle cerebral artery supply area of the dominant hemisphere were selected and randomly divided into treatment group and control group at a ratio of 1:1 according to the random number table method, with 15 patients in each group. Patients in the control group were treated with conventional western medicine, while patients in the treatment group combined the International Standard Scalp Acupuncture (MS5, MS6 and MS7). All the patients were evaluated for efficacy and received whole brain fMRI scan before and after the treatment. The observation indicators included (1) NHISS score and its sub-item scores related to dyskinesia before and after treatment. (2) the amplitude of low-frequency fluctuations (ALFF), regional homogeneity (ReHo), and voxel-mirror homotopy connection (VMHC) analyzed based on Matlab 2012a platform, SPM12, and REST1.8 before and after treatment.Results: 1. The difference of NHISS scores between the two groups was statistically significant before and after treatment (P<0.05), indicates that patients in the treatment group were improved better. 2. The changes in brain area activation between the two groups of patients were as follows: (1) The values of VMHC increased in brain regions dominated by bilateral BA6 and BA8; (2) The values of ALFF increased mainly in the left BA39 and the adjacent superior temporal gyrus and middle temporal gyrus . (3) The values of ReHo increased in the brain region of left middle temporal gyrus (including BA21) and its extending to BA37, and the left BA40 and angular gyrus and its extending to BA7. Conclusion: Scalp acupuncture can help the recovery of the patients with acute infarction of superior middle cerebral artery and its mechanism possibly related to the special changes in the regional functional activities of sensory integration, language processing and motor coordination, also the bilateral motor control of frontal lobe.Trial registration: Trial Registration Number: Chinese Clinical Trial Registry ChiCTR-IOR-15007672. Registration date: November 7, 2015.

Objective: To explore the different compensatory mechanisms of brain function between the patients with brain dysfunction after acute ischemic stroke (AIS) in dominant hemisphere and the non-dominant hemisphere, based on Resting-state Functional Magnetic Resonance Imaging (Rs-fMRI).Methods: In this trial, 15 healthy subjects(HS) were used as blank controls. 30 hemiplegic patients with middle cerebral artery acute infarction of the different dominant hemisphere were divided into the dominant hemisphere group (DH) and the non-dominant hemisphere group (NDH), scanned by a 3.0 T MRI scanner, to obtain the amplitude of low frequency fluctuations (ALFF) and regional homogeneity (ReHo) and compare the differences.Results: Compared with the HS, increased ALFF values in the brain areas such as bilateral midbrain were observed in DH. While decreased ReHo values in the brain areas such as right postcentral gyrus (BA3) were also observed. Enhanced ALFF values in the brain areas such as left BA6, and enhanced ReHo values in the brain areas such as left precuneus were observed in NDH. And the ALFF and ReHo values of right BA9 and precentral gyrus were both increased. Compared with DH, NDH have lower ALFF values in left supplementary motor area and lower ReHo values in right BA10.Conclusion: After acute infarction in the middle cerebral artery of the dominant hemisphere, a compensation mechanism is triggered in brain areas of the ipsilateral cortex regulating motor-related pathways, while some brain areas related to cognition, sensation and motor in the contralateral cortex are suppressed, and the connection with the peripheral brain regions is weakened. After acute infarction in the middle cerebral artery of the non-dominant hemisphere, compensatory activation appears in motor control-related brain areas of the dominant hemisphere. After acute middle cerebral artery infarction in the dominant hemisphere, compared with the non-dominant hemisphere, functional specificity in bilateral supplementary motor area weakens. After acute middle cerebral artery infarction in different hemispheres, there are hemispheric differences in the compensatory mechanism of brain function. Trial registration: Ethics Committee of the China-Japan Union Hospital at Jilin University approval. Trial Registration Number:Chinese Clinical Trial Registry ChiCTR-IOR-15007672. Registered July 18, 2016 (No. 2016ks043).