Altered effective connectivity of resting state networks by acupuncture stimulation in stroke patients with left hemiplegia

Fu, Chuanxi; Li, Kuangshi; Ning, Yanzhe; Tan, Zhenghuai; Zhang, Yong; Liu, Hongwei; Han, Xiao; Zou, Yihuai

doi:10.1097/md.0000000000008897

Cited by 15 publications

(17 citation statements)

References 52 publications

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“…In our previous studies [46][47][48][49][50], we gradually and deeply proved that compared with healthy subjects, acupuncture at Yanglingquan(GB34) in patients with hemiplegia showed speci c activation of brain regions and expressed bilateral effects, from the perspectives of single spot, single network and compound network, which provides a relatively deep research foundation for the hypothesis of bilateral cerebral coordinated regulation in this study. For the purposes of task control and reducing the confounding factors of intervention, single acupoint is selected in this study, which is not the actual clinical practice.…”

Section: Discussionmentioning

confidence: 70%

The underlying mechanisms of bilateral cerebral remodeling and acupuncture for rehabilitation after post-stroke hemiplegia: study protocol for a cross-sectional multimodal fMRI trial

Geng

Wang

et al. 2021

Preprint

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Background Acupuncture plays a positive role in promoting the rehabilitation of post-stroke hemiplegia, but its specific central effect mechanism remains unclear. The changes of cerebral integrity, bilateral regulation and coordination are closer to the actual running state of brain after injury, while the research on bilateral cerebral reconstruction after unilateral motor pathway injury is not sufficient. The study of cerebral functional remodeling after stroke and mechanisms of acupuncture for post-stroke hemiplegia still faces many challenges. This study will explore the the underlying mechanisms of bilateral cerebral remodeling and acupuncture for post-stroke hemiplegia rehabilitation. Methods This is a single-center, cross-sectional, multimodal functional magnetic resonance imaging(fMRI) study, with participants and data analyst blinded. 24 post-stroke patients with motor dysfunction and 24 healthy subjects that meet the inclusion criteria will be recruited in this study. All the patients enrolled in this study will receive the conventional standard medical care according to their chief doctors. Clinical data including motor function scales, high-sensitivity C-reactive protein(hs-CRP), other related scales as well as fMRI imaging data will be collected at baseline and 2 weeks later. Functional connectivity(FC) is the primary and core outcome indicator of this study. Voxel-mirrored homotopic connectivity (VMHC), fractional anisotropy (FA),voxel-based morphometry (VBM), Fugl-Meyer Assessment(FMA) and hs-CRP are secondary outcome indicators. During the MRI scan, true or sham Yanglingquan(GB34) acupuncture stimulation on the left side and passive finger movement will be performed on the participants. The connection between cerebral imaging indicators and clinical indicators will be obtained by calculating the Pearson’s correlation coefficient. Discussion The results of our study will help to understand the cerebral remodeling mechanism of motor function improvement after stroke better and provide data support for the better application of acupuncture in clinical practice. Trial registration: Chinese Clinical Trial Registry (ChiCTR1900022220). Regisered on 30 March 2019. http://www.chictr.org.cn/showprojen.aspx?proj=37359

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Section: Discussionmentioning

confidence: 70%

The underlying mechanisms of bilateral cerebral remodeling and acupuncture for rehabilitation after post-stroke hemiplegia: study protocol for a cross-sectional multimodal fMRI trial

Geng

Wang

et al. 2021

Preprint

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“…According to the results of previous studies [ 32 ], acupuncture is beneficial for motor function recovery in stroke patients with hemiplegia and is considered to be safe [ 33 , 34 ]. The mechanism of motor recovery due to acupuncture in stroke hemiplegia may be related to brain plasticity [ 35 ]. Acupuncture in one limb can stimulate bilateral brain areas, increase cerebral blood flow and regulate motor areas damaged by stroke [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…Acupuncture in one limb can stimulate bilateral brain areas, increase cerebral blood flow and regulate motor areas damaged by stroke [ 36 ]. For example, acupuncture in yanglingquan can regulate multiple brain networks in stroke patients [ 35 ]. Thus, it promotes the recovery of hemiplegia limbs.…”

Section: Discussionmentioning

confidence: 99%

Effect of ‘hand and foot acupuncture with twelve needles’ on hemiplegia patients with ‘qi deficiency and blood stasis’ syndrome in the convalescent stage of Ischaemic stroke: study protocol for a randomised controlled trial

Fang

Wang

Liu³

et al. 2021

Trials

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Background Hemiplegia is a common sequela after stroke, and acupuncture is one of the most common physical therapies used to treat hemiplegia during the recovery stage after ischaemic stroke. ‘Hand and foot acupuncture with twelve needles’ is an acupuncture treatment performed after stroke. The principal objective of this study is to assess the efficacy and safety of ‘hand and foot acupuncture with twelve needles’ for hemiplegia in the convalescent stage of ischaemic stroke. Methods This is the protocol for a randomised, controlled clinical trial with two groups: a ‘hand and foot acupuncture with twelve needles’ group and a routine acupuncture group. A total of 208 participants will be randomly assigned to two different groups in a 1:1 ratio and will undergo conventional rehabilitation. Limb function will be evaluated by the simplified Fugl-Meyer assessment scale, Barthel Index, modified Ashworth scale and National Institute of Health stroke scale. The participants will be evaluated at baseline (on the day of enrolment) and followed up at 2 weeks, 1 month, 2 months and 3 months after enrolment. Discussion The results of this study will provide evidence on the effectiveness of ‘hand and foot acupuncture with twelve needles’ in the treatment of limb dysfunction that can be used for future evaluations. Trial registration Chictr.org.cnChiCTR1900021774. Registered on 8 March 2019

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“…Moreover, a study on the effects of sample size on cerebral response to acupuncture with fMRI had shown that the imaging results in 17 healthy controls were similar to the results of studies with 21 cases [ 34 ], which may suggest that approximately 20 subjects maybe a relatively common choice in rs-fMRI studies after acupuncture. The sample size in acupuncture mechanism study using rs-fMRI with stroke patients typically ranges from a few cases to approximately 20 cases [ 33 , 35 – 37 ]. Because this trial is a neuroimaging study, the primary outcome will be based on the subjects' MRI image processing, and patients with left cerebral ischemia accompanied by right limb hemiplegia will be enrolled in this study so as to ensure the relative consistency of cerebral ischemia lesions and reveal the neuroimaging mechanism more regularly.…”

Section: Methodsmentioning

confidence: 99%

Neuromodulatory Effect of Sensorimotor Network Functional Connectivity of Temporal Three-Needle Therapy for Ischemic Stroke Patients with Motor Dysfunction: Study Protocol for a Randomized, Patient-Assessor Blind, Controlled, Neuroimaging Trial

Zhao

Zhang

Liu

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Background. The clinical efficacy of temporal three-needle therapy for stroke dysfunction has been previously demonstrated in China. However, the central mechanism of temporal three-needle therapy remains unclear. Temporal three-needle projects the sensory cortex and the motor cortex, which may impact the cortex function. Current studies seldom focus on it. Hence, according to the “scalp-cortex corresponding theory,” the underlying mechanism of temporal three-needle remains a domain for further research. Methods. This trial is designed to provide objective and visual evidence for the neuromodulatory effect and neuroimaging mechanism of temporal three-needle therapy for stroke patients. This ongoing study is a prospective, randomized, controlled, patient-assessor blind, single-center, neuroimaging trial involving two-parallel patient groups and a healthy control group. Forty eligible patients will be recruited from Shenzhen Nanshan District People’s Hospital and randomized into either the experimental group or the control group. Twenty healthy volunteers will be recruited in the healthy control group and undergo baseline magnetic resonance imaging scans without any intervention. Patients in the control group will receive acupuncture at Dingnieqianxiexian (MS6), in addition to basic medicine and rehabilitative treatments. Patients in the experimental group will receive temporal three-needle therapy plus basic medicine and rehabilitative treatments 5 days per week, 10 sessions over two consecutive weeks. The primary outcome is resting-state functional connectivity, and the secondary outcomes are regional homogeneity, amplitude of low-frequency fluctuations, Fugl–Meyer assessment of the upper limb, and modified Barthel Index. All outcome measures will be assessed at baseline and after 2 weeks of intervention. Discussion. The results will explore the neuromodulatory effects and illustrate the central mechanism of temporal three-needle treatment from the network-level viewpoint of sensorimotor network functional plasticity and promote widespread application in real-world practice. This trial was registered at Chinese Clinical Trial Registry on 14 March 2018 with ChiCTR1800015209.

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Altered effective connectivity of resting state networks by acupuncture stimulation in stroke patients with left hemiplegia

Abstract: Supplemental Digital Content is available in the text

Cited by 15 publications

References 52 publications

The underlying mechanisms of bilateral cerebral remodeling and acupuncture for rehabilitation after post-stroke hemiplegia: study protocol for a cross-sectional multimodal fMRI trial

The underlying mechanisms of bilateral cerebral remodeling and acupuncture for rehabilitation after post-stroke hemiplegia: study protocol for a cross-sectional multimodal fMRI trial

Effect of ‘hand and foot acupuncture with twelve needles’ on hemiplegia patients with ‘qi deficiency and blood stasis’ syndrome in the convalescent stage of Ischaemic stroke: study protocol for a randomised controlled trial

Neuromodulatory Effect of Sensorimotor Network Functional Connectivity of Temporal Three-Needle Therapy for Ischemic Stroke Patients with Motor Dysfunction: Study Protocol for a Randomized, Patient-Assessor Blind, Controlled, Neuroimaging Trial

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