Effect of acupuncture in the acute phase of intracerebral hemorrhage on the prognosis and serum BDNF: a randomized controlled trial

Abstract

BackgroundIntracerebral hemorrhage (ICH) is a common cerebrovascular disease, with a high rate of disability. In the literature on Chinese traditional medicine, there is increasing evidence that acupuncture can help hematoma absorption and improve neurological deficits after cerebral hemorrhage. Brain-derived neurotrophic factor (BDNF), one of the most studied neurotrophic factors, is involved in a variety of neurological functions and plays an important role in brain injury recovery. We investigated the effect of acupuncture intervention in the acute phase of ICH on the prognosis and serum BDNF levels of several patient groups.ObjectiveTo investigate the influence of acupuncture on the prognosis and brain-derived neurotrophic factor (BDNF) levels in patients in the acute phase of ICH.MethodsFrom November 2021 to May 2022, 109 subjects were consecutively enrolled, including patients with ICH, who were randomized into the acupuncture group (AG) and sham acupuncture group (SAG), and a control group (CG). The CG received the same acupuncture intervention as the AG, and the SAG received sham acupuncture, with 14 interventions in each group. The level of consciousness of patients with ICH was assessed and serum BDNF levels were measured in all three groups before the intervention and at 3 weeks after onset, and the level of consciousness and outcomes were assessed at 12 weeks after onset.ResultsAfter the intervention, the level of consciousness of the AG improved significantly (P < 0.05); the BDNF level of only the AG increased significantly (P < 0.05); the changes in Glasgow Coma Scale (GCS) score and BDNF level were significantly greater in the AG than in the SAG (P < 0.05), especially for locomotion (P < 0.05). At 12 weeks post-onset, the AG showed better outcomes and recovery of consciousness than the SAG (P < 0.05).

Effect of Acupuncture on Recovery of Consciousness in Patients with Acute Traumatic Brain Injury: A Multi-Institutional Cohort Study

“…Based on the results in Table 6 and Table 3 , it is suggested that motor response was related to disease severity, further confirming the theory above. With the same classifications as our primary outcome, the result suggested that acupuncture could improve the motor response score in the acute phase of TBI, which was consistent with the findings of the RCT on acute-phase ICH subjects by Li et al in [ 22 ], suggesting that acupuncture could improve motor response. Therefore, we could further hypothesize that the effect of consciousness recovery is mainly reflected in motor response recovery based on the above findings.…”

“…There is also limited evidence to support that the effect of CENA is superior compared to standard acupuncture. The RCT conducted by Li et al also showed significant improvements in the GCS by a median of five points after 12 weeks of intervention in the acupuncture group [ 22 ]. Our baseline data showed that there was a lower percentage of female and higher CAD subjects compared to theirs.…”

“…It has been widely used clinically in Asia to treat various diseases and has gradually expanded to other countries as a complementary and alternative medicine, with its use becoming more common in recent decades [ 16 , 17 , 18 ]. Acupuncture has been used as a feasible approach to consciousness recovery among TBI and stroke patients [ 19 , 20 , 21 , 22 ]. So far, only a small number of studies have been published on consciousness recovery with acupuncture treatment for TBI.…”

Efficacy of acupuncture in experimental intracerebral hemorrhage: a systematic review and meta-analysis

“…Studies have shown that acute head acupuncture intervention can improve Clinical Neurological Function Deficit Scale scores in ICH patients (5). Furthermore, Li et al reported that early head acupuncture intervention can improve the level of consciousness and serum brain-derived neurotrophic factor levels in ICH patients (6). Numerous preclinical studies on ICH have demonstrated that acupuncture can improve neurological function in ICH rats by modulating inflammatory factors, cell apoptosis, autophagy, and other mechanisms, thereby alleviating pathological changes in brain tissue (7)(8)(9)(10)(11)(12).…”

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“…Furthermore, acupuncture improves the integrity of the blood-brain barrier by downregulating the expression of caveolin-1 and matrix metalloproteinases (53). Additionally, acupuncture promotes the secretion of neurotrophic factors and angiogenesis around the hematoma following ICH (6,54,55). Based on these mechanisms, acupuncture exerts neuroprotective effects, thereby improving neurological recovery after ICH.…”