Effects of acupuncture and computer-assisted cognitive training for post-stroke attention deficits: study protocol for a randomized controlled trial

Abstract

BackgroundA majority of stroke survivors present with cognitive impairments. Attention disturbance, which leads to impaired concentration and overall reduced cognitive functions, is strongly associated with stroke. The clinical efficacy of acupuncture with Baihui (GV20) and Shenting (GV24) as well as computer-assisted cognitive training in stroke and post-stroke cognitive impairment have both been demonstrated in previous studies. To date, no systematic comparison of these exists and the potential beneficial effects of a combined application are yet to be examined. The main objective of this pilot study is to evaluate the effects of computer-assisted cognitive training compared to acupuncture on the outcomes of attention assessments. The second objective is to test the effects of a combined cognitive intervention that incorporates computer-assisted cognitive training and acupuncture (ACoTrain).Methods/DesignAn international multicentre, single-blinded, randomised controlled pilot trial will be conducted. In a 1:1:1 ratio, 60 inpatients with post-stroke cognitive dysfunction will be randomly allocated into either the acupuncture group, the computer-assisted cognitive training group, or the ACoTrain group in addition to their individual rehabilitation programme. The intervention period of this pilot trial will last 4 weeks (30 minutes per day, 5 days per week, Monday to Friday). The primary outcome is the test battery for attentional performance. The secondary outcomes include the Trail Making Test, Test des Deux Barrages, National Institute of Health Stroke Scale, and Modified Barthel Index for assessment of daily life competence, and the EuroQol Questionnaire for health-related quality of life.DiscussionThis trial mainly focuses on evaluating the effects of computer-assisted cognitive training compared to acupuncture on the outcomes of attention assessments. The results of this pilot trial are expected to provide new insights on how Eastern and Western medicine can complement one another and improve the treatment of cognitive impairments in early stroke rehabilitation. Including patients with different cultural backgrounds allows a more generalisable interpretation of the results but also poses risks of performance bias. Using standardised and well-described assessments, validated for each region, is pivotal to allow pooling of the data.Trial registrationClinical Trails.gov ID: NCT02324959 (8 December 2014)

Effects of different acupuncture treatment methods on post-stroke cognitive impairment: study protocol for a multicenter randomized controlled trial

“…Although most of the previous studies on acupuncture treatment of cognitive impairment used a combination of body acupuncture points and head acupoints [23][24][25], we will use only two acupuncture points on the head (GV20 and GV24) for treatment, which is based on the results of literature analysis and a continuation of previous research [26,27]. On the other hand, uni ed acupuncture points may reduce variables and increase the accuracy and persuasion of this study.…”

Effectiveness of theta and gamma electroacupuncture for post-stroke patients on working memory and electrophysiology: study protocol for a double-center, randomized, patient- and assessor-blinded, sham-controlled, parallel, clinical trial

“…The efficacy of Shenting (DU24) is similar to Baihui. These two acupoints are often used in combination in clinical practice [ 12 ]. In modern times, many studies using animal models of stroke have revealed that acupuncture at the Baihui (DU20) and Shenting (DU24) acupoints can ameliorate the learning and memory deficits of rats with cerebral ischemia/reperfusion (I/R) injury [ 47 , 48 ].…”

“…The EA device (Hwato, SDZ-III, Suzhou, China) is placed behind the patient to ensure that the patient does not know the specific frequency parameters of the intervention. Patients should receive an intervention last for 4 weeks (30 min a day, 5 days a week, Monday to Friday) [ 12 ]. During the intervention, patients are asked to be quiet to minimize other interference factors.…”

“…Acupuncture, as the main treatment method of traditional Chinese medicine, is commonly used in the clinical treatment of neurological diseases [ 12 – 14 ]. The method of executing electrical stimulation on the needle body after inserting the needle into the acupoints is called electroacupuncture (EA) [ 15 ].…”

Evaluation of the efficacy and safety of the use of acupuncture for the adjuvant treatment of patients with post-stroke cognitive impairment: protocol for a randomized controlled trial

“…Acupuncture, as an important part of the appropriate technology of traditional Chinese medicine (TCM), is currently the most commonly used complementary and alternative treatment [8].. Acupuncture has a significant regulating effect on human psychology. Modern studies have found that acupuncture can improve cognitive function by affecting cerebral blood flow and hemorheology, protecting the internal structure of brain nerve cells [9].…”