The cerebrovascular response to traditional acupuncture after stroke

Abstract

Acupuncture is useful in treating the nausea and vomiting related to chemotherapy, adult postoperative surgery pain and postoperative dental pain. We obtained single-photon emission computed tomography (SPECT) brain perfusion images of six patients with middle cerebral artery occlusion obtained before and after acupuncture and compared the changes in regional cerebral blood flow (rCBF) to those in normal control. Images were obtained before and after acupuncture at six traditional acupoints (LI 4, 10, 11, 15 and 16 and TE5) in the affected arm. The baseline image was subtracted from the postacupuncture image, to produce a subtraction image displaying only voxels with values >2 SD from the mean and those voxels were coregistered to the baseline SPECT or T2-weighted MRI. Similar images were obtained before and after acupuncture of eight normal volunteers. Statistical parametric mapping with a threshold of P =0.001 and a corrected P of 0.05 was performed for group comparison between postacupuncture and baseline SPECT. Focally increased CBF was seen in all patients especially in the hypoperfused zone surrounding the ischaemic lesion, the ipsilateral or contralateral sensorimotor area, or both. Normal subjects showed increased rCBF mainly in the parahippocampal gyrus, premotor area, frontal and temporal areas bilaterally and ipsilateral globus pallidus. Acupuncture stimulation after stroke patients appears to activate perilesional or use-dependent reorganised sites and might be a way of looking at brain reorganisation.

Increased Brain Activation in Motor Cortex After Acupuncture Treatment for Motor Recovery in Chronic Stroke Patients

“…A brain imaging study that used single-photon emission computed tomography has shown that acupuncture increases activity in peri-infarct regions within the motor cortex of stroke patients [6]. In the present study, conjunction analysis demonstrated common regions that are activated during either acupuncture stimulation or hand grip task.…”

“…Acupuncture alters pain threshold via release of neurotransmitters and neuropeptides [5]. Acupuncture also induces changes in regional cerebral blood flow surrounding infarcts [6]. However, to date, no convincing scientific evidence from clinical trials has been published showing acupuncture to be effective as a therapy after stroke in enhancing functional improvement [7][8][9][10].…”

An fMRI study of somatosensory‐implicated acupuncture points in stable somatosensory stroke patients

“…fMRI study of brain activation may illustrate the functional substrate of the purported therapeutically beneficial effect of acupuncture in stroke rehabilitation and features of the neural mechanism of acupuncture. Lee et al (13) reported acupuncture-induced changes in regional cerebral blood flow (rCBF) after stroke, using single photon emission computed tomography (SPECT) perfusion imaging. Focally increased CBF was observed in all patients, especially in the hypoperfused zone surrounding the ischemic lesion, the ipsilateral or contralateral sensorimotor area, or both.…”

A Meta-Analysis of Acupuncture Use in the Treatment of Cognitive Impairment After Stroke

“…Litscher and colleagues 32 reported that acupuncture may increase mean values of regional cerebral oxygen saturation and significantly increase mean blood flow velocity of the right middle cerebral artery. Lee and coworkers 33 investigated the correlation between acupuncture and neuroimaging using single-photon emission computed tomography in patients with stroke. The results of their study suggested that postacupuncture images showed multiple activation sites in the periphery of the ischemic area or in the hypoperfused zone in the affected vascular territory.…”