Bilateral effect of acupuncture on cerebrum and cerebellum in ischaemic stroke patients with hemiparesis:a randomised clinical and neuroimaging trial  

作　　者：Tianzhu Chen Tianyan Chen Yong Zhang Kang Wu Yihuai Zou 

机构地区：[1]Department of Neurology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing,China [2]School of Journalism and Communication,Renmin University of China,Beijing,China [3]Department of Rehabilitation,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing,China

出　　处：《Stroke & Vascular Neurology》2024年第3期306-317,I0264-I0273,共22页卒中与血管神经病学（英文）

基　　金：funded by the National Natural Science Foundation of China(Grant No.82174331,Grant No.81873257);the Beijing Municipal Natural Science Foundation(Grant No.7182104).

摘　　要：Background Acupuncture involving the limb region may be effective for stroke rehabilitation clinically,but the visualised and explanatory evidence is limited.Our objectives were to assess the specific effects of acupuncture for ischaemic stroke(IS)patients with hemiparesis and investigate its therapy-driven modification in functional connectivity.Methods IS patients were randomly assigned(2:1)to receive 10 sessions of hand-foot 12 needles acupuncture(HA,n=30)or non-acupoint(NA)acupuncture(n=16),enrolling gender-matched and age-matched healthy controls(HCs,n=34).The clinical outcomes were the improved Fugl-Meyer Assessment scores including upper and lower extremity(ΔFM,ΔFM-UE,ΔFM-LE).The neuroimaging outcome was voxel-mirrored homotopic connectivity(VMHC).Static and dynamic functional connectivity(sFC,DFC)analyses were used to study the neuroplasticity reorganisation.Results 46 ISs(mean(SD)age,59.37(11.36)years)and 34 HCs(mean(SD)age,52.88(9.69)years)were included in the per-protocol analysis of clinical and neuroimaging.In clinical,ΔFM scores were 5.00 in HA group and 2.50 in NA group,with a dual correlation betweenΔFM andΔVMHC(angular:r=0.696,p=0.000;cerebellum:r=-0.716,p=0.000)fitting the linear regression model(R2=0.828).In neuroimaging,ISs demonstrated decreased VMHC in bilateral postcentral gyrus and cerebellum(Gaussian random field,GRF corrected,voxel p<0.001,cluster p<0.05),which fitted the logistic regression model(AUC=0.8413,accuracy=0.7500).Following acupuncture,VMHC in bilateral superior frontal gyrus orbital part was increased with cerebro-cerebellar changes,involving higher sFC between ipsilesional superior frontal gyrus orbital part and the contralesional orbitofrontal cortex as well as cerebellum(GRF corrected,voxel p<0.001,cluster p<0.05).The coefficient of variation of VMHC was decreased in bilateral posterior cingulate gyrus(PPC)locally(GRF corrected,voxel p<0.001,cluster p<0.05),with integration states transforming into segregation states overall(p<0.05).There was no acupuncture-related a

关 键 词：ACUPUNCTURE ACUPUNCTURE random 

分 类 号：R743.3[医药卫生—神经病学与精神病学]