1Department of Pathology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
Abstract
The discovery of adult neurogenesis was a turning point in the field of neuroscience. Adult neurogenesis offers an enormous possibility to open a new therapeutic paradigm of neurodegenerative diseases and stroke. Recently, several studies suggested that acupuncture may enhance adult neurogenesis. Acupuncture has long been an important treatment for brain diseases in the East Asia. The scientific mechanisms of acupuncture treatment for the diseases, such as Alzheimer’s disease, Parkinson’s disease, and stroke, have not been clarified yet; however, the neurogenic effect of acupuncture can be a possible reason. Here, we have reviewed the studies on the effect of stimulation at various acupoints for neurogenesis, such as ST36 and GV20. The suggested mechanisms are also discussed including upregulation of brain-derived neurotrophic factor, glial cell line-derived neurotrophic factor, basic fibroblast growth factor and neuropeptide Y, and activation of the function of primo vascular system.
1Department of Acu-morxibustion, Wuhan Hospital of Integrated Chinese & Western Medicine, Wuhan 430022, China. bluesea-zl2000@163.com
Abstract
OBJECTIVE:
To explore the possible mechanism of scalp acupuncture (SA) in relieving cerebral ischemia reperfusion (CI-R) injury.
METHODS:
Seventy male SD rats were randomized into sham-operation (sham, n = 10), model (n = 30) and SA (n = 30) groups. The later 2 groups were further divided into 24 h, 48 h and 72 h subgroups respectively, with 10 cases in each. CI-R model was established by middle cerebral artery occlusion (MCAO) and reperfusion. Electroacupuncture (2 mA, 2 Hz/100 Hz) was applied to “Dingnie Houxiexian” (MS 7) and “Dingnie Qianxiexian” (MS 6) for 30 min, once every 24 h. Changes of the animal behavior were observed by using neurological severity score (NSS), nuclear factor-kappa B (NF-kappaB) and cyclooxygenase (COX-2) contents and their mRNA expression were detected with enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) techniques respectively.
RESULTS:
Following modeling, the NSS at 24 h, 48 h and 72 h after MCAO increased significantly, while compared with model group, NSS of SA group at the 3 time-points decreased considerably (P < 0.05, P < 0.01), suggesting an improvement of the neurological functions after SA treatment. In comparison with sham group, NF-kappaB mRNA and COX-2 mRNA, and NF-kappaB and COX-2 protein expression of model group in the infarcted cerebral tissue were significantly upregulated at the 3 time-points (P < 0.01) except NF-KB mRNA at 72 h (no significant change), while compared with the 3 time-points of model group, NF-kappaB mRNA and COX-2 mRNA, and NF-KB and COX-2 protein expression of SA group were downregulated obviously (P < 0.01) except COX-2 mRNA at 72 h.
CONCLUSION:
Scalp acupuncture can suppress cerebral ischemia-induced upregulation of NF-kappaB mRNA and COX-2 mRNA, and NF-kappaB and COX-2 protein expression, which may contribute to its effect in promoting neurofunctional rehabilitation of CI-R rats by reducing cytokines-mediated inflammatory reaction.
PMID: 20128288 [PubMed – indexed for MEDLINE]
**Effect of acupuncture therapy for postponing Wallerian degeneration of cerebral infarction as shown by diffusion tensor imaging
J Alternative & Complementary medicine
2012 Dec;18(12):1154-60. doi: 10.1089/acm.2011.0493. Epub 2012 Sep 5.
Effect of acupuncture therapy for postponing Wallerian degeneration of cerebral infarction as shown by diffusion tensor imaging.
1Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
Abstract
OBJECTIVE:
One aim of this study was to investigate the effects of acupuncture on cerebral function of patients with acute cerebral infarction. Another goal was to evaluate the relationship between acupuncture treatment and motor recovery patients with stroke and to provide a foundation for using acupuncture therapy for such patients.
DESIGN:
Twenty (20) patients with recent cerebral infarction were divided randomly to an acupuncture group and a control group. The infarction area in each patient was in the basal ganglia or included the basal ganglia with an area size of > 1 cm(2). Serial diffusion tensor imaging (DTI), fluid-attenuated inversion recovery (FLAIR), and T2-weighted imaging (T(2)WI) scans were performed on all patients and the results were evaluated using the National Institute of Health Stroke Scale and the Barthel Index each week. DTI images were postprocessed and analyzed. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values of abnormal signals on DTI in the infarction areas and cerebral peduncles were calculated for both groups and compared with one another.
RESULTS:
(1) The ADC value of infarction lesions decreased at stroke onset; then, a significant elevation was observed after the acute stage, and a significant reduction in FA values was observed from stroke onset to the chronic stage. (2) The ADC of the bilateral cerebral peduncle was reduced on the infarction side. (3) There was a significant difference in ADC and FA values between the acupuncture and control groups. The FA value was higher in the acupuncture group than the control group.
CONCLUSIONS:
ADC and FA values might correlate to patient recovery and reveal the progress of secondary degeneration. Acupuncture treatment is effective for protecting neurons and facilitating recovery.
PMID: 22950816 [PubMed – indexed for MEDLINE] PMCID: PMC3513977
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Effect of scalp-acupuncture on plasma and cerebral TNF-alpha and IL-1beta contents in acute cerebral ischemia/reperfusion injury rats.
1Department of Acu-moxibustion, Wuhan Integrated Chinese and Western Medicine Hospital, Wuhan 430022, China. bluesea-zl2000@163.com
Abstract
OBJECTIVE:
To explore the underlying mechanism of scalp-acupuncture therapy in the treatment of acute cerebral ischemia (ACI) in the rat.
METHODS:
A total of 140 SD female rats were randomly assigned to sham-operation (n=20), model (n=60), scalp-acupuncture (SA, n=60) groups, and the later two groups were further divided into 24 h, 48 h and 72 h subgroups separately, with 20 cases in each. Among them, 70 rats were used for cerebral tissue section, and the other 70 cases for homogenating cerebral tissue. ACI model was established by occlusion of the middle cerebral artery (MCAO) for 1 h and reperfusion. EA (2/100 Hz, 2 mA) was applied to bilateral “Dingnie Houxiexian” (MS 7) and “Dingnie Qianxiexian” (MS 6) for 20 min, once daily for 1 d, 2 d and 3 d respectively. The rat’s neurological severity score (NSS) was assessed before and after EA. Blood and brain tissue were sampled for detecting TNF-alpha and IL-1beta contents respectively with enzyme-linked immunosorbent assay. Haematoxylin-eosine (H&E) staining method was used for displaying the inflammatory cells in the ischemic brain tissue.
RESULTS:
(1) After ACI, NSS at each time-point increased significantly, while compared with model group, NSS of SA group decreased apparently 72 h after ACI (P<0.01). Compared with the corresponding time-points of sham-operation group, the number of inflammatory cells, plasma and cerebral TNF-alpha and IL-1beta contents at 24 h, 48 h and 72 h in model group increased considerably (P<0.01, 0.05). In comparison with the corresponding time-points of model group, the number of inflammatory cells at 48 h and 72 h, plasma and cerebral TNF-alpha and IL-1beta contents at 72 h in SA group declined significantly (P<0.01).
CONCLUSION:
Scalp-acupuncture can relieve inflammatory cell infiltration, and reduce plasma and cerebral TNF-alpha and IL-1beta contents in ACI rats, which may contribute to its effect in promoting neurofunctional recovery.
Using MicroPET Imaging in Quantitative Verification of the Acupuncture Effect in Ischemia Stroke Treatment
Using MicroPET Imaging in Quantitative Verification of the Acupuncture Effect in Ischemia Stroke Treatment
Acupuncture has been indispensable in Chinese medicine. However, its function still remains elusive. This paper studies the effect of acupuncture in ischemia stroke treatment using the Sprague Dawley rat animal model. We induced focal cerebral ischemia in rats using the middle cerebral artery occlusion (MCAO) procedure. For each rat in the real acupuncture group (n = 63), the sham acupoint treatment group (n = 62), and the blank control group (n = 30), we acquired 3-D fluorodeoxyglucose-microPET images at baseline, after MCAO, and after treatment, respectively. Then, we measured the changes of the injury-volume in the right hemisphere of these rats. The measurements showed that real acupuncture slightly reduced the injury-volume, sham acupoint treatment increased the injury-volume, and blank control had no obvious effect in reducing the injury-volume. Statistical tests also confirmed that acupuncture was more effective than random stimulus in improving the metabolic recovery after stroke.
1School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China.
Abstract
OBJECTIVE:
Acupuncture is beneficial in treating stroke neuropsychiatric symptoms. The present study aimed to identify functional brain response to active acupuncture in patients with unilateral ischaemic stroke using functional MRI (fMRI).
METHODS:
A total of 10 patients aged 47-65 years with left hemispheric ischaemic stroke received single-session manual acupuncture at the TE5 point of the affected (right) forearm. A 6-min tactile control procedure in which an acupuncture needle tip was alternately touched and removed from the skin at the acupuncture point for 30 s each was performed first, followed by active acupuncture in a blocking paradigm consisting of six 30-s twist blocks of rotation interspersed between six 30-s blocks of rest. A whole brain scan was simultaneously conducted on a 3.0-T imager. Activated and deactivated brain regions during tactile stimulation and active acupuncture relative to rest were obtained via group analysis.
RESULTS:
Compared to tactile stimulation, needling with twist manipulation modulated many more widespread brain areas. All the brain areas activated and deactivated by active acupuncture relative to tactile stimulation were distributed in the primary sensorimotor and medial frontal cortex of the unaffected, but not the affected hemisphere.
CONCLUSIONS:
Active acupuncture results in lateralisation of functional cerebral response to the contralateral unaffected hemisphere in patients with unilateral stroke. This lateralisation may represent an effect of acupuncture in enhancing a compensatory process by redistributing functions into the intact cortex, particularly in the unaffected hemisphere.
Acupuncture Stimulation for Motor Cortex Activities: A 3T fMRI Study
Sin-Soo Jeun et al, Am. J. Chin. Med.33, 573 (2005). DOI: 10.1142/S0192415X0500317X
Acupuncture Stimulation for Motor Cortex Activities: A 3T fMRI Study
Sin-Soo Jeun
Correspondence to: Dr. Sin-Soo Jeun, Department of Neurosurgery, Kangnam St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, #505 Banpo-Dong, Seocho-Gu, Seoul 137-040, Korea. Tel: (+82) 2-590-2734, Fax: (+82) 2-594-4248.
Department of Neurosurgery, The Catholic University of Korea, Seoul, Korea
Jeong-Seok Kim
Department of Biomedical Engineering, The Catholic University of Korea, Seoul, Korea
Bum-Soo Kim
Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
Sang-Dong Park
Dong-Seo Hospital of Oriental Medicines, Seoul, Korea
Eun-Chul Lim
Dong-Seo Hospital of Oriental Medicines, Seoul, Korea
Gi-Soon Choi
Dong-Seo Hospital of Oriental Medicines, Seoul, Korea
Bo-Young Choe
Department of Biomedical Engineering, The Catholic University of Korea, Seoul, Korea
Abstract
The acupoint, GB34, located in the back of the knee, is known to be effective in recovering motor function after a stroke. This study uses a functional magnetic resonance imaging (fMRI) study with 3T scanner to investigate whether or not acupuncture of GB34 produces a significant response of the modulation of somatomotor areas. A fMRI of the whole brain was performed in ten normal healthy subjects during two task stimulations of acupuncture manipulation on GB34 and sham points, inserting and twisting the needle for 25 seconds at a rate of approximately 120 times per minute; the needle manipulation was paused for a duration of 25 seconds as a control state. The process was repeated four times to have four epochs of stimulation. Bilateral sensorimotor areas (BA 3, 4, 6 and 7) showed approximately 6% of stimulation-related BOLD signal contrast, whereas very few areas were activated when sham stimulation was given. Acupuncture stimulation in GB34 modulates the cortical activities of the somatomotor area in humans. The present findings may shed light on the CNS mechanism of motor function by acupuncture, and form a basis for future investigations of motor modulation circuits in stroke patients.
Correlated Change in Upper Limb Function and Motor Cortex Activation After Verum and Sham Acupuncture in Patients with Chronic Stroke
The Journal of Alternative and Complementary Medicine. June 2007, Vol. 13, Issue 5 13(5): 527-532. doi:10.1089/acm.2007.6316.
Correlated Change in Upper Limb Function and Motor Cortex Activation After Verum and Sham Acupuncture in Patients with Chronic Stroke
To cite this article:
Judith D. Schaechter, Brendan D. Connell, William B. Stason, Ted J. Kaptchuk, David E. Krebs, Eric A. Macklin, Rosa N. Schnyer, Joel Stein, Donna M. Scarborough, Stephen W. Parker, Chris A. McGibbon, and Peter M. Wayne.
Published in Volume: 13 Issue 5: June 29, 2007
Judith D. Schaechter, Ph.D. Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA.
Brendan D. Connell, B.A. Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA.
William B. Stason, M.D. Harvard School of Public Health, Boston, MA.
Ted J. Kaptchuk, O.M.D. Osher Institute, Harvard Medical School, Boston, MA.
David E. Krebs, Ph.D. Massachusetts General Hospital Biomotion Laboratory, Harvard Medical School, Boston, MA.
Eric A. Macklin, Ph.D. New England Research Institutes, Watertown, MA.
Rosa N. Schnyer, L.Ac. Osher Institute, Harvard Medical School, Boston, MA.
New England School of Acupuncture, Watertown, MA.
Joel Stein, M.D. Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA.
Donna M. Scarborough, M.S. Massachusetts General Hospital Biomotion Laboratory, Harvard Medical School, Boston, MA.
Stephen W. Parker, M.D. Department of Neurology, Massachusetts General Hospital, Boston, MA.
Chris A. McGibbon, Ph.D. Institute of Biomedical Engineering, University of New Brunswick, Federicton, New Brunswick, Canada.
Peter M. Wayne, Ph.D. Osher Institute, Harvard Medical School, Boston, MA.
New England School of Acupuncture, Watertown, MA.
ABSTRACT
Background: Acupuncture may improve motor function in patients with chronic hemiparetic stroke, yet the neural mechanisms underlying such an effect are unknown. As part of a sham-controlled, randomized clinical trial testing the efficacy of a 10-week acupuncture protocol in patients with chronic hemiparetic stroke, we examined the relationship between changes in function of the affected upper limb and brain activation using functional magnetic resonance imaging (fMRI).
Methods: Seven (7) chronic hemiparetic stroke patients underwent fMRI and testing of function of the affected upper limb (spasticity and range-of-motion) before and after a 10-week period of verum (N = 4) or sham (N = 3) acupuncture. The correlation between changes in function of the affected upper limb and brain activation after treatment was tested across patients.
Results: We found a significant positive correlation between changes in function of the affected upper limb (spasticity and range of motion) and activation in a region of the ipsilesional motor cortex. Patients treated with verum acupuncture showed a trend toward a greater maximum activation change in this motor cortical area as compared to those treated with sham acupuncture.
Conclusions: Acupuncture may improve function of the affected upper limb in chronic hemiparetic stroke patients by increasing activity in the ipsilesional motor cortex.
Acupuncture regulates the glucose metabolism in cerebral functional regions in chronic stage ischemic stroke patients—a PET-CT cerebral functional imaging study
Centrally Administered Nociceptin/Orphanin FQ and the Neuroprotective Effect of Electroacupuncture Against Cerebral Ischemia Following Middle Cerebral Artery Occlusion/Reperfusion in Rats
Huanmin Gao, Bo Xiang, Cao Wang
Medical Acupuncture. Jun 2009, Vol. 21, No. 2: 99-106
1Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
2Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA
Christina WY Hui-Chan, Department of Physical Therapy, University of Illinois at Chicago, 1919 West Taylor Street (MC898), Chicago, IL 60612, USA. Email: chuichan@uic.edu
Abstract
Objectives: To determine whether adding electrical stimulation of upper limb acupoints to conventional rehabilitation during acute stroke could produce greater and longer lasting motor improvements of the arm.
Setting: Acute stroke wards, followed by rehabilitation hospitals and subjects’ residences.
Participants: Seventy-three patients ≤ 46 hours post stroke onset with moderate to severe weakness in the arm contralateral to the side of stroke.
Intervention: All subjects received conventional rehabilitation. Twenty-nine received additional electrical stimulation, 21 received additional placebo-electrical stimulation and 23 received conventional rehabilitation only, as control. Electrical stimulation or placebo-electrical stimulation was applied to acupoints GB20, LI15, LI11, LI10 and LI4, 60 minutes a day, five days a week, for four weeks.
Measurements: Primary outcome measures were hand grip and pinch strength, with Action Research Arm Test (ARAT) as secondary outcome measure. These were assessed on the affected arm at recruitment, then 4 (W4), 12 (W12) and 24 weeks (W24) afterwards.
Results: Post-hoc analysis showed that the electrical stimulation group had greater improvements than the control group in hand grip (P = 0.015) and pinch strength (P = 0.007) at W4, with the gains maintained at W12 and W24. In contrast, the placebo-electrical stimulation group did not differ from either the control or the electrical stimulation group. Between-group improvements in ARAT scores from baseline to W24 (by 16.8 in control, 27.6 in placebo-electrical stimulation group and 26.3 in electrical stimulation group) were not significant.
Conclusions: Adding four weeks of electrical stimulation during acute stroke appears to produce greater and longer lasting hand grip and pinch strength improvements than administering conventional rehabilitation alone.
Acupuncture is used as a treatment in stroke patients with aphasia, yet the underlying neural mechanisms are unknown. This study aims to examine the relationship between changes in language function and brain activation using functional magnetic resonance imaging in chronic stroke patients with aphasia who underwent an 8-week acupuncture protocol. Seven chronic stroke patients were identified from a stroke database of a regional acute hospital in Hong Kong between January and July 2007. Patients were treated three times a week over a period of 8 weeks. Four acupoints were stimulated on the weak side of the patient’s body. No other rehabilitation was given during the study period. Changes in language function were measured by aphasia quotient (AQ) of Cantonese Aphasia Battery (CAB). Functional magnetic resonance imaging blood oxygen level dependent signals were used to demonstrate the correlation between changes in AQ and brain activation after treatment. The patients were divided into well-recovered and poorly- recovered groups based on their CAB scores at entry. The well-recovered group showed significant improvement in CAB scores after receiving acupuncture treatment. A significant correlation between changes in AQ and blood oxygen level dependent activation in the lesioned Wernicke’s speech area was found. These preliminary results suggest that acupuncture may be beneficial to language recovery in chronic stroke patients.
Copyright (c) 2010 Korean Pharmacopuncture Institute. Published by .. All rights reserved.
1Daniel Freeman Memorial Hospital, Inglewood, CA, USA.
Abstract
This pilot study obtained preliminary data on the effects of acupuncture treatment combined with a standard inpatient stroke rehabilitation program on poststroke motor recovery and physical function. Thirty-two patients with acute stroke were recruited and randomized to 1 of 2 treatment arms: standard rehabilitation (control group) or a combination of acupuncture and standard rehabilitation (acupuncture group). Baseline and discharge assessments were obtained on motor recovery as measured by the Fugl-Meyer (FM) Assessment and on physical function as measured by the Functional Independence Measure (FIM). Comparisons were made between the acupuncture and control group in total FM and FIM as well as for each subscale of the FM and FIM. No differences between treatment groups were found in the total FM or the total FIM. However, statistically significant benefit due to acupuncture was observed for the FM lower extremity motor function subscale (P = 0.01) and the tub/shower transfer mobility subscale of the FIM (P = 0.03). Marginally significant benefit due to acupuncture was noted for the toilet transfer mobility subscale of the FIM (P = 0.09). The effectiveness of acupuncture as an adjunct to standard poststroke rehabilitation programs may be demonstrated when more specific measures of stroke motor recovery and physical function are used.
1System Emotional Science, University of Toyama, Toyama, Japan; Department of Judo Neurophysiotherapy, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.
Abstract
Effective therapeutic factors in acupuncture therapy include specific stimulation points, called acupoints, and specific sensations, called de-qi, that are induced by needling manipulation. Human neuroimaging studies have reported that acupuncture stimulation with de-qi sensations induced specific activity patterns in the brain and modulated autonomic nervous activity. However, acupoints and nonacupoints have been reported to induce de-qi sensations. Thus, it remains unclear whether these physiological responses induced by acupuncture and associated with therapeutic efficacy are related to specific stimulation sites (acupoints) or unique de-qi sensations. This review focuses on the cerebral hemodynamic responses and autonomic nervous activity changes induced by acupuncture stimulation at acupoints and nonacupoints with and without de-qi sensations. We argue that the specific sensations induced by acupuncture are more important than the specific stimulation sites for inducing cerebral hemodynamic and autonomic responses and that autonomic responses during acupuncture, which might be important for therapeutic efficacy, might be mediated though the brain activity changes exemplified by the cerebral hemodynamic responses during acupuncture.
Clinical Effects of Scalp Electrical Acupuncture in Stroke: A Sham-Controlled Randomized Clinical Trial
To cite this article: Wu Tu Hsing, Marta Imamura, Kayleen Weaver, Felipe Fregni, and Raymundo S. Azevedo Neto. The Journal of Alternative and Complementary Medicine. April 2012, 18(4): 341-346. doi:10.1089/acm.2011.0131.
Published in Volume: 18 Issue 4: April 19, 2012 Online Ahead of Print: April 10, 2012
Wu Tu Hsing, MD, PhD,1 Marta Imamura, MD, PhD,2 Kayleen Weaver, BA,3 Felipe Fregni, MD, PhD,3,4 and Raymundo S. Azevedo Neto, MD, PhD1
1Department of Pathology, University of São Paulo School of Medicine, São Paulo, Brazil.
2Division of Physical Medicine, Institute of Orthopaedics and Traumatology, University of São Paulo School of Medicine, São Paulo, Brazil.
3Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA.
4Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Objectives: The majority of individuals who survive a stroke are disabled because of persisting neurological impairments. The objective of this study was to evaluate the efficacy of subcutaneous electrical stimulation of the scalp in spontaneous functional recovery of patients with chronic ischemic stroke, by evaluating clinical, neurological, and functional findings.
Subjects and methods: Sixty-two (62) subjects who were at least 18 months postdiagnosis of ischemic stroke were randomized to receive 10 sessions of placebo or active low-frequency electrical stimulation (2/100 Hz) using subcutaneous acupuncture needles over the scalp. Functional and neurological evaluations were indexed by the Barthel, Rankin, and National Institutes of Health Stroke Scale (NIHSS).
Results: Results show that there was a significant difference in functional improvement between the sham and active group as indexed by NIHSS scale. The active group had a larger functional improvement after 10 sessions of scalp electrical acupuncture. The other two functional scales (Rankin and Barthel) failed to show significant differences between the two treatment groups.
Conclusions: These results support further testing of scalp electrical acupuncture for the treatment of stroke as well further mechanistic studies to understand mechanisms associated with the observed improvement. Further studies need to consider longer follow-up assessments to investigate potential functional changes associated with electrical acupuncture.
1Balgrist University Hospital, University of Zurich, Zurich, Switzerland
2Brain Research Institute, University of Zurich, Zurich, Switzerland
3Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
Michelle L. Starkey, University of Zurich, Balgrist University Hospital, Forchstrasse 340, CH-8008 Zurich, Switzerland Email: mstarkey@paralab.balgrist.ch
Abstract
Stroke is a common problem, and with an aging population, it is likely to become more so. Outcomes from stroke are wide ranging from death to complete recovery, but the majority result in severe motor impairments that affect quality of life and become a burden on health care systems, family, and friends. Therapeutically, removal of thromboses can greatly improve outcomes, but for many stroke sufferers, the only currently available therapy is rehabilitative training in which spared brain areas and fiber tracts are strengthened and trained to take over new functions.
Experimental data in animals show that this is in part based on changes in the connectivity of the brain and spinal cord and on the growth of new nerve fiber branches, a process called structural plasticity. So, just how plastic is the brain after a stroke? In this review, we explore the factors that affect plasticity after strokes, such as age and the overall size and location of the lesion. We discuss the peri-infarct area as extensive research has shown that processes occurring there are likely to be involved mechanistically in plastic changes in cortical circuitry. Finally, we review promising interventions being tested preclinically and discuss those that have been translated into clinical research.
Journal of NeurophysiologyPublished 1 April 1998Vol. 79no. 4, 2119-2148
Plasticity of Primary Somatosensory Cortex Paralleling Sensorimotor Skill Recovery From Stroke in Adult Monkeys
ChristianXerri, Michael M.Merzenich, Bret E.Peterson, WilliamJenkins
Abstract
Adult owl and squirrel monkeys were trained to master a small-object retrieval sensorimotor skill. Behavioral observations along with positive changes in the cortical area 3b representations of specific skin surfaces implicated specific glabrous finger inputs as important contributors to skill acquisition. The area 3b zones over which behaviorally important surfaces were represented were destroyed by microlesions, which resulted in a degradation of movements that had been developed in the earlier skill acquisition. Monkeys were then retrained at the same behavioral task. They could initially perform it reasonably well using the stereotyped movements that they had learned in prelesion training, although they acted as if key finger surfaces were insensate.
However, monkeys soon initiated alternative strategies for small object retrieval that resulted in a performance drop. Over several- to many-week-long period, monkeys again used the fingers for object retrieval that had been used successfully before the lesion, and reacquired the sensorimotor skill. Detailed maps of the representations of the hands in SI somatosensory cortical fields 3b, 3a, and 1 were derived after postlesion functional recovery. Control maps were derived in the same hemispheres before lesions, and in opposite hemispheres.
Among other findings, these studies revealed the following
1) there was a postlesion reemergence of the representation of the fingertips engaged in the behavior in novel locations in area 3b in two of five monkeys and a less substantial change in the representation of the hand in the intact parts of area 3b in three of five monkeys.
2) There was a striking emergence of a new representation of the cutaneous fingertips in area 3a in four of five monkeys, predominantly within zones that had formerly been excited only by proprioceptive inputs. This new cutaneous fingertip representation disproportionately represented behaviorally crucial fingertips.
3) There was an approximately two times enlargement of the representation of the fingers recorded in cortical area 1 in postlesion monkeys. The specific finger surfaces employed in small-object retrieval were differentially enlarged in representation.
4) Multiple-digit receptive fields were recorded at a majority of emergent, cutaneous area 3a sites in all monkeys and at a substantial number of area 1 sites in three of five postlesion monkeys. Such fields were uncommon in area 1 in control maps. 5
) Single receptive fields and the component fields of multiple-digit fields in postlesion representations were within normal receptive field size ranges.
6) No significant changes were recorded in the SI hand representations in the opposite (untrained, intact) control hemisphere. These findings are consistent with “substitution” and “vicariation” (adaptive plasticity) models of recovery from brain damage and stroke.
Stroke. 2010 Apr;41(4):e171-9. doi: 10.1161/STROKEAHA.109.573576. Epub 2010 Feb 18.
Abstract
BACKGROUND AND PURPOSE:
Acupuncture is a low-risk treatment with purported claims of effectiveness for poststroke rehabilitation. To comprehensively assess the efficacy of acupuncture in poststroke rehabilitation, we conducted a systematic review and meta-analysis of all randomized clinical trials of acupuncture for poststroke rehabilitation.
To evaluate the therapeutic effect of comprehensive therapeutic protocol of electroacupuncture combined with active-blood-and-dissolve-stasis herbs and rehabilitation training for cerebral infarction.
Acupuncture has been studied for years in the west to scientifically understand how these little needles provoke healing. Here are a few of the conclusions:
1. Acupuncture increases the circulation of blood- reducing pain and swelling
2. It causes the release of certain neurotransmitters- benefitting mental health
3. Acupuncture stimulates the natural release of opioids- reducing pain
4. A reaction with the central nervous system occurs- benefitting overall health.
See the Scientific Research section under FAQs.
Why Herbs & Nutraceuticals instead of pharmaceutical drugs?
Herbs and Nutraceuticals correct the underlying dysfunctional biological mechanism that causes the symptoms whereas drugs only seek to alleviate the symptom.
Herbs and nutraceuticals are safer than drugs. According to the CDC there are “0” deaths annually due to herbs and nutraceuticals whereas prescription drugs cause approxiamtely 250,000 deaths annually.
Dr. Van Harding has experienced an emergency situation that precludes him from seeing patients or continuing his practice at this time. We will provide an update as conditions change. We apologize for any inconvenience that this may cause.
by Blake Farmer Feb. 16, 2012