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Acupuncture & Stroke

Acupuncture stimulation induces neurogenesis in adult brain

Int Rev Neurobiol. 2013;111:67-90. doi: 10.1016/B978-0-12-411545-3.00004-3.

Acupuncture stimulation induces neurogenesis in adult brain.

Author information

  • 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.

Book: Neurobiology of Acupuncture  2013
© 2013 Elsevier Inc. All rights reserved.

KEYWORDS:

Acupuncture; Adult neurogenesis; Alzheimer’s disease; Parkinson’s disease; Stroke

PMID:
24215918
[PubMed – indexed for MEDLINE]

Effect of scalp acupuncture on the expression of NF-kappaB mRNA, COX-2 mRNA and their proteins in rats with acute cerebral ischemia-reperfusion injury

Zhen Ci Yan Jiu. 2009 Oct;34(5):304-8.

Effect of scalp acupuncture on the expression of NF-kappaB mRNA, COX-2 mRNA and their proteins in rats with acute cerebral ischemia-reperfusion injury

[Article in Chinese]

Author information

  • 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.

Zhen Ci Yan Jiu. 2008 Jun;33(3):173-8.

Effect of scalp-acupuncture on plasma and cerebral TNF-alpha and IL-1beta contents in acute cerebral ischemia/reperfusion injury rats

[Article in Chinese]

Author information

  • 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

Huafeng Liu,1, 4   Xiaoyan Shen,1, 4,   Hongtu Tang,2, 4Jia Li,2Ting Xiang2& Weichuan Yu3,

Scientific ReportsVolume:3,Article number:1070DOI:doi:10.1038/srep01070

Received Accepted Published 

Abstract

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.

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Using MicroPET Imaging in Quantitative Verification of Acupuncture Effect in Ischemia Stroke Treatment

**Lateralisation of cerebral response to active acupuncture in patients with unilateral ischaemic stroke: an fMRI study

2013 Sep;31(3):290-6. doi: 10.1136/acupmed-2012-010299. Epub 2013 Jul 3.

Lateralisation of cerebral response to active acupuncture in patients with unilateral ischaemic stroke: an fMRI study.

Author information

  • 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.

KEYWORDS:

Acupuncture; Stroke

PMID: 23822904  [PubMed – indexed for MEDLINE]

To purchase this study visit the website Acupuncture In Medicine

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.

To purchase a copy of this study visit the website Mary Ann Leibert Publishing, Inc

This paper was cited by:

Non-pharmaceutical therapies for stroke: Mechanisms and clinical implications

Fan Chen, Zhifeng Qi, Yuming Luo, Taylor Hinchliffe, Guanghong Ding, Ying Xia, Xunming Ji

Progress in Neurobiology. Apr 2014, Vol. 115: 246-269

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Functional Brain Correlates of Upper Limb Spasticity and Its Mitigation following Rehabilitation in Chronic Stroke Survivors

Svetlana Pundik, Adam D. Falchook, Jessica McCabe, Krisanne Litinas, Janis J. Daly

Stroke Research and Treatment. Jan 2014, Vol. 2014: 1-8

CrossRef

Acupuncture Enhances Effective Connectivity between Cerebellum and Primary Sensorimotor Cortex in Patients with Stable Recovery Stroke

Zijing Xie, Fangyuan Cui, Yihuai Zou, Lijun Bai

Evidence-Based Complementary and Alternative Medicine. Jan 2014, Vol. 2014: 1-9

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Acupuncture Modulates the Functional Connectivity of the Default Mode Network in Stroke Patients

Yong Zhang, Kuangshi Li, Yi Ren, Fangyuan Cui, Zijing Xie, Jae-Young Shin, Zhongjian Tan, Lixin Tang, Lijun Bai, Yihuai Zou

Evidence-Based Complementary and Alternative Medicine. Jan 2014, Vol. 2014: 1-7

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Upper limb rehabilitation following stroke: current evidence and future perspectives

Zoe Adey-Wakeling, Maria Crotty

Aging Health. Dec 2013, Vol. 9: 629-647

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Lateralisation of cerebral response to active acupuncture in patients with unilateral ischaemic stroke: an fMRI study

Y. Huang, J.-Q. Chen, X.-S. Lai, C.-Z. Tang, J.-J. Yang, H. Chen, J.-X. Wu, H.-L. Xiao, S.-S. Qu, Y.-D. Zhang, Z.-J. Zhang

Acupuncture in Medicine. Jul 2013

CrossRef

A comparison of brain activity between healthy subjects and stroke patients on fMRI by acupuncture stimulation

Seung-Yeon Cho, Mia Kim, Jong Joo Sun, Geon-Ho Jahng, Hengjun J. Kim, Seong-Uk Park, Woo-Sang Jung, Chang-Nam Ko, Jung-Mi Park

Chinese Journal of Integrative Medicine. Apr 2013, Vol. 19: 269-276

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Acupuncture Therapy for Stroke Patients

Xin Li, Qiang Wang

. Jan 2013: 159-179

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Development of a disease-specific health-related quality of life questionnaire for patients with post-stroke spasticity

Yanhong Zhang, Baoyan Liu, Zhishun Liu, Yin Wang, Hong Zhao, Mingjie Zi, Liping Wang, Hong Liu, Zhen Chen, Ying Xie

Journal of Traditional Chinese Medicine. Dec 2012, Vol. 32: 674-678

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Clinical Effects of Scalp Electrical Acupuncture in Stroke: A Sham-Controlled Randomized Clinical Trial

Wu Tu Hsing, Marta Imamura, Kayleen Weaver, Felipe Fregni, Raymundo S. Azevedo Neto

The Journal of Alternative and Complementary Medicine. Apr 2012, Vol. 18, No. 4: 341-346

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Acupuncture regulates the glucose metabolism in cerebral functional regions in chronic stage ischemic stroke patients—a PET-CT cerebral functional imaging study

Yong Huang, Chunzhi Tang, Shuxia Wang, Yangjia Lu, Wei Shen, Junjun Yang, Junqi Chen, Renyong Lin, Shaoyang Cui, Huiling Xiao, Shanshan Qu, Xinsheng Lai, Baoci Shan

BMC Neuroscience. Jan 2012, Vol. 13: 75

CrossRef

 

Neural Acupuncture Unit: A New Concept for Interpreting Effects and Mechanisms of Acupuncture

Zhang-Jin Zhang, Xiao-Min Wang, Grainne M. McAlonan

Evidence-Based Complementary and Alternative Medicine. Jan 2012, Vol. 2012: 1-23

CrossRef

 

Electroacupuncture Pretreatment as a Novel Avenue to Protect Brain against Ischemia and Reperfusion Injury

Xin Li, Peng Luo, Qiang Wang, Lize Xiong

Evidence-Based Complementary and Alternative Medicine. Jan 2012, Vol. 2012: 1-12

CrossRef

 

Functional magnetic resonance imaging studies of acupuncture mechanisms: a critique

Florian Beissner

Focus on Alternative and Complementary Therapies. Mar 2011, Vol. 16, No. 10.1111/fct.2011.16.issue-1: 3-11

CrossRef

 

The effectiveness and safety of acupuncture therapy in depressive disorders: Systematic review and meta-analysis

Zhang-Jin Zhang, Hai-Yong Chen, Ka-chee Yip, Roger Ng, Vivian Taam Wong

Journal of Affective Disorders. Jul 2010, Vol. 124: 9-21

CrossRef

 

fMRI Study of Effect on Brain Activity According to Stimulation Method at LI11, ST36: Painful Pressure and Acupuncture Stimulation of Same Acupoints

Seung-Yeon Cho, Geon-Ho Jahng, Seong-Uk Park, Woo-Sang Jung, Sang-Kwan Moon, Jung-Mi Park

The Journal of Alternative and Complementary Medicine. Apr 2010, Vol. 16, No. 4: 489-495

Abstract | Full Text PDF or HTML | Reprints | Permissions | Download Metadata

 

Changes in Regional Cerebral Blood Flow and Glucose Metabolism Following Electroacupuncture at LI 4 and LI 11 in Normal Volunteers

Young-Sil An, Sang-Kwan Moon, In-Kyu Min, Deog-Yoon Kim

The Journal of Alternative and Complementary Medicine. Oct 2009, Vol. 15, No. 10: 1075-1081

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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

Abstract | Full Text PDF | Reprints | Permissions | Download Metadata

Neuroimaging Acupuncture Effects in the Human Brain

Rupali P. Dhond, Norman Kettner, Vitaly Napadow

The Journal of Alternative and Complementary Medicine. Aug 2007, Vol. 13, No. 6: 603-616

Abstract | Full Text PDF | Reprints | Permissions | Download Metadata

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Electro-Acupuncture to Affected Arm in Acute Stroke

Electrical acupoint stimulation of the affected arm in acute stroke: a placebo-controlled randomized clinical trial


  1. 1Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China

  2. 2Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA
  1. 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.

Design: Double-blind, randomized, placebo-controlled trial.

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.

To purchases a copy of this study visit the SAGE Journals website, Clinical Rehabilitation.

 

Acupuncture fMRI of Stroke Aphasia

An fMRI study showing the effect of acupuncture in chronic stage stroke patients with aphasia.

J Acupunct Meridian Stud. 2010 Mar;3(1):53-7. doi: 10.1016/S2005-2901(10)60009-X.

Abstract

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.

* Acupuncture & Post Stroke Motor Recovery

Neurorehabil Neural Repair. 2004 Dec;18(4):259-67.

Effects of acupuncture treatment on poststroke motor recovery and physical function: a pilot study.

Author information

  • 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.

PMID: 15537996 [PubMed – indexed for MEDLINE]

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Effects of Acup on Poststroke Motor Recovery & Physical Function 2004

 

Effects of acupuncture needling with specific sensation on cerebral hemodynamics and autonomic nervous activity in humans

2013;111:25-48. doi: 10.1016/B978-0-12-411545-3.00002-X.

Effects of acupuncture needling with specific sensation on cerebral hemodynamics and autonomic nervous activity in humans.

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.

© 2013 Elsevier Inc. All rights reserved.

KEYWORDS:

Medial prefrontal cortex; Near infrared spectroscopy; Supplementary motor area; de-qi sensation

PMID:  24215916  [PubMed – indexed for MEDLINE]

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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.
Address correspondence to:
Wu Tu Hsing, MD, PhD
Department of Pathology

University of São Paulo School of Medicine

Avenida Dr. Arnaldo, 455 sala 1349
01246-903 São Paulo, S.P.

Brazil
E-mail:

ABSTRACT

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.

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How Plastic Is the Brain after a Stroke?

How Plastic Is the Brain after a Stroke?


  1. 1Balgrist University Hospital, University of Zurich, Zurich, Switzerland

  2. 2Brain Research Institute, University of Zurich, Zurich, Switzerland

  3. 3Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
  1. 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.

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Brain Plasticity & Stroke

Plasticity of Primary Somatosensory Cortex Paralleling Sensorimotor Skill Recovery From Stroke in Adult Monkeys

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Acupuncture & Poststroke Rehab Review

Acupuncture in poststroke rehabilitation: a systematic review and meta-analysis of randomized trials.

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.

 

Acupuncture,Herbs & Cerebral Infarction

Comprehensive therapeutic protocol of electroacupuncture combined with Chinese herbs and rehabilitation training for treatment of cerebral infarction: a multi-center randomized controlled trial

[Article in Chinese] Zhongguo Zhen Jiu. 2010 Jan;30(1):6-9.

Abstract OBJECTIVE:

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.

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