Modulatory effect of acupuncture at Waiguan (TE5) on the functional connectivity of the central nervous system of patients with ischemic stroke in the left basal ganglia

Abstract

Objective: To study the influence of acupuncture at Waiguan (TE5) on the functional connectivity of the central nervous system of patients with ischemic stroke.

Methods: Twenty-four patients with ischemic stroke in the left basal ganglia were randomized based on gender to receive TE5 acupuncture (n = 12) or nonacupoint acupuncture (n = 12). Each group underwent sham acupuncture and then verum acupuncture while being scanned with functional magnetic resonance imaging. Six regions of interest (ROI) were defined, including bilateral motor, somatosensory, and bilateral basal ganglia areas. The functional connectivity between these ROIs and all voxels of the brain was analyzed in Analysis of Functional NeuroImages (AFNI) to explore the differences between verum acupuncture and sham acupuncture at TE5 and between TE5 acupuncture and nonacupoint acupuncture. The participants were blinded to the allocation.

Result: The effect of acupuncture on six seed-associated networks was explored. The result demonstrated that acupuncture at Waiguan (TE5) can regulate the sensorimotor network of the ipsilesional hemisphere, stimulate the contralesional sensorimotor network, increase cooperation of bilateral sensorimotor networks, and change the synchronization between the cerebellum and cerebrum. Furthermore, a lot of differences of effect existed between verum acupuncture and sham acupuncture at TE5, but there was little difference between TE5 acupuncture and nonacupoint acupuncture.

Conclusion: The modulation of synchronizations between different regions within different brain networks might be the mechanism of acupuncture at Waiguan (TE5). Stimulation of the contralesional sensorimotor network and increase of cooperation of bilateral hemispheres imply a compensatory effect of the intact hemisphere, whereas changes in synchronization might influence the sensorimotor function of the affected side of the body.

Trial registration: Chinese Clinical Trial Registry ChiCTR-ONRC-08000255.

Figure 1. Stimulation and scanning pattern.

Figure 2. Waiguan and nonacupoint on the right forearm.

Figure 3. Consort flow diagram.

Figure 4. Differences of seed associated networks between ROIs from the left hemisphere and the right hemisphere.

Full line represents stronger correlation under acupuncture compared with sham acupuncture, whereas the “dash–dot–dot” line represents weaker correlation. Dash line stands for weaker correlation compared with nonacupoint acupuncture (P<0.05, multiple comparison error corrected using Monte Carlo simulation). Regions of the left hemisphere and right hemisphere that had significant differences in correlation with seeds are placed on left side and right side, respectively, and ROIs in the same box are from the same hemisphere.