The clinical efficacy and mechanism of gamma frequency electroacupuncture stimulation on the rehabilitation of upper limb motor function in stroke patients: study protocol of a randomized clinical trial

Abstract

Background: The field of neuroscience has discovered that gamma oscillations (30-100 Hz) in the brain play a key role in neuroplasticity, information conduction and neuroprotective mechanisms. Electroacupuncture stimulation (ES) is a modern treatment method that combines the advantages of Chinese acupuncture with those of electrical stimulation, and is widely used in the field of stroke rehabilitation. At present, there is a lack of research on the clinical efficacy and mechanism of applying gamma frequency (40-Hz) ES, a new neuromodulation mode of integrated Chinese and Western medicine, to induce gamma oscillations and promote the rehabilitation of upper limb motor function in stroke patients.

Methods and analysis: This trial uses a randomized, double-blind and controlled method to evaluate the effect of 40-Hz ES of LI11 (Quchi) acupoint on upper limb motor functional rehabilitation in stroke patients. Based on this new rehabilitation program combining Traditional Chinese medicine with modern technique, all patients will receive baseline assessment, 1-week post-intervention assessment and 2-week post-intervention assessment. The primary outcomes are the Fugl-Meyer Assessment Upper Extremity Scale. The secondary indicators include electroencephalogram, National Institutes of Health Stroke Scale, Mini-mental State Examination and Modified Barthel Index.

Discussion: This trial offers novel perspectives on the application of 40-Hz electroacupuncture stimulation in neural oscillation regulation and the effectiveness of this clinically widespread technique in treating upper extremity dysfunction after a stroke and improving patients' quality of life. The results of this study will contribute to the scientific community's understanding of the potential mechanisms of this novel neuromodulation method, including changes in neural network connectivity, and improve existing clinical treatments to benefit more stroke patients.

Clinical trial registration: https://www.chictr.org.cn/showprojEN.html?proj=217786, identifier ChiCTR2400082208.

Keywords: electroacupuncture stimulation; gamma oscillations; neurological recovery; stroke; upper limb motor function.

Figure 1

Flow chart of the study. FMA-UE, Fugl-Meyer Assessment Upper Extremity Scale; EEG, Electroencephalogram; NIHSS, National Institutes of Health Stroke Scale; MMSE, Mini-mental State Examination; MBI, Modified Barthel Index.

Figure 2

Schedule of enrollment, interventions, and assessments. “√” means things will be done. t0: Baseline assessment. t1: The first week of the intervention. t2: 1-week post-intervention assessment. t3: The second week of the intervention. t4: 2-week post-intervention assessment.

Figure 3

A schematic diagram of the acupuncture intervention. LU5 belongs to the Hand Taiyin Lung Meridian, which is located in the elbow area, on the transverse stripe of the elbow, in the concave radial margin of the biceps brachii tendon. LI11 belongs to the Hand Yangming Large Intestine Meridian and is located at the lateral end of the transverse elbow stripe, with the elbow flexed, at the midpoint of the line connecting the LU5 and the Lateral epicondyle of the humerus. Place a dry sterile cotton ball between the two needles to prevent short circuits caused by accidental contact between the cathode and anode.