[Application and research progress of fMRI in acupuncture treatment for ischemic stroke]

Focusing on functional magnetic resonance imaging (fMRI) technology, the paper systematically reviews fMRI research on brain functional activity and structural abnormalities after ischemic stroke (IS), and summarizes the regulatory effects of acupuncture on abnormal brain function and structure after IS. Studies have demonstrated that IS can induce the dysregulation of functional activity and microstructural damage in brain regions. Acupuncture, through bidirectional modulation of motor and related brain activities, can ameliorate abnormal brain functional patterns, promote the restoration of functional network coordination and balance, facilitate the remodeling of white matter microstructure and enhance neural pathway connectivity. Additionally, it exerts the positive effect on cerebral blood flow and metabolic status. Furthermore, fMRI demonstrates the potential value in identifying populations with specific responses, guiding acupoint selection and optimizing acupuncture parameters. However, existing researche has predominantly focus on motor dysfunction, with the insufficient attention to the other symptoms related to cognitive and swallowing functions. Besides, the methodological limitations are presented in the single analytical method and the lack of high-quality randomized controlled trials. Future research should advance large-sample, multicenter, sham-acupuncture controlled trials, integrate multimodal indexes and interdisciplinary approaches and deepen the mechanistic exploration of acupuncture effect on different symptoms and among subgroups in patients, so as to provide more robust scientific evidence for the clinical application and standardization of acupuncture in treatment of IS.