Neuroplastic Mechanisms of Acupuncture in Post-Stroke Motor Recovery: A Randomized Multimodal MRI Trial

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Integrative Medicine

Background:

• Ischemic stroke frequently causes hemiplegia, a motor impairment.
• Stroke recovery involves brain network reorganization, linked to clinical outcomes.
• Acupuncture shows promise for motor function improvement, but its neurobiological mechanisms require further investigation.

Purpose of the Study:

• To investigate the neuroplastic effects of acupuncture on stroke recovery.
• To analyze acupuncture's modulation of cortical gray matter volume (GMV) and dynamic functional network topology.

Main Methods:

• Stroke patients were randomized to true-acupoint (TA) or sham-acupoint (SA) groups for two weeks.
• Clinical outcomes assessed via Fugl-Meyer Assessment (FMA), Brunnstrom Scale, and NIHSS.
• Neuroplastic changes evaluated using GMV analysis and dynamic functional network metrics; correlations with clinical improvements were examined.

Main Results:

• The TA group showed significant improvements in Brunnstrom scores, indicating superior motor recovery compared to SA.
• TA modulated default mode network (DMN) dynamics, reducing disjointedness and flexibility, correlating with better motor outcomes.
• TA increased GMV in sensorimotor and cognitive-motor integration regions, with increases in specific areas positively correlating with motor recovery.

Conclusions:

• True acupuncture treatment effectively alleviates neurological impairment and enhances motor recovery post-stroke.
• Therapeutic effects are attributed to functional DMN modulation and structural gray matter plasticity in critical brain regions.
• Acupuncture's mechanisms involve promoting neuroplasticity essential for sensorimotor and cognitive-motor integration in movement control.