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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
Chen J, Wang J, Huang Y, Lai X, Tang C, Yang J, Wu J, Zeng T, Qu S
PLoS ONE 2014 Jun;9(6):e96777
clinical trial
2/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: Yes; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: No; Point estimates and variability: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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.

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