Neural Effects of Low-Frequency Acupoint Electrical Stimulation Therapy on Patients With Poststroke Motor Dysfunction: A Resting-State Functional Magnetic Resonance Imaging Study.

OBJECTIVE

To investigate differences in brain functional activity between patients with poststroke motor dysfunction and healthy individuals, and to examine the effects of low-frequency acupoint electrical stimulation on brain regional homogeneity (ReHo) in patients.

DESIGN

This was a case-control study.

SETTING

The study was conducted in a local tertiary hospital.

PARTICIPANTS

Twenty-eight patients with poststroke motor dysfunction (infarcts in the right basal ganglia region; 19 men, 9 women; mean age 59.07±9.03y) were recruited to form the Treatment group (Tx). Concurrently, 20 age- and gender-matched healthy controls (HCs) were recruited (14 men and 6 women, with an average age of 57.60±8.36y).

INTERVENTIONS: The Tx received low-frequency acupoint electrical stimulation. Scalp Acupoint Selection: motor area on the affected hemisphere. Limb Acupoint Selection: acupoints on the affected limb, forming the following pairs: Shousanli (LI10) - Waiguan (SJ5); Ximen (PC4) - Neiguan (PC6); Zusanli (ST36) - Shangjuxu (ST37); and Heyang (BL55) - Chengshan (BL57). Head: frequency 2 Hz, pulse width 100 µs, and intensity 1.5 mA. Upper limb: frequency 35 Hz, pulse width 200 µs, and intensity 40 mA. Lower limb: frequency 50 Hz, pulse width 400 µs, and intensity 40 mA. Each session lasted 30 minutes, administered once daily for 6 sessions per week over 3 weeks.

MAIN OUTCOME MEASURES: The primary endpoint was the improvement from baseline in ReHo for patients with stroke at 3 weeks.

RESULTS

Compared with HCs, patients with stroke showed increased ReHo in the bilateral parahippocampal gyrus, bilateral cerebellum, and cerebellar vermis, whereas ReHo decreased in sensorimotor network (SMN)-related brain regions (false discovery rate [FDR]-corrected, P<.05). After intervention, ReHo increased in the right SMN-related brain regions, whereas ReHo decreased in the left cerebellum and left angular gyrus (FDR-corrected, P<.05). Right precentral gyrus ReHo changes positively correlated with Fugl-Meyer Assessment improvement. Left cerebellum ReHo changes positively correlated with Modified Barthel Index improvement but negatively with National Institute of Health Stroke Scale improvement. Other regions showed no significant correlation.

CONCLUSIONS

Abnormal synchrony between SMN and cerebellum may be a key pathologic feature in poststroke motor dysfunction. Lateralized SMN functional remodeling is a potential neural mechanism for motor recovery via low-frequency acupoint electrical stimulation.