Table 3.
The mechanisms of acupuncture on regulating functional reorganization in the treatment of ischemic stroke.
| Study | Model/Objects | Intervention | Acupoints | Comparison | Acupuncture parameters | Effect measurements | Biochemical measurements |
|---|---|---|---|---|---|---|---|
| Li et al. (2015) | Stroke patients with unimanual motor deficits (n = 14) | Acupuncture + conventional treatment | GB20, GB39, LI11, LI4, ST36, SP6, (bilateral), GV20 | Conventional treatment | 30 min, 5 days, 4 weeks | FMA↑ | Diffusion indices values were changed in the corpus callosum and bilateral corticospinal tracts, the inferior longitudinal fasciculus, the inferior frontooccipital fasciculus, the superior longitudinal fasciculus, the forceps minor, the cingulum gyrus, and the thalamic radiation. |
| Wen et al. (2018) | MICD rats | EA | GV20, GV24 | Non-EA | 1/20 Hz, 6 V, 2 mA, 30 min, 14 days from 24 h from MICD | MWM test: the time to find the platform↓, the number of times the platform crossed↑ | The activation of hippocampus, retrosplenial cortex, cingulate gyrus, prelimbic cortex, and sensory cortex↑ |
| Wu et al. (2017) | Ischemic stroke patients (n = 21) | Acupuncture + conventional treatment | GV20, GB20, LI11, LI4, ST36, GB33, GB39, SP6 | Conventional treatment | 30 min, 5 days, 4 weeks | NDS↓, FMA↑, MBI↑ | ReHo in the frontal lobe (BA6, BA46), supra-marginal gyrus (BA40), middle temporal gyrus (BA21), cerebellum, and insula↑ |
| Wu et al. (2018) | MCAO rats | EA | LI11, ST36 | Non-EA | 2/20 Hz, 30 min, 7 days from 24 h after reperfusion | Neurological deficits↓; the infarct volumes↓; catwalk gait and rotarod test: the motor function↑ | The neural activity of CPu, MCTX, SCTX regions↑ |
| Liang et al. (2017) | MCAO rats | EA | ST36, LI11 | Non-EA | 1/20 Hz, 6 V, 2 mA, 30 min, 7 days from 24 h after MCAO | Neurologic deficits↓; the cerebral infarctions↓ | The neural activity of motor cortex, dorsal thalamus, and ST↑ |
| Li et al. (2021) | MCAO rats | EA | ST36, LI11 | Non-EA | 2/20 Hz, 30 min, 14 days from 24 h after MCAO | Infarct volumes↓; mNSS↑; motor functional performances↑ | The FC between the left motor cortex and the motor function-related brain regions, including the motor cortex, sensory cortex and ST↑ |
| Chen et al. (2020) | Patients with ischemic stroke in the left hemiplegia (n = 10) | MA | ST36, LI11 | Self-control | Twisting for ± 180°, 60 circles per min, 15 min | - | ReHo values at the right precentral gyrus and superior frontal gyrus↑, ReHo values at right LPs, left fusiform gyrus and left SMA↓ |
| Chen et al. (2014) | Patients with ischemic stroke in the left basal ganglia (n = 24) | Acupuncture | TE5 | Sham acupuncture, non-acupoint acupuncture | Twisted for ± 180°, 60 circles, 6 min and 30 s | - | The sensorimotor network of the ipsilesional hemisphere is regulated, the contralesional sensorimotor network is stimulated, the cooperation of bilateral sensorimotor networks is increased, and the synchronization between the cerebellum and cerebrum is changed. |
| Huang et al. (2013) | Patients with ischemic stroke in the left hemisphere (n = 10) | MA | Right TE5 | Tactile stimulation | 30-s twist and 30-s rest, six times, 60 circles per min | - | The activation of the postcentral gyrus (BA2, BA3), precentral gyrus (BA4, BA6), medial frontal gyrus (BA6)↑, the postcentral (BA3), precentral gyrus (BA6)↓ |
| Huang et al. (2012) | Patients with ischemic stroke in the left internal capsule (n = 43) | MA | Right TE5 | Sham needling, Non-needling | Twirling the needling 180°, 60 times, 3 min | - | The activation of BA30↑ (Compared with the non-needling group), BA13, 19, and 47↑ (Compared with sham needling at TE5), BA9↓ (Compared with needling at the sham point) |
| Fang et al. (2012) | Patients with ischemic stroke in the right basal ganglion region (n = 6) | EA | GV20, right GB7 | Self-control | 2 Hz, 20 min | - | First EA treatment: the activation of M1, PMC, LPs bilaterally, SMA↑ on the unaffected right hemisphere 3 weeks of EA treatments: Bilateral M1 and LPs significantly↑, insula, putamen, and cerebellum↑ |
| Zhang et al. (2021) | MICD rats | EA | GV20, GV24 | Non-EA | 1/20 Hz, 6 V, 0.2 mA, 30 min, 14 days from 24 h after MICD | MWM test: escape latency times↓, the number of times the platform crossed↑ | FC between the RSC and hippocampus, cingulate gyrus and midbrain↑ |
| Wu et al. (2018) | Ischemic stroke patients | Acupuncture + conventional treatment | GV20, GB20, LI11, LI4, GB33, ST36, SP6, GB39 | Conventional treatment | 30 min, 5 days/week, 4 weeks | MBI scores↑ | The GMV of left frontal lobe, precentral gyrus, superior parietal gyrus, anterior cingulate cortex, middle temporal gyrus↑, the right frontal gyrus, inferior parietal gyrus, middle cingulate cortex ↓ |
| Chen et al. (2013) | Patients with ischemic stroke in the left hemisphere (n = 10) and six healthy controls (n = 6) | EA | Right TE5 | Self-control | Twirling the needle ± 180°, 60 times, 6 min | - | The activation of left BA5, 6, 7, 18, 19, 24, 32, hypothalamus, the ventral posterolateral nucleus, the right BA4, 6, 7, 18, 19, 32↑, left BA13, the hypothalamus, posterior lobe of the tonsil of cerebellum, the culmen of the anterior lobe of hypophysis, right BA13↓; the deactivation of the left BA6, 11, 20, 22, 37, 47, the culmen of the anterior lobe of hypophysis, alae lingulae cerebella, the posterior lobe of the tonsil of cerebellum, right BA8, 37, 45, 47, the culmen of the anterior lobe of hypophysis, nodule of the anterior lobe of hypophysis, inferior border of the lentiform nucleus, lateral globus pallidus, the parahippocampal gyrus↑, BA7↓ |
| Liu et al. (2020) | Patients with acute infarction in the middle cerebral artery supply area in the dominant hemisphere (n = 30) | MA + conventional treatment | ISSA, needling at the parietal midline (MS5) and left anterior/posterior parietal-temporal oblique lines (MS6 and MS7) | Conventional treatment | Twisting at 200 turns, 30 min, two times a day, six days | NIHSS scores↑; motor function scores↑ | Centered to the seed region of the left SMA, FC at the left middle cerebellar peduncle, left cerebellum posterior lobe (uvula and declive), vermis, fusiform gyrus, lingual gyrus, inferior occipital gyrus, calcarine, cuneus, precuneus, BA7, BA18, and BA19, etc↑; Centered to the seed region of the left PG, FC at the left precuneus, inside-paracingulate, inferior parietal gyrus, paracentral lobule, BA5, BA6, BA7, and BA40, right median cingulate, precuneus, BA19, BA23, and BA31, etc↑. |
Notes: ↑, upregulated by acupuncture; ↓, downregulated by acupuncture. Abbreviation: MCAO, middle cerebral artery occlusion; EA, electroacupuncture; GV20, Baihui; GB7, Qubin; BDNF, brain-derived neurotrophic factor; GV14, Dazhui; GFAP, glial fibrillary acidic protein; NF-κB, Nuclear Factor kappa B; TNF-α, Tumour Necrosis Factor alpha; iNOS, Inducible nitric oxide synthase; MAPK, mitogen-activated protein kinases; TRADD, TNFR1-associated death domain protein; FADD, Fas-associated protein with death domain; BL23, Shenshu; BL17, Geshu; PSD, post-synaptic density; NGF, Nerve growth factor; LI11, Quchi; ST36, Zusanli; BrdU, 5-bromo-2’-dexoyuridine; CDK4, cyclin-dependent kinase 4; p-Rb, phosphorylated retinoblastoma protein; IL-1β, interleukin-1beta; IL-10, interleukin-10; P2X7R, P2X7 receptor; P2Y1R, P2Y1 receptor.