Correlated change in upper limb function and motor cortex activation after verum and sham acupuncture in patients with chronic stroke.
BACKGROUND
Acupuncture may improve motor function in patients with chronic hemiparetic stroke, yet the neural mechanisms underlying such an effect are unknown. As part of a sham-controlled, randomized clinical trial testing the efficacy of a 10-week acupuncture protocol in patients with chronic hemiparetic stroke, we examined the relationship between changes in function of the affected upper limb and brain activation using functional magnetic resonance imaging (fMRI).


METHODS
Seven (7) chronic hemiparetic stroke patients underwent fMRI and testing of function of the affected upper limb (spasticity and range-of-motion) before and after a 10-week period of verum (N=4) or sham (N=3) acupuncture. The correlation between changes in function of the affected upper limb and brain activation after treatment was tested across patients.


RESULTS
We found a significant positive correlation between changes in function of the affected upper limb (spasticity and range of motion) and activation in a region of the ipsilesional motor cortex. Patients treated with verum acupuncture showed a trend toward a greater maximum activation change in this motor cortical area as compared to those treated with sham acupuncture.


CONCLUSIONS
Acupuncture may improve function of the affected upper limb in chronic hemiparetic stroke patients by increasing activity in the ipsilesional motor cortex.
Schaechter
Judith D
JD
Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA 02129, USA. judith@nmr.mgh.harvard.edu
Connell
Brendan D
BD
Stason
William B
WB
Kaptchuk
Ted J
TJ
Krebs
David E
DE
Macklin
Eric A
EA
Schnyer
Rosa N
RN
Stein
Joel
J
Scarborough
Donna M
DM
Parker
Stephen W
SW
McGibbon
Chris A
CA
Wayne
Peter M
PM
D015670:Acupuncture Therapy / Q000379:methods*; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004311:Double-Blind Method; D005260:Female; D006429:Hemiplegia / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000473:pathology*; D009048:Motor Skills; D010865:Pilot Projects; D020127:Recovery of Function; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation