title: Correlated change in upper limb function and motor cortex activation after verum and sham acupuncture in patients with chronic stroke.
abstract: 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.
authors.affiliation: Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA 02129, USA. judith@nmr.mgh.harvard.edu
authors.forename: Judith D
authors.initials: JD
authors.lastname: Schaechter
authors.forename: Brendan D
authors.initials: BD
authors.lastname: Connell
authors.forename: William B
authors.initials: WB
authors.lastname: Stason
authors.forename: Ted J
authors.initials: TJ
authors.lastname: Kaptchuk
authors.forename: David E
authors.initials: DE
authors.lastname: Krebs
authors.forename: Eric A
authors.initials: EA
authors.lastname: Macklin
authors.forename: Rosa N
authors.initials: RN
authors.lastname: Schnyer
authors.forename: Joel
authors.initials: J
authors.lastname: Stein
authors.forename: Donna M
authors.initials: DM
authors.lastname: Scarborough
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Parker
authors.forename: Chris A
authors.initials: CA
authors.lastname: McGibbon
authors.forename: Peter M
authors.initials: PM
authors.lastname: Wayne
mesh_terms: 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