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Acupunct Med 31:290-296 doi:10.1136/acupmed-2012-010299
  • Original paper

Lateralisation of cerebral response to active acupuncture in patients with unilateral ischaemic stroke: an fMRI study

  1. Zhang-Jin Zhang6
  1. 1School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
  2. 2School of Acupuncture and Rehabilitation, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
  3. 3School of Biomedical Engineering, Southern Medical University, Guangzhou, China
  4. 4Department of Acupuncture and Moxibustion, Shantou Central Hospital, Shantou, China
  5. 5First Clinic Medical School, Southern Medical University, Guangzhou, China
  6. 6School of Chinese Medicine, The University of Hong Kong, Hong Kong, China
  1. Correspondence to Prof Zhang-Jin Zhang, School of Chinese Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, China; zhangzj{at}hku.hk; and Professor Xin-Sheng Lai, Department of Acupuncture and Massage, Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong 510405, China; lai1023{at}163.com
  • Received 17 December 2012
  • Accepted 3 June 2013
  • Published Online First 3 July 2013

Abstract

Objective Acupuncture is beneficial in treating stroke neuropsychiatric symptoms. The present study aimed to identify functional brain response to active acupuncture in patients with unilateral ischaemic stroke using functional MRI (fMRI).

Methods A total of 10 patients aged 47–65 years with left hemispheric ischaemic stroke received single-session manual acupuncture at the TE5 point of the affected (right) forearm. A 6-min tactile control procedure in which an acupuncture needle tip was alternately touched and removed from the skin at the acupuncture point for 30 s each was performed first, followed by active acupuncture in a blocking paradigm consisting of six 30-s twist blocks of rotation interspersed between six 30-s blocks of rest. A whole brain scan was simultaneously conducted on a 3.0-T imager. Activated and deactivated brain regions during tactile stimulation and active acupuncture relative to rest were obtained via group analysis.

Results Compared to tactile stimulation, needling with twist manipulation modulated many more widespread brain areas. All the brain areas activated and deactivated by active acupuncture relative to tactile stimulation were distributed in the primary sensorimotor and medial frontal cortex of the unaffected, but not the affected hemisphere.

Conclusions Active acupuncture results in lateralisation of functional cerebral response to the contralateral unaffected hemisphere in patients with unilateral stroke. This lateralisation may represent an effect of acupuncture in enhancing a compensatory process by redistributing functions into the intact cortex, particularly in the unaffected hemisphere.