You have got to be kidding:
Impossible to have effects except as a placebo. Energy meridians have never been proven to exist.
No mechanism of action is possible.
But if you believe, have at it, recognizing these possible side effects;
The latest here:
Neuroplasticity of Acupuncture for Stroke: An Evidence-Based Review of MRI
Jinhuan Zhang
,1 Chunjian Lu,1 Xiaoxiong Wu,1 Dehui Nie,1 and Haibo Yu1,21The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen 518033, China
2Shenzhen Traditional Chinese Medicine Hospital, Shenzhen 518033, China
Abstract
Acupuncture is widely recognized as a potentially effective treatment for stroke rehabilitation. Researchers in this area are actively investigating its therapeutic mechanisms. Magnetic resonance imaging (MRI), as a noninvasive, high anatomical resolution technique, has been employed to investigate neuroplasticity on acupuncture in stroke patients from a system level. However, there is no review on the mechanism of acupuncture treatment for stroke based on MRI. Therefore, we aim to summarize the current evidence about this aspect and provide useful information for future research. After searching PubMed, Web of Science, and Embase databases, 24 human and five animal studies were identified. This review focuses on the evidence on the possible mechanisms underlying mechanisms of acupuncture therapy in treating stroke by regulating brain plasticity. We found that acupuncture reorganizes not only motor-related network, including primary motor cortex (M1), premotor cortex, supplementary motor area (SMA), frontoparietal network (LFPN and RFPN), and sensorimotor network (SMN), as well as default mode network (aDMN and pDMN), but also language-related brain areas including inferior frontal gyrus frontal, temporal, parietal, and occipital lobes, as well as cognition-related brain regions. In addition, acupuncture therapy can modulate the function and structural plasticity of post-stroke, which may be linked to the mechanism effect of acupuncture.
1. Introduction
Stroke is a common disease that affects one in four people during their lifetime [1], globally, and it continues to be a leading cause of death and long-term disability worldwide, imposing a significant financial burden on healthcare systems and families [2, 3]. Although stroke incidence and prevalence have declined worldwide, however, a recent national epidemiological survey [4, 5] indicated that China has an estimated 11 million prevalent cases of stroke, 2.4 million new cases of stroke, and 1.1 million stroke-related deaths. Hemiparesis and aphasia are two of the prominent impairments caused by a stroke that affect activities of daily living activities and quality of life [6–8]. More than 80% of poststroke patients experience upper or lower limb hemiplegia, severely disturbing their daily activities [9]. Some studies have found that almost 20%-40% of all stroke survivors have chronic aphasic symptoms [10, 11]. It is well known that returning to work and social activities is the key priority for stroke survivors. Therefore, it is critical to understand stroke pathogenesis and explore its appropriate treatment.
Previous studies [12, 13] have demonstrated that poststroke patients have structural and connectivity changes in their brains. Luckily, the brain’s plasticity, a broad term for the proof the human brain to adapt to environmental pressure, experiences, and challenges including brain damage [14, 15], enables stroke rehabilitation. Although many patients experience some degree of spontaneous recovery, that is, a time-determined amount of improvement in physical function and activity [16], it is often incomplete and the recovery rates of neurological function vary. Therefore, external stimulus interventions are still needed. However, despite extensive research efforts on multiple treatment modalities, no single rehabilitation intervention has been demonstrated to be definitively beneficial for recovery [17]. Even the most commonly used repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) were not recommended for routine stroke treatment in two Cochrane reviews [18, 19]. Due to a lack of effective therapy, researchers considered alternative approaches that improve stroke recovery. As a relatively inexpensive and safe treatment, acupuncture has been widely employed to improve motor, sensation, and some neurological functions of stroke for thousands of years. Furthermore, several clinical [20–22] research and systematic reviews [17, 23, 24] revealed that acupuncture, as a promising intervention, could improve motor and language function and daily living activities. Numerous studies [25–27] have suggested that plasticity and reorganization contribute to the recovery.
However, the current understanding of neuroplasticity after stroke is primarily based on invasive methods, such as histology and immunohistochemistry, which do not allow for dynamic assessment of functional recovery and tissue remodeling [28]. In contrast, magnetic resonance imaging (MRI) can noninvasively monitor dynamic change after stroke and in vivo. Structural magnetic resonance imaging (sMRI) technique can provide a high anatomical resolution [29], whereas functional magnetic resonance imaging (fMRI) can reveal real-time brain activity by indirect measurement of regional blood flow [30]. Combined with sMRI and fMRI, the central nervous effect of acupuncture for stroke could be fully elucidated from an anatomical and functional perspective. Moreover, emerging clinical studies have demonstrated that acupuncture could reorganize motor-related networks and increase functional connectivity between premotor cortex (PM)/adjacent supplementary motor area (SMA) and supramarginal gyrus (SMG) [31–33]. In addition, acupuncture therapy has various properties, such as the choice of acupoints, whether deqi or not, which may be the influencing factors of acupuncture on the plasticity of stroke patients.
Nevertheless, the underlying neuroplasticity mechanisms on acupuncture for stroke have received little attention to date. Therefore, the review will mainly focus on the evidence to elucidate the possible mechanisms of acupuncture therapy in treating stroke through regulating brain plasticity based on MRI to better select and stratify patients for future appropriate treatment strategies that promote poststroke recovery. We firstly describe research characteristics of acupuncture for stroke based on MRI. Then, we discuss the neuroplasticity mechanism of acupuncture and its properties on stroke. Furthermore, we also review the limitations and prospects to be explored in the future.
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