Acupuncture improves stroke recovery and reshapes brain networks

HOW?

Ask your competent? doctor to explain the mechanism of action since energy meridians have never been proven to exist.

 No mechanism of action is possible except as a placebo or do you believe in hand waving.

Acupuncture improves stroke recovery and reshapes brain networks

A new study published in CNS Neuroscience and Therapeutics highlights the potential benefits of acupuncture in alleviating neurological impairment and improving motor recovery in patients with stroke.

Researchers investigate acupuncture's effects on neuroplasticity

Ischemic stroke is a leading cause of physical disability in adults, often resulting in unilateral motor impairment or hemiplegia, a condition of complete or severe muscle paralysis on one side of the body. Post-stroke hemiplegia significantly affects the overall quality of life of affected individuals and puts heavy economic pressure on the healthcare system and families.

Several clinical studies have revealed abnormal functional connectivity in brain regions involved in vital motor functions in stroke patients, including the sensorimotor, default mode, and cognitive control networks. Studies have also highlighted brain structural alterations in stroke patients, including cortical thinning.

The recovery of motor function in stroke patients is associated with complex structural and functional reorganization of the brain. Recent evidence highlights the potency of acupuncture in improving neurological functions. However, it remains largely unknown whether acupuncture helps restore the brain's structural and functional frameworks in stroke patients.

Given that acupuncture is considered to be a safe, effective, and low-cost complementary treatment for stroke, this randomized controlled trial aimed to explore neural mechanisms by which acupuncture adjusts motor dysfunction in patients with post-stroke hemiplegia.

Researchers track brain changes after treatment

A total of 56 stroke patients were enrolled in the trial. They were randomly allocated in a 2:1 ratio to receive either real acupuncture or sham acupuncture (control group) over a period of two weeks.

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After completion of the intervention period, all patients were assessed for motor impairment and recovery, neurological deficits, and limb motor control. Post-intervention structural and functional changes in the brain were also assessed using Magnetic Resonance Imaging (MRI).

After exclusions related to treatment completion and MRI data quality, 46 patients were included in the final MRI analysis.

Acupuncture improves motor recovery beyond sham

Post-treatment assessments showed that motor function improved in both groups, but patients who received real acupuncture experienced greater gains in limb motor control and overall motor recovery than those in the sham acupuncture group. These clinical improvements were accompanied by measurable changes in brain function and structure.

MRI analyses revealed reduced disjointedness and a trend toward lower flexibility within the default mode network, changes that were associated with better motor outcomes.

Acupuncture was also linked to increased gray matter volume in regions involved in sensorimotor processing and cognitive-motor integration. Importantly, participants who showed larger reductions in default mode network disruption and greater increases in gray matter volume also tended to experience greater improvements in motor impairment and recovery. 

Findings support further rehabilitation research using acupuncture

The findings suggest that acupuncture may support motor recovery after stroke by promoting changes in both brain function and structure. Patients who received real acupuncture showed better motor control and recovery, accompanied by signs of a more stable and less fragmented default mode network, a brain system involved in attention, self-awareness, and other cognitive processes that help guide movement.

The treatment was also associated with increased gray matter volume in regions linked to sensorimotor processing, cognition, and coordination, suggesting broader recovery-related adaptations across the brain. Together, these functional and structural changes may help support the planning and execution of movement following stroke.

The authors caution, however, that MRI-derived changes in gray matter volume are imaging markers of structural adaptation rather than direct evidence of cellular-level neuroplasticity. They also note that some clinical improvement was observed in the sham acupuncture group, potentially reflecting placebo-related effects and the standard pharmacotherapy received by both groups.

In addition, the trial did not demonstrate a statistically significant group-by-time interaction, and the lack of long-term follow-up means it remains unclear whether the observed brain changes translate into lasting functional benefits. Larger studies with extended follow-up will therefore be needed to confirm the findings and clarify the role of acupuncture as a complementary rehabilitation strategy.

Download your PDF copy by clicking here.

Mechanisms of Action and Advances in Application of Music Therapy in Improving Cognitive Impairment Based on the Theory of Neuroplasticity

 We know music therapy works in stroke; but does your incompetent? doctor even have a protocol for you?

• music therapy (105 posts back to October 2014)

Mechanisms of Action and Advances in Application of Music Therapy in Improving Cognitive Impairment Based on the Theory of Neuroplasticity

• 

  Zi-Tong Zeng

• J

  Jia-Xin Tang

• S

  Si-Rong Wang

• L

  Li-Zhu Lei

• Z

  Zi-Yi Xing

• J

  Jian-Mei Wang

• 

  Jing Wu

• Hunan University of Chinese Medicine, Changsha, China

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Abstract

As global population aging accelerates, preventing and treating cognitive impairment has become a major public health priority. Music therapy is a safe, well-tolerated non-pharmacological intervention with substantial potential to improve cognitive function. This review synthesizes the neurologic music therapy (NMT) framework, encompassing techniques targeting attention, memory, and executive function, delivered through both active and receptive approaches. Clinical investigations indicate that music therapy may improve cognition and neuropsychiatric symptoms in Alzheimer's disease (AD), vascular cognitive impairment (VCI), Parkinson's disease–related cognitive impairment, mild cognitive impairment (MCI), and traumatic brain injury (TBI); however, effects appear to vary by intervention duration and disease stage. This narrative review aims to provide a theoretical foundation and practical guidance for the non-pharmacological intervention of cognitive impairment by collating evidence on the neuroplasticity theoretical foundations, technical systems, and clinical applications of music therapy.

Summary

Copyright

© 2026 Zeng, Tang, Wang, Lei, Xing, Wang and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Acupuncture Anti-Inflammatory Effects on Post-Stroke Depression

Ask your competent? doctor to explain the mechanism of action since energy meridians have never been proven to exist.

 No mechanism of action is possible except as a placebo.

Acupuncture Anti-Inflammatory Effects on Post-Stroke Depression

 

A randomized clinical trial from clinicians affiliated with Nanjing University of Chinese Medicine reports that a six-week course of acupuncture produced clinically meaningful reductions in post-stroke depression severity comparable to escitalopram, while also shifting serum inflammatory markers in an anti-inflammatory direction, including lower IL-1β, IL-6, TNF-α, and IFN-γ and higher IL-10. At follow-up four weeks after treatment ended, the electroacupuncture (EA) group maintained lower depression scores than the escitalopram group, suggesting a short-term durability advantage after discontinuation of therapy. [1]

The study enrolled 150 adults aged 20–70 years with ischemic stroke confirmed by CT or MRI and mild-to-moderate post-stroke depression defined by a Hamilton Depression Scale–17 item (HAMD-17) score between 8 and 24. Participants were randomized to electroacupuncture with oral placebo or to escitalopram with sham electroacupuncture. Seventy-two participants in the EA arm and seventy-one in the escitalopram arm completed the protocol. Both groups continued standard secondary stroke prevention medications and rehabilitation programs, but acupuncture was not otherwise incorporated into routine rehabilitation care.

Clinical outcomes included clinician-rated and self-rated depression scales. In the electroacupuncture group, mean HAMD-17 scores decreased from 18.88 at baseline to 13.75 at week 6 and to 10.47 at the four-week post-treatment follow-up. In the escitalopram group, HAMD-17 scores decreased from 18.52 at baseline to 12.92 at week 6 and to 12.10 at follow-up. Self-rated depression assessed using the Zung Self-Rating Depression Scale (SDS) showed similar changes. EA reduced SDS scores from 62.06 at baseline to 48.18 at week 6 and 42.47 at follow-up, while escitalopram reduced SDS scores from 62.93 to 46.79 and 44.35 over the same time points.

Functional outcomes were assessed using the Modified Barthel Index (MBI), a scale measuring independence in activities of daily living. In the EA group, MBI scores increased from 58.54 at baseline to 69.44 at week 6 and 73.64 at follow-up. The escitalopram group improved from 59.82 to 70.44 and 74.87 over the same period. These functional improvements occurred alongside reductions in depressive symptoms in both treatment arms.

The electroacupuncture protocol was narrowly defined and fully reproducible. Four acupuncture points were used: GV20 (Baihui), GV29 (Yintang), LV3 (Taichong), and LI4 (Hegu), with LV3 and LI4 needled bilaterally. Electrical stimulation was applied between GV20 and Yintang and between ipsilateral LV3 and LI4. Patients were treated in the supine position after skin disinfection with iodophor.

Needle specifications and insertion techniques were explicitly reported. GV20 was needled using a 0.30 mm × 25 mm sterile disposable needle inserted at a 45-degree angle to a depth of approximately 15–20 mm. Yintang was needled with a 0.30 mm × 25 mm needle directed downward at a 15-degree angle to a depth of approximately 10–15 mm. LV3 and LI4 were needled perpendicularly using 0.30 mm × 40 mm needles to a depth of approximately 25–30 mm. Manual manipulation consisting of lifting, thrusting, and twirling was applied until deqi sensations were elicited.

Electrical stimulation was delivered using an electronic acupuncture apparatus. A alternating frequency of 2/15 Hz was used, with intensity adjusted to patient tolerance. Each session lasted 30 minutes and treatments were administered once daily, five days per week, for six consecutive weeks, totaling 30 sessions. All treatments were performed by a licensed acupuncture physician with more than ten years of clinical experience.

The escitalopram group received oral escitalopram at a dose of 10–20 mg daily for 40 days and concurrent sham electroacupuncture. Sham needling used 0.30 mm × 15 mm needles inserted superficially to a depth of 3–5 mm at sites located 0.5–1.0 cm away from the true acupuncture points. Electrodes were attached, but electrical output was set to zero. [1]

Objective biological outcomes focused on inflammatory cytokines. Fasting venous blood samples were collected at baseline and within 48 hours after completion of the six-week intervention. Serum IL-1β, IL-6, IL-10, TNF-α, and IFN-γ levels were measured using immunofluorescence on a BD FACSCanto II flow cytometer. In the electroacupuncture group, IL-1β decreased from 10.59 to 5.62 pg/mL, IL-6 decreased from 36.21 to 23.16 pg/mL, TNF-α decreased from 12.94 to 7.37 pg/mL, and IFN-γ decreased from 15.52 to 10.11 pg/mL. IL-10 increased from 10.12 to 17.22 pg/mL. These are beneficial effects since the aforementioned cytokines are pro-inflammatory with the exception of of IL-10, which is anti-inflammatory. [1]

Comparable cytokine shifts were observed in the escitalopram group, with IL-1β decreasing from 10.99 to 6.14 pg/mL, IL-6 decreasing from 36.57 to 22.13 pg/mL, TNF-α decreasing from 12.93 to 7.49 pg/mL, IFN-γ decreasing from 16.06 to 10.58 pg/mL, and IL-10 increasing from 9.49 to 16.75 pg/mL.

Adverse events were mild and self-limited. In the electroacupuncture group, four participants experienced localized pain or hematoma at needle sites. In the escitalopram group, dizziness and drowsiness were reported, and several participants experienced short-lived discontinuation symptoms lasting less than 48 hours. No serious adverse events occurred.

This trial demonstrates that a focused acupuncture protocol delivered at high frequency can reduce depressive symptoms after ischemic stroke while producing measurable reductions in proinflammatory cytokines. For licensed acupuncturists, the study provides a clearly defined point prescription, needle specifications, stimulation parameters, and treatment frequency associated with both clinical and biological effects in post-stroke depression. [1]

Reference:

1. Ma, Feixiang, Guiping Cao, Lu Lu, Yingling Zhu, Wanlang Li, and Li Chen. “Electroacupuncture versus Escitalopram for Mild to Moderate Post-Stroke Depression: A Randomized Non-Inferiority Trial.” Frontiers in Psychiatry 15 (2024): Article 1332107.

Meridian Acupuncture in Stroke Rehabilitation: A literature review

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;

• acupuncture side effects (1)

 

Meridian Acupuncture in Stroke Rehabilitation: A literature review

• Deny Prasetyanto Nurse
• Sri Yona

Keywords: stroke, rehabilitation, quality of life, acupuncture, meridians

Abstract

Abstract
Rehabilitation therapy has an important role in restoring bodily functions comprehensively due to stroke which aims to restore function so as to reduce disability. One therapy that nurses can do is to use acupuncture meridian points. Acupuncture is considered to play a leading role in the treatment of symptoms related to stroke.(Really? In what universe?) This literature review aims to analyze the benefits of the acupuncture points in stroke rehabilitation. The research method used by the author is a literature review using several databases namely Pubmed, Cochrane Library, EbscoHost, Proquest and Google Scholar from 2008 to 2018. An article that discusses rehabilitation of stroke patients using acupuncture meridian points is used as a medium of rehabilitation. The literature search results show that the rehabilitation of acupuncture meridian points provides the benefits of recovery of stroke symptoms such as hemiparese, dyspagia, dementia, and reduced volume and infarction including neurological deficits so as to improve the quality of life for stroke patients.
Keywords: stroke, rehabilitation, quality of life, acupuncture, meridians

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References

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New study ties egg and cholesterol consumption to heart disease risk

So I don't understand how dietary cholesterol affect levels in the blood, this for example from February 2015.  Has this been refuted?

Why You Should No Longer Worry About Cholesterol in Food

This seems to be all correlation because it doesn't explain a mechanism of action as to how the cause and effect occurs. 

New study ties egg and cholesterol consumption to heart disease risk

Reuters Health News | March 18, 2019

After a raft of studies reassuring consumers that eggs are OK to eat, a new report associates an increasing risk of heart disease with the increasing consumption of eggs. The report, combining data from six earlier studies, found a 6% increased risk of cardiovascular disease when the average number of eggs consumed per day went up by half an egg.

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"The take home message is that individuals who consume higher levels of dietary cholesterol are at increased risk for the development of heart disease and mortality later in life," said study coauthor Norrina Allen, an associate professor of preventive medicine at Northwestern University's Feinberg School of Medicine in Chicago. "And in the US diet, eggs are one of the top sources of cholesterol."
Still, Allen isn't ready to tell everyone to go cold turkey on eggs. "I'm not advocating people take them completely out of their diets," she said. "I'm just suggesting that people eat them in moderation." It can be hard to translate the association between eggs and heart disease into advice, Allen allowed. That's because we don't all deal with cholesterol in the same way, she said. "The amount of cholesterol you consume isn't linked in a straightforward way with the amount found in your blood," Allen explained. "That depends on a lot of factors including your genes and how you metabolize cholesterol."
Allen's team analyzed data pooled from six studies involving a total of 29,615 people who were followed for a median of 17.5 years, according to the report in JAMA on March 15. At the start, participants filled in questionnaires detailing the foods they ate. They were not asked about their diets again.

• See Also: The percentage of adults taking cholesterol-lowering medication regularly remains low

Over time, there were 5,400 cardiovascular-related adverse outcomes, including 2,088 fatal and non-fatal heart disease events, 1,302 fatal and non-fatal stroke events, 1,897 fatal and non-fatal heart failure events, and 113 other cardiovascular disease deaths.
When they analyzed the data, the researchers found an association between egg consumption as reported at the start of the study and participants' risk of developing cardiovascular disease. As their egg consumption rose, so did their risk.
The association was weakened to the point that it was no longer statistically significant when researchers accounted for total cholesterol consumption. That, Allen said, means the association between eggs and heart disease is explained by the cholesterol in the eggs. Other experts weren't entirely convinced that the study shows that eggs were causing heart disease.
Cholesterol's role in the development of heart disease has been discussed for more than three decades, said Dr. Dennis Bruemmer, a cardiologist with the Heart and Vascular Institute and an associate professor of medicine at the University of Pittsburgh Medical Center. "The particular contribution of cholesterol derived from eggs has also been studied in several studies, with varying and discrepant results," Bruemmer said. "This study does have clear limitations, including self-reporting at a single time point. This limits its validity."
While eggs contain quite a bit of cholesterol—about 200 mg, the maximum daily amount recommended in current guidelines—"eggs in moderation are probably acceptable from a nutritional standpoint," Bruemmer said in an email. Moderation, he added, is "less than one egg a day on average, including eggs in foods such as bread."
Dr. Holly Andersen agrees that the study has "real limitations." "It's not good science," said Andersen, a preventive cardiologist and director of education and outreach at the Ronald O. Perelman Heart Institute at the NewYork-Presbyterian/Weill Cornell Medical Center and an associate professor of clinical medicine at Weill Cornell Medicine. A big issue for Andersen is that fact that a lot of the egg-eating participants also appeared to be consuming "large amounts of meats and processed meats," she said. "If you're consuming a huge amount of processed meats, it doesn't matter how many eggs you're eating."
Moreover, Andersen said, the study is observational, which means it can only show there's an association between egg consumption and heart disease but it can't prove eggs are the culprit. It may just be that the people eating a lot of eggs are also consuming a lot of bacon, Andersen said.
That said, the study does have the strength of large numbers, Andersen said. "More than 29,500 patients is a lot and the follow-up of 17.5 years is also a lot," she added. "That means we should at least be looking at the conclusions."
—Linda Carroll

Acupuncture MRI Results After Ischemic Stroke

Really? Impossible to have effects except as a placebo. Energy meridians have never been proven to exist.
No mechanism of action is possible.

Acupuncture MRI Results After Ischemic Stroke 

Acupuncture regulates brain regions for ischemic stroke patients. Southern Medical University researchers gathered MRI data in a controlled clinical trial consisting of both healthy subjects and patients suffering from ischemic stroke. In a controlled human clinical trial, Waiguan (TB5) applied unilaterally to the right arm produced significant MRI findings. True acupuncture caused important changes in brain functional connectivity.
The researchers determined that true acupuncture triggers significant negative activation in the default mode network (DMN) and other brain regions specific to the Traditional Chinese Medicine (TCM) indications of Waiguan. The DMN is a network of highly correlated brain regions, which is active under resting-state conditions. In addition, they found that ischemic stroke affects the brain’s overall response to acupuncture. The healthy control group and the ischemic stroke group had different negatively-activated brain regions in the DMN when receiving true acupuncture. [1]

Waiguan (TB5)
The earliest introduction of Waiguan was found in the Huangdi Neijing (The Yellow Emperor’s Classic of Medicine). Waiguan is the luo-connecting point of the hand shaoyang sanjiao meridian as well as one of the eight confluent points. It is the confluent point of the yang linking vessel. Needling Waiguan is indicated for the treatment of the following disorders: upper limb disorders (e.g., upper limb paralysis, pain, numbness, swelling and other motor and sensory dysfunction), head and sensory organ disorders (e.g., migraines, red and swollen eyes, tinnitus, deafness), fever and exogenous diseases (e.g., common cold, febrile illnesses). The researchers found that needling Waiguan raises negative activation in the somatic motor cortex, somatic sensory cortex, visual information processing cortex, and auditory information process cortex.

Results
In the normal control group, the brain regions deactivated by real acupuncture included the left superior parietal lobule, left inferior parietal lobule, left precuneus, left superior frontal gyrus, left precentral gyrus, left postcentral gyrus, left occipital lobe, right precentral gyrus, right postcentral gyrus, right precuneus, and right cuneus. The precentral gyrus and superior frontal gyrus are involved in somatic motor functions. The superior parietal lobule and postcentral gyrus are associated with somatic sensory functions. The occipital lobe interprets visual information. The aforementioned regions are specific to the indications of Waiguan. The inferior parietal lobule, occipital lobe, and precuneus are DMN related regions. On the other hand, the brain regions deactivated by sham acupuncture included the left precentral gyrus, left postcentral gyrus, and right superior frontal gyrus. The results indicate specific brain activation patterns associated with true acupuncture and sham acupuncture respectively.
In the ischemic stroke group, the brain regions deactivated by real acupuncture included the left medial frontal gyrus, left postcentral gyrus, left middle temporal gyrus, right postcentral gyrus, right precentral gyrus, and right medial frontal gyrus. The middle temporal gyrus is associated with interpreting auditory information. It is regarded as a Waiguan indication-specific region along with the precentral gyrus, postcentral gyrus, and middle temporal gyrus. The medial frontal gyrus is a part of DMN regions. By contrast, the brain regions deactivated by sham acupuncture included the left and right precuneus.

Design
The researchers (Zhang et al.) used the following study design. A total of 44 subjects participated in the study and were divided into two groups, with 24 and 20 subjects in each group respectively. The treatment group subjects were selected from the Nanfang Hospital and the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine. The treatment group patients were diagnosed with ischemic stroke. The control group subjects included healthy volunteers.
The statistical breakdown for each group was as follows. The treatment group was comprised of 10 males and 10 females. The mean age of the treatment group was 52.8 years. The mean weight was 50.3 kg. The mean height was 160.3 cm. The mean course of disease was 2.2 months. The control group was comprised of 12 males and 12 females. The mean age of the control group was 24.6±3.4 years. The mean weight was 51.4 kg. The mean height was 163.4 cm. There were no significant differences in terms of their gender, age, height, and weight. Both groups were scanned using fMRIs after receiving true or sham acupuncture intervention.

Real Acupuncture
True acupuncture and sham acupuncture were performed by the same acupuncturist with clinical and research experience. Both procedures employed the use of a tube-guided device that can be attached to the skin (Park Sham Tube, AcuPrime). The Park Sham Tube needle is a research device that mimics true acupuncture; however, the needle never penetrates the skin. Instead, the needle retracts into the handle when tapped, thereby visibly appearing as true acupuncture.
After disinfection of the acupoint site, a 0.30 × 40 mm disposable filiform needle was tapped into the acupoint of each patient with a high needle entry speed, reaching a depth of 10 (±2) mm. Upon a deqi sensation, the Ping Bu Ping Xie (attenuating and tonifying) manipulation technique was applied, with a twisting range of 180 degrees and frequency of 60 times/minute. The manipulation was not employed for the first 30 seconds, it was then initiated for the second 30 seconds, and then stopped again for the third 30 second interval. The whole process was repeated continuously for a total of 180 seconds. The device was placed on the skin until the treatment session was finished.

Sham Acupuncture Treatment Simulation
The sham acupuncture group use needles with a retractable, flattened needle point. The Ping Bu Ping Xie (attenuating and tonifying) manipulation was applied. For the first 30 seconds, the needle was slightly lifted to keep the needle point away from the skin; for the second 30 seconds, the needle was tapped into the tube to make the needle point slightly touch the skin, for the third 30 seconds, the needle was lifted again. The whole process was repeated continuously for a total of 180 seconds. The device was placed on the skin until the treatment session was finished.

Summary
According to the research, true acupuncture at Waiguan regulates DMN brain regions and raises negative activation in indication-specific regions, including the somatic motor cortex, somatic sensory cortex, visual information processing cortex, and auditory information process cortex. The process was verified by repeated applications across multiple subjects and was verified by MRIs. The results indicate that acupuncture produces point-specific effects on brain regions in ischemic stroke patients.
This type of research supports additional findings by other researchers. In another investigation, Yang et al. conclude that acupuncture has the ability to “promote the proliferation and differentiation of neural stem cells in the brain… accelerate angiogenesis and inhibit apoptosis…. prevent and treat neural injuries following cerebral ischemia.” [2] Yang et al. add that GV20 (Baihui) and GV26 (Shuigou) regulate cells which “increase the release of nerve growth factors (NGFs) to make nerve cells survive and axons grow, synthesize neurotransmitters, (and) metabolize toxic substances….” In addition, the researchers note that needling CV24 (Chengjiang), CV4 (Guanyuan), GV26, and GV20 “inhibit excessive proliferation of the hippocampal astrocytes and promote cellular differentiation.”
Yang et al. also note that acupuncture at GV20 and GV14 (Dazhui) affect the contents and expression of signal transducers and activators of transcription (STATs). STATs are active in the Janus kinase STAT pathway and transmit information from chemical signals outside the cell, through the cell membrane, and into gene promoters on the DNA inside the cell nucleus (causing DNA transcription and cellular activity). Yang et al. note that acupuncture’s influence on STATs indicates that it activates self-protection and reduction of “apoptosis of the nerve cells in and around the ischemic focus.” This indicates that acupuncture has a neuroprotective effect for stroke patients.

References
[1] Zhang GF, Huang Y, Tang CS, Lai XS, Chen JQ. Identification of Deactivated Brain Regions by Real and Non-penetrating Sham Acupuncture Stimulation on Waiguan: An fMRI Study in Normal Versus Pathological Conditions [J]. Chinese General Practice, 2017, 20(9):1098-1103.
[2] Zhou-xin Yang, Peng-dian Chen, Hai-bo Yu, Wen-shu Luo, Yong-Gang Wu, Min Pi, Jun-hua Peng, Yong-feng Liu, Shao-yun Zhang, Yan-hua Gou. Research advances in treatment of cerebral ischemic injury by acupuncture of conception and governor vessels to promote nerve regeneration. Journal of Chinese Integrative Medicine, 01-2012. vol. 10, 1. Shenzhen Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine.

Clinical evaluation of acupuncture as treatment for complications of cerebrovascular accidents: A randomized, sham-controlled, subject- and assessor-blind trial

How the hell can acupuncture have any mechanism of action? Except as placebo? There is no proof that energy meridians exist.
https://www.mdlinx.com/internal-medicine/medical-news-article/2017/03/24/cerebrovascular-accidents/7100984/?

Evidence-based Complementary and Alternative Medicine

Liao HY, et al.

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The objective of the study described in this paper was to research the impact of acupuncture as a treatment for poststroke complications. The outcome of this study suggests acupuncture provided more effective poststroke pain relief than sham acupuncture treatment. However, acupuncture had no better impact on neurological, functional, and psychological improvement.

Methods

• Patients with first–time acute stroke were enrolled in this study.
• Participants were randomized to receive 24 sessions of either real or sham acupuncture amid an eight–week period.
• The primary outcome measure was change in National Institute of Health Stroke Scale (NIHSS) score.
• Secondary outcome measures included changes in Barthel Index (BI), Instrumental Activities of Daily Living (IADL), Hamilton Depression Rating Scale (HAM–D), and Visual Analogue Scale (VAS) for pain scores.

Results

• Out of 52 patients who were randomized to receive acupuncture (n = 28) or placebo (n = 24), 10 patients in the acupuncture group and 9 patients in the placebo group failed to finish the treatment.
• In this study, total 18 patients in the acupuncture group and 15 patients in the control group finished the treatment course.
• Reduction in pain was significantly greater in the acupuncture group than in the control group (p value = 0.04).
• They found there were no important differences in the other measures between the two groups.

Acupuncture Alleviates Cognitive Dysfunction After Stroke

How the hell can acupuncture have any mechanism of action? Bad research design, you never have two variables. Three in this case; spontaneous recovery, acupuncture, TCM. 
https://www.healthcmi.com/Acupuncture-Continuing-Education-News/1698-acupuncture-alleviates-cognitive-dysfunction-after-stroke
Acupuncture combined with herbal medicine outperforms drugs for alleviating cognitive dysfunction after a cerebral infarction. Researchers (Wang et al.) compared the therapeutic effects of acupuncture plus herbs with that of a pharmaceutical medication. Two groups were compared. The Traditional Chinese Medicine (TCM) group received acupuncture to benefit the occipital blood vessels and nerves. In addition, the herbal formula Bu Yang Huang Wu Tang was prescribed. The drug group received piracetam, a nootropic derivative of GABA, in tablet form. Nootropic medications are prescribed to benefit memory and cognitive function. The acupuncture plus herbs group achieved a 90% total treatment effective rate. The drug group achieved a 70% total effective rate.



Acupuncture was applied to Fengchi (GB20) and extra point Gongxue. In this study, Gongxue is located 1.5 cun below Fengchi. However, note that Lifang et al. use an alternate location for Gongxue (1 cun below GB20) in their research entitled Additional effects of acupuncture on early comprehensive rehabilitation in patients with mild to moderate acute ischemic stroke: a multicenter randomized controlled trial. Notably, Lifang et al. conclude that “acupuncture is safe and has additional multi-effect in improving neurologic deficits….”
Getting back to the Wang et al. research, Fengchi and Gongxue were selected for their proximity to the lesser occipital nerve branches and the occipital blood vessels. The focus was to enhance vertebral artery and internal carotid artery blood circulation to benefit the brain. Bu Yang Huang Wu Tang was chosen for its ability to promote qi and blood circulation, dispel blood stasis, and dredge the meridian blockages. Wang et al. cite research demonstrating the Bu Yang Huang Wan Tang is an appropriate herbal formula for this application noting that it regulates the ratio of Bc1 to Bax (Wang, Tong & Sun), effectively benefitting mitochondria, mitigating downregulation of 5-HT, and increasing the concentration of monoamine neurotransmitters in the brain. The focus was to improve brain metabolism and protect cells.
The drug group received 3 tablets of piracetam, three times per day for 8 weeks. The acupuncture group received nape acupuncture at Fengchi and Gongxue with 0.30 mm x 40 mm acupuncture needles. The needle retention time was 30 minutes per acupuncture session. Acupuncture therapy was conducted once per day, 6 days per week, followed by a 1 day break for the duration of the 8 week study. Bu Yang Huang Wu Tang was administered in the following modified version:

• Huang Qi
• Dang Gui Wei
• Chuan Xiong
• Chi Shao
• Tao Ren
• Hong Hua
• Di Long
• E Zhu
• Shi Chang Pu
• Shui Zhi

Notice the addition of the last three herbs, which are very powerful blood invigorators. The decoction was prepared with normal water boiling processes down to a 400 ml serving, ingested once in the morning and once at night. The results demonstrate that acupuncture has a 90% total effective rate for the alleviation of cognitive dysfunction after a cerebral infarction. Furthermore, acupuncture has been shown to benefit brain function in additional studies.
This research underscores the importance of acupuncture for the treatment of post-stroke syndrome. Scalp acupuncture is often a leading style used for this condition. According to scalp acupuncture theory, there are several windows of opportunity to benefit from acupuncture after a stroke. The most effective window of opportunity is the 24 – 72 hour period after a stroke. Here, treatment results may potentially be completely restorative. Next, there is the 1, 2, and 3 week windows of time. Each sequential week after a stroke brings new challenges. Efficacy diminishes significantly if the first acupuncture treatment is applied outside of the three week window.
Gu et al. confirm that acupuncture benefits stroke patients using the Fugl-Meyer Assessment (FMA) of sensorimotor recovery after stroke. Researchers (Gu et al.) from the Second Hospital (Jiaxing) conducted the study to investigate the treatment efficacy of scalp electroacupuncture after a stroke. Two groups were compared. Each received identical functional recovery therapies and medications, with one exception. The treatment group also received scalp electroacupuncture.
Stainless steel acupuncture needles (0.25 mm x 40 mm) were applied to the scalp motor and sensory areas, including the upper and lower limb regions. Mild reinforcing and reducing techniques were applied with lifting, thrusting, and twirling. Once manual acupuncture achieved the arrival of deqi, electroacupuncture was applied. A disperse-dense wave of 10 – 15 Hz was applied with an intensity level set to patient tolerance levels or until muscle contractions were observable. Electroacupuncture was applied once per day, 20 minutes per acupuncture session, 6 times per week, for a total of 6 weeks. Using the FMA, the researchers concluded that acupuncture assists in the functional rehabilitation of stroke patients, including improvements in both motor and sensory functions.
Tang et al. confirm that acupuncture benefits stroke patients. Using FMA, National Institutes of Health Stroke Scale (NIHSS), and Barthel Index (BI) assessments, the Chongqing Medical University researchers determined that acupuncture lowers the incidence of fatality and paralysis for stroke patients. Measurements were taken at 3 and 6 months following completion of the acupuncture treatment sessions.
Tang et al. cite prior research (Andersson & Lundeberg) determining that acupuncture promotes regulation of neurotransmitters and peptides in the brain and spinal cord. Two groups were compared in the study. Both groups received conventional neurological therapies. One group, however, also received acupuncture. The acupoints used were the following:

• Qianshencong – Xuanli (anterior oblique scalp line of vertex-temporal)
• Neiguan (PC6)
• Jiquan (HT1)
• Chize (LU5)
• Jianyu (LI15)
• Xiaoluo (TB12)
• Tianjing (TB10)
• Waiguan (TB5)
• Sanyinjiao (SP6)
• Weizhong (BL40)
• Xuehai (SP10)
• Taixi (KD3)
• Zusanli (ST36)
• Huantiao (GB30)
• Yanglingquan (GB34)
• Xuanzhong (GB39)

Scalp acupuncture needles were applied to achieve deqi with manual techniques followed by rotations for 2 – 3 minutes. Needles were rotated every 5 minutes and total needle retention time was 30 minutes. The remaining acupuncture needles were manually stimulated using reinforcing and reducing techniques. Needles were manually re-stimulated every 10 minutes during the 30 minute needle retention time. Acupuncture sessions were once per day for 20 days. The results demonstrate that adding acupuncture to conventional therapy produces superior patient outcomes to using only conventional therapy. Acupuncture lowered the incidence of fatalities and paralysis.