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 ex-amined the relationship between changes in function of the affected upper limb and brain activation using func-tional magnetic resonance imaging (fMRI). Methods: Seven (7) chronic hemiparetic stroke patients underwent fMRI and testing of function of the af-fected 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 acti-vation 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. 52