A fMRI study of language-implicated acupoint in stroke patients with expressive aphasia

Little is known about the neural basis of recovery in aphasia following stroke. In this study, we used fMRI to map the brain activations during four sequential tasks: word generation only; word generation plus insertion of acupuncture needles into a language-implicated acupoint, SJ8; word generation and electro-acupuncture; and electro-acupuncture alone. We studied 6 stable stroke patients with expressive aphasia lasted for more than six months since their left middle cerebral artery (MCA) territory infarction and compared the results with that of 14 age-matched control subjects. All subjects were strongly right-handed. fMRI data were analyzed using SPM99. In the control subjects, strong activations were seen over the principal language sites, including the Broca¡¦s and Wernicke¡¦s areas, in the control subjects during the language task with or without the electro-acupuncture; the Wernicke¡¦s area and other supplementary language sites were activated during electro-acupuncture alone. In the stroke patients, small areas of activations were observed in the peri-lesional areas of the principal language sites as well as the mirror-image sites over the non-dominant hemisphere during any of the four tasks. Our novel results suggest that recruitment of the peri-lesional areas of the principal language sites and the homologous sites over the non-dominant right hemisphere with functional reorganizations of these sites may be a mechanism for functional recovery of language following insults such as stroke. In addition, our results illustrate the potential benefit of electro-acupuncture over a language-implicated acupoint in promoting the functional reorganization of the non-principal language sites and, in turn, achieving functional recovery of aphasia due to stroke