Acupuncture Enhances Effective Connectivity between Cerebellum and Primary Sensorimotor Cortex in Patients with Stable Recovery Stroke

Recent neuroimaging studies have demonstrated that stimulation of acupuncture at motor-implicated acupoints modulates activities of brain areas relevant to the processing of motor functions. This study aims to investigate acupuncture-induced changes in effective connectivity among motor areas in hemiparetic stroke patients by using the multivariate Granger causal analysis. A total of 9 stable recovery stroke patients and 8 healthy controls were recruited and underwent three runs of fMRI scan: passive finger movements and resting state before and after manual acupuncture stimuli. Stroke patients showed significantly attenuated effective connectivity between cortical and subcortical areas during passive motor task, which indicates inefficient information transmissions between cortical and subcortical motor-related regions. Acupuncture at motor-implicated acupoints showed specific modulations of motor-related network in stroke patients relative to healthy control subjects. This specific modulation enhanced bidirectionally effective connectivity between the cerebellum and primary sensorimotor cortex in stroke patients, which may compensate for the attenuated effective connectivity between cortical and subcortical areas during passive motor task and, consequently, contribute to improvement of movement coordination and motor learning in subacute stroke patients. Our results suggested that further efficacy studies of acupuncture in motor recovery can focus on the improvement of movement coordination and motor learning during motor rehabilitation

Editorial: Advances and applications of artificial intelligence and numerical simulation in risk emergency management and treatment

No abstract available

Acupuncture Modulates the Functional Connectivity of the Default Mode Network in Stroke Patients

Abundant evidence from previous fMRI studies on acupuncture has revealed significant modulatory effects at widespread brain regions. However, few reports on the modulation to the default mode network (DMN) of stroke patients have been investigated in the field of acupuncture. To study the modulatory effects of acupuncture on the DMN of stroke patients, eight right hemispheric infarction and stable ischemic stroke patients and ten healthy subjects were recruited to undergo resting state fMRI scanning before and after acupuncture stimulation. Functional connectivity analysis was applied with the bilateral posterior cingulate cortices chosen as the seed regions. The main finding demonstrated that the interregional interactions between the ACC and PCC especially enhanced after acupuncture at GB34 in stroke patients, compared with healthy controls. The results indicated that the possible mechanisms of the modulatory effects of acupuncture on the DMN of stroke patients could be interpreted in terms of cognitive ability and motor function recovery

Efficacy of Chuanxiong Ding Tong Herbal Formula Granule in the Treatment and Prophylactic of Migraine Patients: A Randomized, Double-Blind, Multicenter, Placebo-Controlled Trial

Objective. To evaluate the efficacy of traditional Chinese herbal ChuanXiong Ding Tong herbal formula granule (CXDT-HFG) for migraine patients with “the Syndrome of Liver Wind and Blood Stasis.” Methods. 150 migraine patients were recruited and assigned randomly in a double-blind, placebo-controlled study to receive CXDT-HFG (n=99) plus necessary analgesics, or placebo (n=51) plus necessary analgesics for 16 weeks (12 weeks’ intervention and 4 weeks’ follow up). Outcome measures included migraine days, frequency of migraine attacks, analgesics consumption for acute treatment, and the proportion of responders as well as the visual analogue scale (VAS) scores and intensity for pain. Results. Compared with the placebo group, the CXDT-HFG group showed significant reduction in migraine days and attacks frequency at week 12 and follow-up period (P0.05). Conclusion. CXDT-HFG was more effective than placebo in decreasing days of migraine attacks, frequency, VAS scores, and relieving pain intensity for migraine patients

Pharmacological Mechanisms Underlying the Therapeutic Effects of Danhong Injection on Cerebral Ischemia

Background. Although Danhong injection (DHI) has been proved to be curative, the mechanism of its action against ischemia stroke (IS) is not clear. Here, we explored the therapeutic basis of DHI by network pharmacology. Methods. Putative targets and activity scores for each compound in DHI were obtained from the Traditional Chinese Medicine System Pharmacology Database, Encyclopedia of Traditional Chinese Medicine, and Quantitative Structure Activity Relationships. Next, target proteins of IS were identified on GeneCards and CTD. Overlapping targets of DHI associated with IS were acquired via Venn diagram. GO and KEGG pathway analyses were done using WebGestalt. Cytoscape software was used for PPI network construction and hub nodes screening. Several validation studies were carried out by using AutoDock-Vina, label-free mass spectrometry, and transcriptome RNA-sequencing. Results. The 37 active compounds and 66 targets were identified. Of these, 26 compounds and 41 targets belonged to diterpenoid quinones (DQs), which is the predominant category based on chemical structure. The results of enrichments analysis show that 8 DQs target proteins associated with IS were involved in several biological processes and signaling pathway such as apoptotic, cell cycle, cellular response to xenobiotic stimulus process, and the PI3K-Akt signaling. Moreover, 3 nodes in core module involved in PI3K-Akt signaling and 1 hub node were identified by PPI network analysis. Finally, the results of molecular docking and label-free mass spectrometry display good effect on hub node regulation in DHI treatment. Conclusions. DQs is the predominant category of DHI and play an important role in antiapoptotic activity mediated by modulating PI3K-Akt signaling. Our findings offer insight into future research and clinical applications in IS therapy

Current trends in tai chi for stroke rehabilitation

Background There are an increasing number of studies focusing on the effect of tai chi for different diseases. As a special form of physical activity, tai chi may be beneficial for the rehabilitation of stroke, a leading cause of disability worldwide. Objective This review summarizes the existing literature on the potential benefits of tai chi for stroke rehabilitation and offers recommendations for future research. Methods Studies on the biomechanics and physiology of tai chi for stroke rehabilitation are reviewed. Research on tai chi for stroke rehabilitation and related diseases are summarized. Finally, the shortcomings of existing studies and recommendations for future studies are discussed. Conclusions Tai chi appears to be beneficial for stroke rehabilitation. But reporting quality of existing studies are sub-optimal. Future trials should define tai chi style, apply rigorous methodology to sample size calculation, randomization, recruiting criteria, and outcome measures. To avoid inadequacies during the research and reporting processes, investigators may wish to follow CONSORT guidelines and refer to well-conducted clinical studies on tai chi

Tai Chi for Stroke Rehabilitation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background: Stroke is a major cause of poor health and has numerous complications. Tai Chi (TC) may have positive effects on the rehabilitation of stroke survivors, but recent clinical findings have not been included in previously published reviews.Objectives: We conducted this systematic review and meta-analysis to determine the effectiveness of all types of TC vs. conventional rehabilitation therapy for all aspects of stroke survivors' rehabilitation that have been studied.Method: We searched seven electronic literature databases (three in English, four in Chinese) and one clinical registry platform using established strategies to identify randomized controlled trials performed up to October 2017. Screening, quality assessment, and data collection were performed by two researchers separately, using the same standard. The results were analyzed using RevMan 5.3.0. The quality of evidence was evaluated with GRADEpro.Results: A total of 21 studies with 1,293 stroke survivors met inclusion criteria; 14 were included in the quantitative synthesis to evaluate four aspects and five outcomes. Nine studies indicated that TC was able to improve independent activities of daily living (ADL), especially TC vs. conventional rehabilitation therapy [mean difference (MD) [95% confidence interval (CI)] = 9.92 [6.82, 13.02], P < 0.00001]. Five studies reported significant effects of TC plus conventional rehabilitation therapy in increasing scores on the Fugl–Meyer Assessment for the upper limb [MD (95%CI) = 8.27 [4.69, 11.84], P < 0.0001], lower limb [MD (95%CI) = 2.75 [0.95, 4.56], P = 0.003], and overall [MD (95%CI) = 4.49 [1.92, 7.06], P = 0.0006]. The Berg Balance Scale revealed significant improvements according to pooled estimates for TC vs. conventional rehabilitation therapy [MD (95%CI) = 5.23 [3.42, 7.05], P < 0.00001]. TC plus conventional rehabilitation therapy also improved walking ability as measured by the Holden scale [MD (95%CI) = 0.61 [0.38, 0.85], P < 0.00001] and up-and-go time [MD (95%CI) = 2.59 [1.76, 3.43], P < 0.00001].Conclusion: TC has an overall beneficial effect on ADL, balance, limb motor function, and walking ability among stroke survivors, based on very low-quality evidence, and may also improve sleep quality, mood, mental health, and other motor function. Well-designed, higher-quality trials with longer-term follow-up periods are needed to develop better-quality evidence