Effect of adjunctive acupuncture on structural-functional connectivity coupling in stroke patients
Poster No:
1441
Submission Type:
Abstract Submission
Authors:
Pearly Joubert1, Frances Robertson1, Marc Combrink1, Xuesheng Ma2, Fleur Warton1, Sesethu Ntsinde1, Hai Lu3, Qian Song4, Jiu Chen3, Nelleke Langerak1, Gillian Ferguson1, Xuesong Ren4, Chunhong Zhang4, Ernesta Meintjes1, Jia Fan1
Institutions:
1University of Cape Town, Cape Town, Western Cape, 2University of the Western Cape, Cape Town, Western Cape, 3Nanjing University, Nanjing, Jiangsu, 4Tianjin University of Traditional Chinese Medicine, Tianjin, Tianjin
First Author:
Co-Author(s):
Introduction:
Stroke is the second leading cause of mortality and the third leading cause of disability, worldwide (Feigin et al., 2017). China bears the biggest burden of stroke in the world, with about 2 million new cases each year. Stroke rehabilitation is important to improve the patient's motor performance. In China, acupuncture is the most common form of stroke rehabilitation. However, the mechanism of acupuncture on the structural-functional connectivity (SC-FC) coupling in the brain is not fully understood.
Methods:
Fourteen right-handed male hemiplegic stroke patients (aged 46-70 yr) with basal ganglia infarcts were recruited from the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, randomized into two treatment groups: 1) True Acupuncture (TA) and Physiotherapy (PT) (n=6), and 2) PT and Sham Acupuncture (SA, non-acupoint acupuncture, n=8). Patients underwent 15 sessions of acupuncture and physiotherapy over 3 weeks. The Xing Nao Kai Qiao method was used for both true and sham acupuncture (Yang et al., 2023). The Fugl-Meyer Assessment (FMA), a quantitative measure for assessing recovery in hemiplegic stroke patients (Gladstone et al., 2002), and a set of MRI data were obtained after treatment. The patients were imaged using a 3T Skyra MRI (Siemens, Erlangen, Germany), with Diffusion Tensor Imaging (DTI), resting-state Functional Magnetic Resonance Imaging (rs-fMRI), and T1-weighted images acquired. The TORTOISE software package was used for pre-processing DTI data (Pierpaoli et al., 2010). The network nodes were defined by using the automated anatomical labeling (AAL116) atlas (Liu et al., 2023). The 3dTrackID was used to estimate tracts across the whole brain (Taylor and Saad, 2013) and the mean fractional anisotropy (FA) was used to construct the SC matrices. The rs-FMRI data was pre-processed using the GRETNA toolbox (Wang et al., 2015). The FC matrices were obtained using the mean time series.
Results:
A weak positive correlation was observed between the SC and the FC for the SA+PT (r=0.13) and the TA+PT (r=0.15) group at the group level (Figure 1.A&B) indicating a slight tendency for higher SC to be associated with higher FC. At the individual level, a slightly higher SC-FC coupling was observed for the SA+PT group compared to the TA+PT group (Figure 1. C), however, the difference was not significant. Furthermore, a weak positive correlation (r=0.29) was observed between the SC-FC coupling and the FMA score for the SA+PT group (Figure 2.A), which was not statistically significant (p-value=0.48). The TA+PT group exhibited a weak negative correlation between SC-FC coupling and FMA scores (r=−0.21), which was not statistically significant (Figure 2.B). Motor recovery was not significantly different between the groups where most of the patients in the TA+PT group had higher FMA scores compared to the SA+PT group (Figure 2.C).
Conclusions:
Ischemic stroke results in a reduction of SC-FC coupling compared to healthy controls (Chen et al., 2021). Although our study lacked a control group, our data suggests that the weak SC-FC coupling observed in both the SA+PT and TA+PT groups may result from compromised functional activity due to white matter damage as FC depends on the SC in the brain (Litwińczuk et al., 2022). Our sample size was too small to achieve statistical significance, so future studies should examine this in a larger sample. Unexpectedly, in the TA+PT group, SC-FC coupling decreased while FMA scores increased, in contrast to the SA+PT group. Despite these differences, most of the patients in the TA+PT group had better motor recovery than the SA+PT group. This might suggest that while the structural connectivity improves, the functional networks might reflect compensatory adaptations rather than the restoration of original connectivity patterns (Santillo et al., 2024).
Modeling and Analysis Methods:
Diffusion MRI Modeling and Analysis 2
fMRI Connectivity and Network Modeling 1
Keywords:
ADULTS
Data analysis
DISORDERS
FUNCTIONAL MRI
Physical Therapy
Therapy
White Matter
WHITE MATTER IMAGING - DTI, HARDI, DSI, ETC
1|2Indicates the priority used for review
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Provide references using APA citation style.
Feigin, V. L., Norrving, B., & Mensah, G. A. (2017). Global burden of stroke. Circulation research, 120 (3), 439–448.
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Litwińczuk, M. C., Muhlert, N., Cloutman, L., Trujillo-Barreto, N., & Woollams, A. (2022). Combination of structural and functional connectivity explains unique variation In specific domains of cognitive function. NeuroImage, 262, 119531.
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