Acupuncture, an effective treatment for post-stroke neurologic dysfunction

This comprehensive review systematically examines the efficacy of acupuncture in the treatment of post-stroke neurologic dysfunction, a condition that affects millions of people globally. Stroke, responsible for approximately 87% of all cerebrovascular events, frequently results in devastating sequelae including hemiparesis, spasticity, dysphagia, sensory dysfunction, cognitive impairment, depression, and aphasia. Acupuncture, recognized by the World Health Organization for stroke treatment, emerges as a promising therapeutic modality due to its distinct advantages in managing cerebrovascular disease. The methodology of this review involved systematic analysis of clinical and experimental studies published over the past two decades, examining both randomized clinical trials and studies in animal models.

The researchers focused specifically on improvements in post-stroke neurologic dysfunctions attributable to acupuncture treatment, elucidating potential mechanisms of action proposed in recent years. The results demonstrate that acupuncture acts through multiple mechanisms to improve stroke sequelae. For motor dysfunction, including hemiparesis and spasticity, acupuncture promotes remodeling of neural circuits through repair of the corticospinal tract (CST), modulates neuronal excitability and muscle structure, and maintains homeostasis of neurotransmitters such as GABA and glutamate. The most commonly used acupoints include ST-36 and GB-34 for motor dysfunction, with scalp acupuncture targeting the bilateral anterior parieto-temporal oblique region showing clear therapeutic effects.

For post-stroke dysphagia, the primary treatment point is CV-23, which improves swallowing function through two neural conduction pathways: motor and sensory. The mechanism involves neuronal activation, improvement of circulation, increased myoelectric conduction velocity, and upregulation of relevant target proteins, activating the M1 and S1 areas via the hypoglossal nerve. For sensory dysfunction, specifically central post-stroke pain and hemiplegic shoulder pain, acupuncture demonstrates efficacy through modulation of inflammatory pathways and reduction of ultrasonographic indicators of joint dysfunction. Psychological and mental conditions, including post-stroke depression, post-stroke cognitive impairment, and post-stroke aphasia, respond favorably to acupuncture treatment.

Point GV-20 is frequently used due to its role in cerebral control, significantly improving the inflammatory response and metabolic disturbances in the brain. Treatment maintains the integrity of the hippocampus and white matter areas, while HT-5 plays a key role in improving language function through activation of Broca's area. Cellular and molecular mechanisms include activation of endogenous recovery processes, induction of ischemic tolerance responses, and anti-inflammatory, antioxidant, and anti-apoptotic properties. Acupuncture also significantly promotes neurologic recovery through increased vascular and nerve regeneration and stimulation of release of neurotrophic factors that provide neuroprotection.

Neuroimaging analysis reveals that acupuncture modulates functional neural networks, including the sensorimotor network, interoceptive network, default mode network, and salience network, contributing to improvement of motor function in the affected limb. The clinical implications of this review are substantial, providing robust evidence for the integration of acupuncture into post-stroke rehabilitation protocols. The therapy offers an effective, low-cost alternative with minimal adverse effects compared with conventional pharmacologic interventions. Identified limitations include variability in study designs, lack of standardization in acupoints used, and the need for more robust clinical studies to establish definitive treatment guidelines.