Neuroimaging mechanisms of acupuncture on functional reorganization for post-stroke motor improvement: a machine learning-based functional magnetic resonance imaging study

Exploring the potential of machine learning and magnetic resonance imaging in early stroke diagnosis: a bibliometric analysis (2004-2023)

Objective

To examine the focal areas of research in the early diagnosis of stroke through machine learning identification of magnetic resonance imaging characteristics from 2004 to 2023.

Methods

Data were gathered from the Science Citation Index-Expanded (SCI-E) within the Web of Science Core Collection (WoSCC). Utilizing CiteSpace 6.2.R6, a thorough analysis was conducted, encompassing publications, authors, cited authors, countries, institutions, cited journals, references, and keywords. This investigation covered the period from 2004 to 2023, with the data retrieval completed on December 1, 2023, in a single day.

Results

In total, 395 articles were incorporated into the analysis. Prior to 2015, the annual publication count was under 10, but a significant surge in publications was observed post-2015. Institutions and authors from the USA and China have established themselves as mature academic entities on a global scale, forging extensive collaborative networks with other institutions. High-impact journals in this field predominantly feature in top-tier publications, indicating a consensus in the medical community on the application of machine learning for early stroke diagnosis. "deep learning," "magnetic resonance imaging," and "stroke" emerged as the most attention-gathering keywords among researchers. The development in this field is marked by a coexisting pattern of interdisciplinary integration and refinement within major disciplinary branches.

Conclusion

The application of machine learning in the early prediction and personalized medical plans for stroke patients using neuroimaging characteristics offers significant value. The most notable research hotspots currently are the optimal selection of neural imaging markers and the most suitable machine learning algorithm models.

Overview of evidence-based research on acupuncture for stroke treatment using magnetic resonance imaging technology

Background

Stroke is a neurological condition characterized by high rates of disability and mortality. Magnetic resonance imaging (MRI) is widely used to examine the mechanisms of acupuncture in stroke treatment.

Purpose

This review provides neuroimaging evidence for the efficacy of acupuncture in treating stroke using MRI.

Method

We conducted a comprehensive search of databases, including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang Data, Chinese BioMedical Literature Database (CBM), and Chonqing VIP (CQVIP), from inception to April 2024. Relevant neuroimaging studies on acupuncture for stroke were included, and the research findings were presented through charts and textual analyses.

Results

A total of 158 studies were included, and the overall methodological quality of the included studies was moderate to high. The results were divided into three categories: basic characteristics, clinical characteristics, and quality assessment of the included literature.

Conclusion

We elucidated the neural mechanisms underlying the effects of acupuncture on stroke; however, the evidence remains preliminary. There is a need for large-scale, well-designed, multimodal neuroimaging trials. This review represents the first active use of an evidence map to systematically review and illustrate the current state of neuroimaging research on the acupuncture treatment of stroke, thereby providing a valuable reference for future research.

Investigating combined acupuncture and transcranial direct current stimulation in patients with poststroke shoulder pain from China: protocol for a randomised controlled trial

INTRODUCTION

Poststroke shoulder pain is a common complication that severely affects the recovery of upper limb motor function. Acupuncture has positive analgesic effects in treating poststroke shoulder pain, and studies have demonstrated the efficacy of transcranial direct current stimulation (tDCS) in treating patients with this pain. However, whether acupuncture combined with tDCS has a superior rehabilitation effect on poststroke shoulder pain is currently unknown. We aimed to observe the effect of the combined intervention on poststroke shoulder pain and explore its possible central analgesic mechanism.

METHODS AND ANALYSIS

This study describes a randomised controlled trial using assessor blinding. A total of 135 poststroke patients with shoulder pain will be randomly assigned in a 1:1:1 ratio to the tDCS group, acupuncture group and combined group (acupuncture plus tDCS). All three groups will undergo conventional rehabilitation treatment. Participants in the tDCS group will receive tDCS stimulation on the M1 area for 20 min, while the acupuncture group will receive 20 min of acupuncture. The combined treatment group will receive both. All treatments will be performed five times per week for 4 weeks. The primary outcome indicator in this study is the Visual Analogue Scale pain score. Secondary outcome indicators include shoulder mobility, Shoulder Pain and Disability Index, Fugl-Meyer Motor Function Scale, Modified Barthel Index Scale, Self-Rating Anxiety and Depression Scale and functional MRI. All scale results will be assessed at baseline and at 2 weeks and 4 weeks, and during follow-up at 1 month, 3 months and 6 months postdischarge. A repeated analysis of variance will be conducted to observe the group×time interaction effects of the combined intervention. Moreover, functional MRI will be applied to explore the central analgesic mechanism.

ETHICS AND DISSEMINATION

Ethics approval was obtained from the Ethics Committee of the Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine (2023KY-039-001). The results of the study will be published in a peer-reviewed journal and presented at scientific conferences.

TRIAL REGISTRATION NUMBER

ChiCTR2300078270.

Bilateral effect of acupuncture on cerebrum and cerebellum in ischaemic stroke patients with hemiparesis: a randomised clinical and neuroimaging trial

BACKGROUND

Acupuncture involving the limb region may be effective for stroke rehabilitation clinically, but the visualised and explanatory evidence is limited. Our objectives were to assess the specific effects of acupuncture for ischaemic stroke (IS) patients with hemiparesis and investigate its therapy-driven modification in functional connectivity.

METHODS

IS patients were randomly assigned (2:1) to receive 10 sessions of hand-foot 12 needles acupuncture (HA, n=30) or non-acupoint (NA) acupuncture (n=16), enrolling gender-matched and age-matched healthy controls (HCs, n=34). The clinical outcomes were the improved Fugl-Meyer Assessment scores including upper and lower extremity (ΔFM, ΔFM-UE, ΔFM-LE). The neuroimaging outcome was voxel-mirrored homotopic connectivity (VMHC). Static and dynamic functional connectivity (sFC, DFC) analyses were used to study the neuroplasticity reorganisation.

RESULTS

46 ISs (mean(SD) age, 59.37 (11.36) years) and 34 HCs (mean(SD) age, 52.88 (9.69) years) were included in the per-protocol analysis of clinical and neuroimaging. In clinical, ΔFM scores were 5.00 in HA group and 2.50 in NA group, with a dual correlation between ΔFM and ΔVMHC (angular: r=0.696, p=0.000; cerebellum: r=-0.716, p=0.000) fitting the linear regression model (R2=0.828). In neuroimaging, ISs demonstrated decreased VMHC in bilateral postcentral gyrus and cerebellum (Gaussian random field, GRF corrected, voxel p<0.001, cluster p<0.05), which fitted the logistic regression model (AUC=0.8413, accuracy=0.7500). Following acupuncture, VMHC in bilateral superior frontal gyrus orbital part was increased with cerebro-cerebellar changes, involving higher sFC between ipsilesional superior frontal gyrus orbital part and the contralesional orbitofrontal cortex as well as cerebellum (GRF corrected, voxel p<0.001, cluster p<0.05). The coefficient of variation of VMHC was decreased in bilateral posterior cingulate gyrus (PPC) locally (GRF corrected, voxel p<0.001, cluster p<0.05), with integration states transforming into segregation states overall (p<0.05). There was no acupuncture-related adverse event.

CONCLUSIONS

The randomised clinical and neuroimaging trial demonstrated acupuncture could promote the motor recovery and modified cerebro-cerebellar VMHC via bilateral static and dynamic reorganisations for IS patients with hemiparesis.

Research trends and hotspots of post-stroke dysphagia rehabilitation: a bibliometric study and visualization analysis

Background

Post-stroke dysphagia (PSD) is one of the most prevalent stroke sequelae, affecting stroke patients' prognosis, rehabilitation results, and quality of life while posing a significant cost burden. Although studies have been undertaken to characterize the pathophysiology, epidemiology, and risk factors of post-stroke dysphagia, there is still a paucity of research trends and hotspots on this subject. The purpose of this study was to create a visual knowledge map based on bibliometric analysis that identifies research hotspots and predicts future research trends.

Methods

We searched the Web of Science Core Collection for material on PSD rehabilitation research from its inception until July 27, 2023. We used CiteSpace, VOSviewer, and Bibliometrix R software packages to evaluate the annual number of publications, nations, institutions, journals, authors, references, and keywords to describe present research hotspots and prospective research orientations.

Results

This analysis comprised 1,097 articles from 3,706 institutions, 374 journals, and 239 countries or regions. The United States had the most publications (215 articles), and it is the most influential country on the subject. "Dysphagia" was the most published journal (100 articles) and the most referenced journal (4,606 citations). Highly cited references focused on the pathophysiology and neuroplasticity mechanisms of PSD, therapeutic modalities, rehabilitation tactics, and complications prevention. There was a strong correlation between the terms "validity" and "noninvasive," which were the strongest terms in PSD rehabilitation research. The most significant words in PSD rehabilitation research were "validity" and "noninvasive brain stimulation," which are considered two of the most relevant hotspots in the field.

Conclusion

We reviewed the research in the field of PSD rehabilitation using bibliometrics to identify research hotspots and cutting-edge trends in the field, primarily including the pathogenesis and neurological plasticity mechanisms of PSD, complications, swallowing screening and assessment methods, and swallowing rehabilitation modalities, and this paper can provide in the follow-up research in the field of PSD rehabilitation. The results of this study can provide insightful data for subsequent studies in the field of PSD rehabilitation.

Effect of auricular acupressure combined with acupuncture for juvenile pseudomyopia

This retrospective study investigated the effect of auricular acupressure combined with acupuncture for juvenile pseudomyopia (JPM). In this retrospective study, we collected and analyzed a total of 66 eligible records of subjects with JPM. They were allocated into a treatment group (n = 33) and a control group (n = 33). All participants in both groups received auricular acupressure. Additionally, children in the treatment group also underwent acupuncture. The primary outcome was naked visual acuity (VA). It was performed using a standard E visual acuity chart. The secondary outcome was visual fatigue symptoms, as assessed by the College of Optometrists in Vision Development Quality of Life (COVD-QoL) questionnaire. All outcomes were analyzed before and after treatment. There were no significant differences regarding the naked VA and COVD-QoL scores before and after treatment between the 2 groups. However, there were significant differences regarding on naked VA (P < .01) and COVD-QoL scores (P < .01) within 2 groups compared before and after treatment. The findings of this study showed that both APP plus acupuncture and APP alone benefit children with JPM.