OBJECTIVE:To observe the effect of Tiaoshen Kaiqiao acupuncture in the treatment of ischemic post-stroke depression.

METHODS:This research was a single-blind, positive-controlled trial done in a single entity. Totally 58 patients with ischemic post-stroke depression were randomly divided into two groups. The acupuncture group was given Tiaoshen Kaiqiao acupuncture therapy and placebo starch tablets treatment, while the control group was treated with fluoxetine tablets and body acupuncture treatment. Evaluated the clinical efficacy of the two groups with Hamilton Depression Scale (HAMD), Anti Depression Drug Side Effects Rating Scale (SERS), Clinical Global Impression Scale (CGI) respectively before treatment, the fourth weekend of treatment, the eighth weekend of treatment, the twelfth weekend of treatment. The adverse reactions in two groups were observed and documented.

RESULTS:The HAMD scale scores of the two groups in different treatment period were significantly decreased compared with that before treatment (P<0.05); the score reduction of HAMD scale between the two groups had no significant differences (P>0.05). There was significant difference between the SERS scores of two groups (P<0.05); the control group had more adverse reactions, and the score would be increased with the extension of treatment time. Effect index (EI) of CGI in the acupuncture group is better than that of control group (P<0.05).

CONCLUSION:The effects of Tiaoshen Kaiqiao acupuncture and fluoxetine in the treatment of ischemic post-stroke depression were similar, but the former had no obvious adverse reaction and side effects.

OBJECTIVES:To determine whether the combination of acupuncture and rehabilitation produces better results in the treatment of acute or subacute stroke sequelae than rehabilitation alone.

METHODS:A systematic review was carried out. A search was conducted in March 2014 using PubMed, Medline, the Cochrane Library, Chinese National Knowledge Infrastructure database (CNKI) and Wanfang databases. English and Chinese language articles published within 10 years of the search were reviewed for inclusion. Randomised control trials comparing combined treatment with acupuncture and rehabilitation and rehabilitation alone in patients with acute or subacute stroke (onset until 3 months after stroke) were included in this review. Three review authors independently checked the titles and abstracts of trials for inclusion based on selection criteria. Studies measuring changes of motor function, activities of daily living, neurological deficit or spasticity/range of motion during the treatment period and at the end of follow-up were included.

RESULTS:17 trials met the inclusion criteria, of which five were of good quality. 14 trials had results favourable to acupuncture combined with rehabilitation, compared with conventional rehabilitation treatment alone.

CONCLUSIONS:Acupuncture in combination with rehabilitation may have benefits for the treatment of acute and subacute stroke sequelae in comparison with rehabilitation alone. However, many of the studies were at risk of bias. Future studies should focus on reaching a consensus about the most appropriate modality of acupuncture intervention, and the appropriate length of treatment for both interventions, to maximise the potential synergistic outcomes.

OBJECTIVES:To determine whether the combination of acupuncture and rehabilitation produces better results in the treatment of acute or subacute stroke sequelae than rehabilitation alone.

METHODS:A systematic review was carried out. A search was conducted in March 2014 using PubMed, Medline, the Cochrane Library, Chinese National Knowledge Infrastructure database (CNKI) and Wanfang databases. English and Chinese language articles published within 10 years of the search were reviewed for inclusion. Randomised control trials comparing combined treatment with acupuncture and rehabilitation and rehabilitation alone in patients with acute or subacute stroke (onset until 3 months after stroke) were included in this review. Three review authors independently checked the titles and abstracts of trials for inclusion based on selection criteria. Studies measuring changes of motor function, activities of daily living, neurological deficit or spasticity/range of motion during the treatment period and at the end of follow-up were included.

RESULTS:17 trials met the inclusion criteria, of which five were of good quality. 14 trials had results favourable to acupuncture combined with rehabilitation, compared with conventional rehabilitation treatment alone.

CONCLUSIONS:Acupuncture in combination with rehabilitation may have benefits for the treatment of acute and subacute stroke sequelae in comparison with rehabilitation alone. However, many of the studies were at risk of bias. Future studies should focus on reaching a consensus about the most appropriate modality of acupuncture intervention, and the appropriate length of treatment for both interventions, to maximise the potential synergistic outcomes.

OBJECTIVE:To observe the impacts on the recovery of swallowing function in patients of dysphagia after acute stroke treated with acupuncture and functional electric stimulation.

METHODS:Seventy-four patients were randomized into an acupuncture plus electric stimulation group (38 cases) and an electric stimulation group (36 cases). The functional electric stimulator was used in the two groups. The electric pads were placed on the hyoid bone, the upper part of thyroid cartilage, the masseter muscle and the mandibular joint. The treatment lasted for 30 mm each time. In the acupuncture plus electric stimulation group, acupuncture was supplemented at motor area of Jiao's scalp acupuncture, lower 2/5 of sensory area, Baihui (CV 20), Lianquan (CV 23), Jinjin (EX-HN 12) and Yuye (EX-HN 13), 30 mm each time. The treatment was given once a day, 6 treatments for one session and there was 1 day at interval between the sessions, 4 sessions were required totally in the two groups. The dysphagia scale was adopted for efficacy evaluation before treatment and after 4 sessions of treatment in the two groups. The removal rate of nasal feeding tube was observed after treatment.

RESULTS:The dysphagia score was increased apparently after treatment compared with that before treatment in the two groups (both P<0.05). After treatment, in the acupuncture plus electric stimulation group, the dysphagia score was increased much more apparently than that in the electric stimulation group (8.01 +/- 1.25 vs 6.73 +/- 1.36, P<0.05). The remarkably effective rate was 84.2% (32/38) in the acupuncture plus electric stimulation group, better than 58.3% (21/36) in the electric stimulation group (P<0.05). The removal rate of nasal feeding tube was 89.5% (34/38) in the acupuncture plus electric stimulation group, which was higher than 50. 0% (18/36) in the electric stimulation group (P<0.05).

CONCLUSION:Acupuncture combined with electric stimulation achieves the much better efficacy on dysphagia after acute stroke and promotes the early removal of nasal feeding tube. The efficacy is better than that of the simple electric stimulation therapy.

OBJECTIVE:To observe the impacts on the recovery of swallowing function in patients of dysphagia after acute stroke treated with acupuncture and functional electric stimulation.

METHODS:Seventy-four patients were randomized into an acupuncture plus electric stimulation group (38 cases) and an electric stimulation group (36 cases). The functional electric stimulator was used in the two groups. The electric pads were placed on the hyoid bone, the upper part of thyroid cartilage, the masseter muscle and the mandibular joint. The treatment lasted for 30 mm each time. In the acupuncture plus electric stimulation group, acupuncture was supplemented at motor area of Jiao's scalp acupuncture, lower 2/5 of sensory area, Baihui (CV 20), Lianquan (CV 23), Jinjin (EX-HN 12) and Yuye (EX-HN 13), 30 mm each time. The treatment was given once a day, 6 treatments for one session and there was 1 day at interval between the sessions, 4 sessions were required totally in the two groups. The dysphagia scale was adopted for efficacy evaluation before treatment and after 4 sessions of treatment in the two groups. The removal rate of nasal feeding tube was observed after treatment.

RESULTS:The dysphagia score was increased apparently after treatment compared with that before treatment in the two groups (both P<0.05). After treatment, in the acupuncture plus electric stimulation group, the dysphagia score was increased much more apparently than that in the electric stimulation group (8.01 +/- 1.25 vs 6.73 +/- 1.36, P<0.05). The remarkably effective rate was 84.2% (32/38) in the acupuncture plus electric stimulation group, better than 58.3% (21/36) in the electric stimulation group (P<0.05). The removal rate of nasal feeding tube was 89.5% (34/38) in the acupuncture plus electric stimulation group, which was higher than 50. 0% (18/36) in the electric stimulation group (P<0.05).

CONCLUSION:Acupuncture combined with electric stimulation achieves the much better efficacy on dysphagia after acute stroke and promotes the early removal of nasal feeding tube. The efficacy is better than that of the simple electric stimulation therapy.

OBJECTIVE:To observe the effects on post-stroke depression treated with acupuncture at the acu points based on ziwuliuzhu (the midnight-noon ebb-flow theory).

METHODS:Ninety-three patients were randomized into a comprehensive group, a ziwuliuzhu group and a prozac group, 31 cases in each group. In the ziwuliuzhu group, acupuncture was applied to the acupoints based on ziwuliuzhu, once a day, 5 times in a week. In the prozac group, fluoxertine hydrochloride (prozac) was prescribed for oral administration, once a day, 20 mg each time. In the comprehensive group, acupuncture based on ziwuliuzhu combined with the oral administration of prozac were adopted and the treatment frequency was the same as the ziwuliuzhu group and the prozac group. The 4-week treatment was taken as one session in the three groups and 6 sessions were required totally. The clinical efficacy and the Hamilton depression rating scale (HAMD) score and the adverse reaction were compared among the 3 groups.

RESULTS:The total effective rate was 96.8% (30/31) in the comprehensive group, better than 83.9% (26/31) in the ziwuliuzhu group and 80. 6% (25/31) in the prozac group (both P<0.05). In 4, 12 and 24 weeks of treatment, HAMD score was lower significantly than that before the treatment in the three groups (all P<0.05), and the score in the comprehensive group at each time point after treatment was lower than the other two groups (all P<0.05). In 4 and 12 weeks of treatment, there were not different significantly between the ziwuliuzhu group and the prozac group (both P>0.05). In 24 weeks of treatment, HAMD score in the ziwuliuzhu group was lower than that in the prozac group (P<0.05). For the adverse reaction, there were 2 cases in the comprehensive group, 6 cases in the prozac group and 0 case in the ziwzuliuzhu group.

CONCLUSION:The comprehensive therapy of acupuncture at the acupoints based on ziwuliuzhu and oral administration of prozac is superior to either the simple oral administration of prozac or the ziwuliuzhu acu-puncture in terms of clinical efficacy and the improvements in depressive state. Regarding the clinical efficacy, the impact of simple ziwuliuzhu acupuncture is not different significantly as compared with the simple oral administration of prozac, but it is better than the simple oral administration of prozac in terms of the long-term HAMD score and safety.

OBJECTIVE:To observe the effects on post-stroke depression treated with acupuncture at the acu points based on ziwuliuzhu (the midnight-noon ebb-flow theory).

METHODS:Ninety-three patients were randomized into a comprehensive group, a ziwuliuzhu group and a prozac group, 31 cases in each group. In the ziwuliuzhu group, acupuncture was applied to the acupoints based on ziwuliuzhu, once a day, 5 times in a week. In the prozac group, fluoxertine hydrochloride (prozac) was prescribed for oral administration, once a day, 20 mg each time. In the comprehensive group, acupuncture based on ziwuliuzhu combined with the oral administration of prozac were adopted and the treatment frequency was the same as the ziwuliuzhu group and the prozac group. The 4-week treatment was taken as one session in the three groups and 6 sessions were required totally. The clinical efficacy and the Hamilton depression rating scale (HAMD) score and the adverse reaction were compared among the 3 groups.

RESULTS:The total effective rate was 96.8% (30/31) in the comprehensive group, better than 83.9% (26/31) in the ziwuliuzhu group and 80. 6% (25/31) in the prozac group (both P<0.05). In 4, 12 and 24 weeks of treatment, HAMD score was lower significantly than that before the treatment in the three groups (all P<0.05), and the score in the comprehensive group at each time point after treatment was lower than the other two groups (all P<0.05). In 4 and 12 weeks of treatment, there were not different significantly between the ziwuliuzhu group and the prozac group (both P>0.05). In 24 weeks of treatment, HAMD score in the ziwuliuzhu group was lower than that in the prozac group (P<0.05). For the adverse reaction, there were 2 cases in the comprehensive group, 6 cases in the prozac group and 0 case in the ziwzuliuzhu group.

CONCLUSION:The comprehensive therapy of acupuncture at the acupoints based on ziwuliuzhu and oral administration of prozac is superior to either the simple oral administration of prozac or the ziwuliuzhu acu-puncture in terms of clinical efficacy and the improvements in depressive state. Regarding the clinical efficacy, the impact of simple ziwuliuzhu acupuncture is not different significantly as compared with the simple oral administration of prozac, but it is better than the simple oral administration of prozac in terms of the long-term HAMD score and safety.

Electroacupuncture (EA) is reported to effectively relieve the central poststroke pain (CPSP). However, the underlying mechanism remains unclear. The present study investigated the detailed mechanisms of action of EA treatment at different frequencies for CPSP. A CPSP model was established with a single collagenase injection to the left ventral posterolateral nucleus of the thalamus. The EA-treated groups then received EA treatment at frequency of 2, 2/15, or 15 Hz for 30 min daily for five days. The pain-related behavioral responses, neuronal apoptosis, glial activation, and the expression of pain signal transmission-related factors (β-catenin, COX-2, and NK-1R) were assessed using behavioral tests, Nissl staining, TUNEL staining, and immunohistochemical staining, respectively. The low-frequency EA treatment significantly (1) reduced brain tissue damage and hematoma sizes and (2) inhibited neuronal apoptosis, thereby exerting abirritative effects. Meanwhile, the high-frequency EA treatment induced a greater inhibition of the aberrant astrocyteactivation, accompanied by the downregulation of the expressions of COX-2, β-catenin, and subsequently NK-1R, thereby alleviating inflammation and producing strong analgesic effects. Together, these findings suggest that CPSP is closely related to pathological changes of the neocortex and hippocampus. EA treatments at different frequencies may exert abirritative effects by inhibiting brain neuronal apoptosis and aberrant astrocyte activation in the brain.

BACKGROUND: Cerebral ischemia increases neurogenesis in the subventricular zone (SVZ) and in the subgranular zone (SGZ) of the dentate gyrus, and this might be modulated by an enriched environment including voluntary physical activity. We examined whether enforced physical training (EPT) influences neurogenesis in the SVZ and SGZ after cerebral ischemia.

METHODS: Adult male Sprague-Dawley rats were subjected to focal cerebral ischemia for 2 h, and divided into an EPT and a non-EPT group. All rats in the EPT group were trained using a rota-rod for 14 days. 5-bromo-2'-deoxyuridine (BrdU) was injected to determine levels of cell proliferation. Functional recovery was assessed using a set of behavioral test batteries. Extents of endogenous neurogenesis in the SVZ and SGZ were quantified by immunofluorescence staining. Although final infarction volumes were not significantly different in the groups, functional recovery was better in the EPT group at 10 and 17 days after ischemia. In the SVZ, BrdU labeling and double labeling of BrdU/Dcx and of BrdU/NeuN were not significantly different in the two groups. However, in the SGZ, EPT significantly increased the number of BrdU-positive cell numbers (EPT vs. non-EPT: 159.1+/-19.9 vs. 101.8+/-7.8, p=0.04), and the number of BrdU/Dcx double-labeled cells (130.6+/-16.9 vs. 73.6+/-7.2, p=0.01).

CONCLUSIONS: The results obtained indicate that EPT promotes neurogenesis in the SGZ of the dentate gyrus after ischemia, but not in the SVZ. The biochemical mechanism that determines the differential effects of EPT remains to be clarified.

[Purpose] The aim of this study was to assess the effects of ergometer cycling on the ambulatory function and cardiovascular fitness of patients with stroke in the sub-acute phase. [Participants and Methods] Twenty (20) patients with stroke in the sub-acute phase were randomly allocated to either an ergometer cycling group (n=10) or a control group (n=10). The experimental (ergometer cycling) group performed cycling exercises in addition to conventional physiotherapy for 60 minutes per session, three times per week for 8 weeks. The control group only received conventional physiotherapy for the same duration as the experimental group. Assessments of participants' functional ambulatory category, ambulatory velocity, 6-minute walk test, heart rate and blood pressure were conducted at baseline and at the end of the 8-week intervention. [Results] The means of the ambulatory velocity and distance walked in 6 minutes were significantly higher in the ergometer cycling group than those of the control group at week 8. However, the increase in the FAC score was not significant. The means of heart rate, systolic and diastolic blood pressures significantly decreased in the ergometer cycling group compared to the control group at the end of the 8-week of intervention. [Conclusion] This study demonstrated that ergometer cycling improved the ambulatory function and cardiovascular fitness of patients with stroke in the sub-acute phase.

[Purpose] This study was to observe the influence of Pilates training on the quality of life in chronic stoke patients. [Subjects and Methods] Forty chronic stroke patients participated in this study. They were divided into same number of experimental group (EG) and control group (CG). EG participated in a 60-min Pilates training program, twice a week for 12 weeks, while the CG did not participate in any exercise-related activities for the duration and participating in general occupational therapy without any exercise-related activities. Then the MMSE-K was performed before and after Pilates training to observe the influence of Pilates training on the quality of life in chronic stroke patients. [Results] Statistically significant improvement in the physical, social, and psychological domains was found in EG after the training. No statistically significant difference was found in all three quality of life domains for the CG. EG experienced a statistically significant improvement in all quality of life domains compared with that of CG. [Conclusion] Therefore, participation in Pilates training was found to effectively improve the quality of life in stroke patients. Pilates training involves low and intermediate intensity resistance and repetition that match the patient's physical ability and can be a remedial exercise program that can improve physical ability and influence quality of life.

Using a pre-post design, eleven chronic stroke patients with large left hemisphere lesions and nonfluent aphasia underwent diffusion tensor imaging and language testing before and after receiving 15 weeks of an intensive intonation-based speech therapy. This treated patient group was compared to an untreated patient group (n=9) scanned twice over a similar time period. Our results showed that the treated group, but not the untreated group, had reductions in fractional anisotropy in the white matter underlying the right inferior frontal gyrus (IFG, pars opercularis and pars triangularis), the right posterior superior temporal gyrus, and the right posterior cingulum. Furthermore, we found that greater improvements in speech production were associated with greater reductions in FA in the right IFG (pars opercularis). Thus, our findings showed that an intensive rehabilitation program for patients with nonfluent aphasia led to structural changes in the right hemisphere, which correlated with improvements in speech production.

BACKGROUND AND PURPOSE:Low-level laser therapy (LLLT) modulates various biological processes. In the present study, we assessed the hypothesis that LLLT after induction of stroke may have a beneficial effect on ischemic brain tissue.

METHODS:Two sets of experiments were performed. Stroke was induced in rats by (1) permanent occlusion of the middle cerebral artery through a craniotomy or (2) insertion of a filament. After induction of stroke, a battery of neurological and functional tests (neurological score, adhesive removal) was performed. Four and 24 hours poststroke, a Ga-As diode laser was used transcranially to illuminate the hemisphere contralateral to the stroke at a power density of 7.5 mW/cm2.

RESULTS:In both models of stroke, LLLT significantly reduced neurological deficits when applied 24 hours poststroke. Application of the laser at 4 hours poststroke did not affect the neurological outcome of the stroke-induced rats as compared with controls. There was no statistically significant difference in the stroke lesion area between control and laser-irradiated rats. The number of newly formed neuronal cells, assessed by double immunoreactivity to bromodeoxyuridine and tubulin isotype III as well as migrating cells (doublecortin immunoactivity), was significantly elevated in the subventricular zone of the hemisphere ipsilateral to the induction of stroke when treated by LLLT.

CONCLUSIONS:Our data suggest that a noninvasive intervention of LLLT issued 24 hours after acute stroke may provide a significant functional benefit with an underlying mechanism possibly being induction of neurogenesis.

BACKGROUND AND PURPOSE:Low-level laser therapy (LLLT) modulates various biological processes. In the present study, we assessed the hypothesis that LLLT after induction of stroke may have a beneficial effect on ischemic brain tissue.

METHODS:Two sets of experiments were performed. Stroke was induced in rats by (1) permanent occlusion of the middle cerebral artery through a craniotomy or (2) insertion of a filament. After induction of stroke, a battery of neurological and functional tests (neurological score, adhesive removal) was performed. Four and 24 hours poststroke, a Ga-As diode laser was used transcranially to illuminate the hemisphere contralateral to the stroke at a power density of 7.5 mW/cm2.

RESULTS:In both models of stroke, LLLT significantly reduced neurological deficits when applied 24 hours poststroke. Application of the laser at 4 hours poststroke did not affect the neurological outcome of the stroke-induced rats as compared with controls. There was no statistically significant difference in the stroke lesion area between control and laser-irradiated rats. The number of newly formed neuronal cells, assessed by double immunoreactivity to bromodeoxyuridine and tubulin isotype III as well as migrating cells (doublecortin immunoactivity), was significantly elevated in the subventricular zone of the hemisphere ipsilateral to the induction of stroke when treated by LLLT.

CONCLUSIONS:Our data suggest that a noninvasive intervention of LLLT issued 24 hours after acute stroke may provide a significant functional benefit with an underlying mechanism possibly being induction of neurogenesis.

We aimed to investigate the effects of low-level light emitting diode therapy (LED-T) on the long-term functional outcomes after cerebral ischemia, and the optimal timing of LED-T initiation for achieving suitable functional recovery. Focal cerebral ischemia was induced in mice via photothrombosis. These mice were assigned to a sham-operated (control), ischemic (vehicle), or LED-T group [initiation immediately (acute), 4 days (subacute) or 10 days (delayed) after ischemia, followed by once-daily treatment for 7 days]. Behavioral outcomes were assessed 21 and 28 days post-ischemia, and histopathological analysis was performed 28 days post-ischemia. The acute and subacute LED-T groups showed a significant improvement in motor function up to 28 days post-ischemia, although no brain atrophy recovery was noted. We observed proliferating cells (BrdU(+) ) in the ischemic brain, and significant increases in BrdU(+) /GFAP(+) , BrdU(+) /DCX(+) , BrdU(+) /NeuN(+) , and CD31(+) cells in the subacute LED-T group. However, the BrdU(+) /Iba-1(+) cell count was reduced in the subacute LED-T group. Furthermore, the brain-derived neurotrophic factor (BDNF) was significantly upregulated in the subacute LED-T group. We concluded that LED-T administered during the subacute stage had a positive impact on the long-term functional outcome, probably via neuron and astrocyte proliferation, blood vessel reconstruction, and increased BDNF expression. Picture: The rotarod test for motor coordination showed that acute and subacute LED-T improves long-term functional recovery after cerebral ischemia.

BACKGROUND:Stroke, a medical condition that causes physical disability and mental health problems, impacts negatively on quality of life. Post-stroke rehabilitation is critical to restoring quality of life in these patients.

OBJECTIVES:This study was designed to evaluate the effect of a mind-body interactive qigong intervention on the physical and mental aspects of quality of life, considering bio-physiological and mental covariates in subacute stroke inpatients.

METHODS:A randomized controlled trial with repeated measures design was used. A total of 68 participants were recruited from the medical and rehabilitation wards at a teaching hospital in northern Taiwan and then randomly assigned either to the Chan-Chuang qigong group, which received standard care plus a 10-day mind-body interactive exercise program, or to the control group, which received standard care only. Data were collected using the National Institutes of Health Stroke Scale, Hospital Anxiety and Depression Scale, Short Form-12, stroke-related neurologic deficit, muscular strength, heart rate variability and fatigue at three time points: pre-intervention, halfway through the intervention (day 5) and on the final day of the intervention (day 10).

RESULTS:The results of the mixed-effect model analysis showed that the qigong group had a significantly higher quality of life score at day 10 (<0.05) than the control group. Among the covariates, neurologic deficit (=0.04), muscle strength (=0.04), low frequency to high frequency ratio (=0.02) and anxiety (=0.04) were significantly associated with changes in quality of life. Conversely, heart rate, heart rate variability (standard deviation of normal-to-normal intervals, low frequency and high frequency), fatigue and depression were not significantly associated with change in quality of life (>0.05).

CONCLUSIONS:This study supports the potential benefits of a 10-day mind-body interactive exercise (Chan-Chuang qigong) program for subacute stroke inpatients and provides information that may be useful in planning adjunctive rehabilitative care for stroke inpatients.

Electroacupuncture (EA) pretreatment elicits the neuroprotective effect against cerebral ischemic injury through cannabinoid receptor type 1 receptor (CB1R). In current study, we aimed to investigate whether the signal transducer and activator of transcription 3 (STAT3) and manganese superoxide dismutase (Mn-SOD) were involved in the antioxidant effect of EA pretreatment through CB1R. At 2 h after EA pretreatment, focal cerebral ischemic injury was induced by transient middle cerebral artery occlusion for 60 min in C57BL/6 mice. The expression of Mn-SOD in the penumbra was assessed by Western blot and immunoflourescent staining at 2 h after reperfusion. In the presence or absenceof Mn-SOD small interfering RNA (siRNA), the neurological deficit score, the infarct volume, the terminal deoxynucleotidyl transferase-mediated dUDP-biotin nick end labeling (TUNEL) staining, and oxidative stress were evaluated. Furthermore, the Mn-SOD protein expression and phosphorylation of STAT3at Y705 were also determined in the presence and absence of CB1R antagonists (AM251, SR141716) and CB1R agonists (arachidonyl-2-chloroethylamide (ACEA), WIN 55,212-2). EA pretreatment upregulated the Mn-SOD protein expression and Mn-SOD-positive neuronal cells at 2 h after reperfusion. EA pretreatment also attenuated oxidative stress, inhibited cellular apoptosis, and induced neuroprotection against ischemic damage, whereas these beneficial effects of EA pretreatment were reversed by knockdown of Mn-SOD. Mn-SOD upregulation and STAT3 phosphorylation by EA pretreatment were abolished by two CB1R antagonists, while pretreatment with two CB1R agonists increased the expression of Mn-SOD and phosphorylation level of STAT3. Mn-SOD upregulation by EA attenuates ischemic oxidative damage through CB1R-mediated STAT3 phosphorylation in stroke mice, which may represent one new mechanism of EA pretreatment-induced neuroprotection against cerebral ischemia.

OBJECTIVE:To verify the clinical efficacy of acupuncture on motor dysfunction in ischemic stroke of subacute stage.

METHODS:The multi-central randomized controlled trial was adopted. One hundred and twenty-six cases of ischemic stroke of subacute stage were randomized into an acupuncture group (61 cases) and a conventional treatment group (65 cases). The basic treatment of western internal medicine and rehabilitation training were applied to the patients of the two groups. In the acupuncture group, acupuncture was supplemented at the body points located on the extensor of the upper limbs and the flexor of the lower limbs. In combination, scalp acupuncture was applied to NS5, MS6 and MS6 on the affected side. The treatment was given 5 times a week and totally 8 weeks were required. The follow-up observation lasted for 3 months. The scores in Fugl-Meyer scale and NIHSS scale and Barthel index were compared between the two groups before treatment, in 4 and 8 weeks of treatment and the 3-month follow-up observation after treatment separately.

RESULTS:In 4 and 8 weeks of treatment and the follow-up observation, Fugl-Meyer scale score was improved obviously in the patients of the two groups (all P<0. 01). In 8 weeks of treatment and the follow-up observation, Fugl-Meyer scale score in the acupuncture groupwas im proved much apparently as compared with that in the conventional treatment group [68. 0 (43. 0,86. 5) vs 52. 5 (30.3, 77.0), 77.0 (49.5, 89.0) vs 63. 0 (33.0, 84.0), both P<0. 05]. Except that NIHSS scale score was not reduced apparently in 4 weeks of treatment in the conventional treatment group (P>0.05), the results of NIHSS scale at the other time points were all decreased obviously as compared with those before treatment in the patients of the two groups (all P<0. 01). In 8 weeks of treatment and the follow-up observation, the results in the acupuncture group were reduced much apparently as compared with those in the conventional treatment group [5. 0 (3.0,8.0) vs 7. 0 (3.0,13.8), 4. 0 (1.5,7.0) vs 6.0 (2.0,11.7) ,both P<0. 05]. In 8 weeks of treatment and the follow-up observation, Barthel index was improved obviously as compared with that before treatment in the patients of the two groups (all P<0. 05). The improvement in the acupuncture group was much more significant as compared with the conventional treatment group [75. 0 (60. 0,87. 5) vs 65. O (36. 3, 87. 5), P<0. 051.

CONCLUSION:Based on the conventional treatment, Acupuncture achieves the satisfactory clinical efficacy on motor dysfunction in ischemic stroke of subacute stage.

OBJECTIVE:To verify the clinical efficacy of acupuncture on motor dysfunction in ischemic stroke of subacute stage.

METHODS:The multi-central randomized controlled trial was adopted. One hundred and twenty-six cases of ischemic stroke of subacute stage were randomized into an acupuncture group (61 cases) and a conventional treatment group (65 cases). The basic treatment of western internal medicine and rehabilitation training were applied to the patients of the two groups. In the acupuncture group, acupuncture was supplemented at the body points located on the extensor of the upper limbs and the flexor of the lower limbs. In combination, scalp acupuncture was applied to NS5, MS6 and MS6 on the affected side. The treatment was given 5 times a week and totally 8 weeks were required. The follow-up observation lasted for 3 months. The scores in Fugl-Meyer scale and NIHSS scale and Barthel index were compared between the two groups before treatment, in 4 and 8 weeks of treatment and the 3-month follow-up observation after treatment separately.

RESULTS:In 4 and 8 weeks of treatment and the follow-up observation, Fugl-Meyer scale score was improved obviously in the patients of the two groups (all P<0. 01). In 8 weeks of treatment and the follow-up observation, Fugl-Meyer scale score in the acupuncture groupwas im proved much apparently as compared with that in the conventional treatment group [68. 0 (43. 0,86. 5) vs 52. 5 (30.3, 77.0), 77.0 (49.5, 89.0) vs 63. 0 (33.0, 84.0), both P<0. 05]. Except that NIHSS scale score was not reduced apparently in 4 weeks of treatment in the conventional treatment group (P>0.05), the results of NIHSS scale at the other time points were all decreased obviously as compared with those before treatment in the patients of the two groups (all P<0. 01). In 8 weeks of treatment and the follow-up observation, the results in the acupuncture group were reduced much apparently as compared with those in the conventional treatment group [5. 0 (3.0,8.0) vs 7. 0 (3.0,13.8), 4. 0 (1.5,7.0) vs 6.0 (2.0,11.7) ,both P<0. 05]. In 8 weeks of treatment and the follow-up observation, Barthel index was improved obviously as compared with that before treatment in the patients of the two groups (all P<0. 05). The improvement in the acupuncture group was much more significant as compared with the conventional treatment group [75. 0 (60. 0,87. 5) vs 65. O (36. 3, 87. 5), P<0. 051.

CONCLUSION:Based on the conventional treatment, Acupuncture achieves the satisfactory clinical efficacy on motor dysfunction in ischemic stroke of subacute stage.

We know from animal studies that a stimulating and enriched environment can enhance recovery after stroke, but little is known about the effects of an enriched sound environment on recovery from neural damage in humans. In humans, music listening activates a wide-spread bilateral network of brain regions related to attention, semantic processing, memory, motor functions, and emotional processing. Music exposure also enhances emotional and cognitive functioning in healthy subjects and in various clinical patient groups. The potential role of music in neurological rehabilitation, however, has not been systematically investigated. This single-blind, randomized, and controlled trial was designed to determine whether everyday music listening can facilitate the recovery of cognitive functions and mood after stroke. In the acute recovery phase, 60 patients with a left or right hemisphere middle cerebral artery (MCA) stroke were randomly assigned to a music group, a language group, or a control group. During the following two months, the music and language groups listened daily to self-selected music or audio books, respectively, while the control group received no listening material. In addition, all patients received standard medical care and rehabilitation. All patients underwent an extensive neuropsychological assessment, which included a wide range of cognitive tests as well as mood and quality of life questionnaires, one week (baseline), 3 months, and 6 months after the stroke. Fifty-four patients completed the study. Results showed that recovery in the domains of verbal memory and focused attention improved significantly more in the music group than in the language and control groups. The music group also experienced less depressed and confused mood than the control group. These findings demonstrate for the first time that music listening during the early post-stroke stage can enhance cognitive recovery and prevent negative mood. The neural mechanisms potentially underlying these effects are discussed.