Revealing the Neuroimaging Mechanism of Acupuncture for Poststroke Aphasia: A Systematic Review
Table 4
Neuroimaging outcomes.
Publication year
First author
Sample size
Neuroimaging technologies
Scanning design
Image acquisition time
Comparison
Neuroimaging results
2021
Binlong Zhang
60 (36 poststroke aphasia, 24 healthy volunteers)
rsfMRI, BOLD (ALFF), and DTI (FA)
—
Before and after acupuncture treatment
AG after treatment vs. healthy volunteer in ALFF
Decreased ALFF: the left temporal pole and increased ALFF in the right supramarginal gyrus, right inferior frontal gyrus, and left angular gyrus
Correlation: the repetition scores have a positive correlation with the FA value of the right supramarginal gyrus
AG after treatment vs. healthy volunteer in DTI
Decreased FA value: bilateral uncinate fasciculus. No significant difference was found in FA between poststroke aphasia patients before and after treatment.
Correlation: the amount of damage in the left uncinate fasciculus was associated with WAB-AQ.
Increased ReHo: the right fusiform gyrus, right inferior frontal gyrus, left anterior cuneiform lobe, and left superior frontal gyrus. Decreased ReHo: the left inferior temporal gyrus, right lingual gyrus, and right anterior central gyrus.
2021
Xiaolin Li
50 (poststroke aphasia)
rsfMRI, DTI (FA)
—
Before and after acupuncture treatment
AG after treatment vs. AG before treatment
Increases intensified functional connectivity: the left hemisphere within the frontoparietal network, default-model network, dorsal attention network, ventral attention network, and sensorimotor network; no significant changes were found in the right hemisphere.
AG after treatment vs. CG after treatment
Increased value: brain network connectivity, brain network node efficiency, and local brain network node efficiency in dorsal attention network 2 and frontoparietal network 1; brain network node degree centrality in sensorimotor network 2, ventral attention network 1, and ventral attention network 2.
Correlation between FA and CRRCAE: FA value in the right inferior longitudinal fasciculus with the reading score and calculation score, FA value in the left cingulate gyrus with the speech score, right inferior longitudinal fasciculus with the reading score, and left superior longitudinal fasciculus with the writing score.
2019
Binlong Zhang
57 (31 poststroke aphasia, 26 healthy volunteers)
rsfMRI, BOLD (ROI)
—
Before and after acupuncture treatment
AG before treatment vs. healthy volunteer
Increased: the connectivity inside the dual-stream network, the connectivity between the dual-stream network and other brain areas except for the opposite dual-stream network. Decreased: the global efficiency of the dual-stream network, the average path length of the left middle gyrus, and correlated with the score of spontaneous speech and BDAE.
AG after treatment vs. AG before treatment
Increased: the connectivity with other regions (left inferior temporal gyrus to the right middle frontal gyrus). Decreased: the connectivity inside the dual-stream network (the left posterior middle temporal gyrus to the left middle temporal gyrus; left upper middle temporal gyrus to the left middle temporal gyrus).
Correlation: the ALFF change of the left temporal pole was positively correlated with WAB-AQ change.
2019
Yukang Xiao
100 (poststroke aphasia)
rsfMRI, BOLD (ReHo)
—
Before and after acupuncture treatment
AG before treatment vs. CG before treatment
Activated brain areas: primary sensorimotor cortex (), temporal lobe (), occipital lobe (), and basal ganglia (), but no significant change was found ().
AG after treatment vs. AG before treatment
Activated brain areas: primary sensorimotor cortex (), temporal lobe (), occipital lobe (), and basal ganglia (); significant changes were found in the activated areas ().
AG after treatment vs. CG after treatment
Activated brain areas: primary sensorimotor cortex (), temporal lobe (), occipital lobe (), and basal ganglia (); activated areas in AG significantly increased compared with CG ().
2018
Mingge Yang
30 (poststroke aphasia)
rsfMRI, BOLD (ROI)
—
Before and after acupuncture treatment
AG after treatment vs. CG after treatment
Increased ReHo: left dorsolateral superior frontal gyrus, insula, precuneus, and calcarine. Right triangle inferior frontal gyrus, fusiform gyrus, medial temporal lobe, and cerebellum. Decreased ReHo: left inferior temporal gyrus, caudate nucleus, right lingual gyrus, and precentral gyrus. Correlation: the auditory comprehension function impairment correlated with the lower ReHo value of the temporal gyrus.
Increased activated areas: left hemisphere Broca’s area. Negative activated areas: mirror area of Broca’s area in the right hemisphere.
CG after treatment vs. CG before treatment
No significant changes were found in the activated areas; the Broca’s area in the left hemisphere and the mirror area of Broca’s area in the right hemisphere were symmetrically activated.
2017
Jingling Chang
22 poststroke aphasia
rsfMRI, BOLD (ROI)
Needling state: 30 s; resting state: 30 s
Instant acupuncture
AG after treatment vs. AG before treatment
Increased activated areas: the left hemisphere.
2016
Aiqin Wang
20 (10 poststroke aphasia, 10 healthy volunteers)
rsfMRI, BOLD (ROI)
—
Before and after acupuncture treatment
AG before treatment vs. healthy volunteer
Decreased FC: left frontal parietal network (left inferior frontal gyrus, left inferior parietal lobule); right frontal parietal network (inferior parietal lobule); salience network (the right middle frontal gyrus, right anterior cingulate); anterior default mode network (left angular gyrus); posterior default mode network (right superior frontal gyrus, left superior parietal lobule, right anterior cuneiform lobe, right inferior frontal gyrus).
AG after treatment vs. AG before treatment
Increased FC: right frontal parietal network (left superior frontal gyrus, right postcentral gyrus). Decreased FC: right frontal parietal network (right supramarginal gyrus); anterior default mode network (left anterior central gyrus, the left middle frontal gyrus). No significant changes of FC were found in the left frontal parietal network, posterior default mode network, and salience network.
Correlation: the average FC value of decreased brain area in the anterior default mode network (left anterior central gyrus, the left middle frontal gyrus) had a negative correlation with the spontaneous score. The FC of the right frontal parietal network (right supramarginal gyrus) had a positive correlation with AQ, repetition, and naming scores.
2016
Binlong Zhang
24 (12 poststroke aphasia, 12 healthy volunteers)
rsfMRI, BOLD (ICA)
—
Before and after acupuncture treatment
AG before treatment vs. CG before treatment
Increased brain areas: auditory network (right anterior central gyrus). Decreased brain areas: right frontoparietal network, frontoparietal network 1, auditory network (left inferior frontal gyrus, the left middle frontal gyrus, the right middle frontal gyrus).
AG after treatment vs. AG before treatment
Increased brain areas: executive control network, auditory network (left paracentral lobule, the right middle frontal gyrus, right superior frontal gyrus).
2016
Jinying Liu
10 poststroke aphasia
rsfMRI, DTI (ROI)
—
Before and after acupuncture treatment
AG before treatment vs. healthy volunteer
Impairment of white matter: bilateral external capsule, bilateral uncinate fasciculus, left cingulate gyrus, left anterior limb of the internal capsule, left superior fronto-occipital fasciculus, and left inferior fronto-occipital fasciculus.
AG after treatment vs. AG before treatment
Increased values: left superior corona radiata (AD), right posterior corona radiata (AD, MD), left external capsule (MD, RD), left superior longitudinal fasciculus (AD, MD, RD), and left superior fronto-occipital fasciculus (AD, MD, RD).
Correlation: for the left superior longitudinal fasciculus, both of the MD value and RD value had negative correlations with WAB naming scores; the AD value had a negative correlation with AQ.
Significant changes were found in the following brain areas: bilateral medial frontal gyrus, bilateral middle frontal gyrus, bilateral inferior frontal gyrus, bilateral anterior central gyrus, left angular gyrus, and left posterior superior temporal gyrus.
AG after treatment vs. AG before treatment
Significant changes were found in the following brain areas: bilateral medial frontal gyrus, bilateral superior frontal gyrus, bilateral middle frontal gyrus, bilateral inferior frontal gyrus, bilateral anterior cuneiform lobe, posterior cingulate cortex, left angular gyrus, left posterior superior temporal gyrus, bilateral cuneus, bilateral lingual gyrus, bilateral inferior occipital gyrus, bilateral basal ganglia, splenium of corpus callosum, and right posterior cerebellar lobe.
AG after treatment vs. CG after treatment
Significant changes were found in the following brain areas: left superior frontal gyrus, left middle frontal gyrus, bilateral inferior frontal gyrus, left anterior central gyrus, left postcentral gyrus, left paracentral lobule, left posterior superior temporal gyrus, posterior cingulate cortex, bilateral anterior cuneiform lobe, bilateral cuneus, left angular gyrus, bilateral lingual gyrus, right hippocampus, right parahippocampal gyrus, bilateral superior occipital gyrus, bilateral inferior occipital gyrus, right posterior cerebellar lobe, left superior cerebellar lobule, and splenium of corpus callosum.
Significant activation in the left inferior frontal gyrus (opercular part, triangular part or insula), right inferior frontal gyrus, or parietal lobe (Rolandic operculum or triangular part). Strong activation on the lesion side of superior and middle frontal gyrus.
Healthy volunteer after acupuncture vs. healthy volunteer before acupuncture
Activated brain areas: left superior and middle frontal gyrus, but relatively weaker compared with AG.
AG after WG vs. AG before WG
Activated brain areas: left inferior frontal gyrus (1 poststroke aphasia) and right inferior frontal gyrus (2 poststroke aphasia).
AG after acupuncture vs. AG after WG
Activated brain areas: the right insula, left precentral gyrus, right median cingulate, and paracingulate gyrus of the limbic lobe.
Significantly smaller activation: both sides of superior and middle frontal gyrus induced by acupuncture compared with WG task.
