Acupuncture, an effective treatment for post-stroke neurologic dysfunction
- Connie Jiao
- Jan 22
- 3 min read
Abstract
Stroke episodes represent a significant subset of cerebrovascular diseases globally, often resulting in diverse neurological impairments such as hemiparesis, spasticity, dysphagia, sensory dysfunction, cognitive impairment, depression, aphasia, and other sequelae. These dysfunctions markedly diminish patients' quality of life and impose substantial burdens on their families and society. Consequently, the restoration of neurological function post-stroke remains a primary objective of clinical treatment. Acupuncture, a traditional Chinese medicine technique, is endorsed by the World Health Organization (WHO) for stroke treatment due to its distinct advantages in managing cerebrovascular diseases, including ischemic stroke. Numerous clinical studies have substantiated the efficacy of acupuncture in ameliorating neurological dysfunctions following stroke. This review systematically examines the improvements in post-stroke neurological dysfunction attributable to acupuncture treatment and elucidates potential mechanisms of action proposed in recent years. Additionally, this article aims to present novel therapeutic concepts and strategies for the clinical management of post-stroke neurological dysfunction.
1. Introduction
Stroke, resulting from cerebral ischemia and hypoxia, leads to ischemic necrosis or softening and subsequent neurological dysfunction. It is the most prevalent form of cerebrovascular disease globally, accounting for approximately 87 % of all cerebrovascular incidents. Stroke is marked by high rates of morbidity, recurrence, disability, and mortality, contributing to a generally poor prognosis. As a leading cause of neurological impairment and death among the elderly, stroke demands global attention(Hankey, 2017; Wang et al., 2020). The condition not only causes irreversible neuronal damage but also triggers a cascade of pathological events, including energy depletion, excessive glutamate (Glu) release, free radical production, inflammation, and ultimately widespread excitotoxic cell death. This chain of events severely disrupts neuronal network function(Durukan and Tatlisumak, 2007). Following neurological damage, 50–70 % of stroke survivors experience sequelae such as hemiparesis, spasticity, dysphagia, sensory dysfunction, cognitive deficits, hemianopsia, and aphasia, significantly impacting their physical and emotional well-being(Coleman et al., 2017; Hankey, 2017). Consequently, there is a growing focus on identifying effective treatments to ameliorate neurological dysfunction, although current therapeutic options remain limited.
Acupuncture is an ancient Chinese therapeutic technique that entails the insertion of needles into the skin or deep tissues at specific anatomical locations, known as acupoints, to restore homeostasis and prevent and treat disease. It may involve various acupuncture methods or enhanced stimulation via electrical currents, such as motion-style acupuncture or electroacupuncture (Hesketh and Zhu, 1997). Acupuncture has gained widespread use as an effective, low-cost treatment for post-stroke rehabilitation with minimal adverse effects. Clinical and experimental evidence indicates that acupuncture ameliorates post-stroke neurological dysfunction through multiple mechanisms. For instance, acupuncture activates endogenous recovery processes and induces ischemic tolerance responses(Hermann and Chopp, 2012), alongside exhibiting anti-inflammatory(Xu et al., 2021), antioxidant(Wang et al., 2019), and anti-apoptotic properties(Sun et al., 2020). Additionally, it has been shown to significantly promote neurological recovery by enhancing vascular(Wu et al., 2021) and nerve regeneration(Deng et al., 2016) and stimulating the release of neurotrophic factors that offer neuroprotection(Zheng et al., 2020). In the context of post-stroke rehabilitation, acupuncture has demonstrated efficacy in improving hemiparesis(Zheng et al., 2020), spasticity(Lim et al., 2015), dysphagia(Cui et al., 2020), neuralgia(Xu et al., 2020), and cognitive dysfunction(Zheng et al., 2020), Moreover, it has been beneficial in regulating mental and psychological conditions(Hung et al., 2019), with numerous stroke patients exhibiting marked neurological improvement following treatment (Sharififar et al., 2018).
Over the past two decades, significant advancements have been made in the treatment of the hyperacute and acute phases of stroke. Consequently, it is imperative to shift our focus toward interventions that actively promote post-stroke rehabilitation. In clinical post-stroke rehabilitation, modulating neurological recovery through therapeutic techniques such as noninvasive brain stimulation, acupuncture, and task-oriented training is crucial(Hermann and Chopp, 2012; Li et al., 2008). This strategy is predicated on the fact that patients in the acute phase of stroke are infrequently encountered in clinical settings and necessitate urgent care, whereas those in the recovery or sequelae phases exhibit a greater variety of needs. Sequelae are often accompanied by a spectrum of neurological dysfunctions, including motor, swallowing, sensory, and mental and psychological impairments (Fig. 1). This paper systematically reviews the efficacy and mechanisms of acupuncture in improving neurological function during the post-stroke sequelae stage, aiming to identify new therapeutic options for clinical practice.
