Modulation of cerebral cortex activity by acupuncture combined with continuous theta-burst stimulation in post-stroke upper limb spasticity: an fNIRS study

ObjectiveTo observe the modulation and clinical efficacy of acupuncture combined with continuous theta-burst stimulation (cTBS) on cerebral cortical activity in post-stroke upper limb spasticity.MethodsPatients with upper limb spasticity after stroke were randomly divided into two groups. The contro...

Full description

Saved in:
Bibliographic Details
Main Authors: Junfeng Zhang, Meng Wang, Hao Chen, Shiyu Fan, Rongshan Sun, Lin Wang, Shan Cong, Tao Yu, Yulin Qian
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1542489/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850157750694182912
author Junfeng Zhang
Junfeng Zhang
Junfeng Zhang
Meng Wang
Hao Chen
Shiyu Fan
Shiyu Fan
Shiyu Fan
Rongshan Sun
Rongshan Sun
Rongshan Sun
Lin Wang
Shan Cong
Shan Cong
Shan Cong
Tao Yu
Tao Yu
Yulin Qian
author_facet Junfeng Zhang
Junfeng Zhang
Junfeng Zhang
Meng Wang
Hao Chen
Shiyu Fan
Shiyu Fan
Shiyu Fan
Rongshan Sun
Rongshan Sun
Rongshan Sun
Lin Wang
Shan Cong
Shan Cong
Shan Cong
Tao Yu
Tao Yu
Yulin Qian
author_sort Junfeng Zhang
collection DOAJ
description ObjectiveTo observe the modulation and clinical efficacy of acupuncture combined with continuous theta-burst stimulation (cTBS) on cerebral cortical activity in post-stroke upper limb spasticity.MethodsPatients with upper limb spasticity after stroke were randomly divided into two groups. The control group (n = 15) received acupuncture treatment, and the experimental group (n = 15) received cTBS treatment of the premotor cortex of the healthy side in addition to acupuncture. The efficacy was evaluated before and after the first treatment and 2 weeks after treatment. MAS, FMA, MBI, fNIRS and F wave evaluation were observed in the two groups.ResultsAfter treatment, there were significant differences between the two groups in MAS, FMA-UE, MBI, F-wave amplitude, and the F/M amplitude ratio index of the experimental group (p < 0.05). Comparison between groups, the MAS-elbow flexor in the experimental group decreased significantly after the first treatment and 2 weeks after treatment. After 2 weeks of treatment, the HbO2 concentration in the CH4 channel exercise phase in the experimental group increased compared with the control group (pFDR <0.05). The strength of functional connection in the left primary motor area (M1)—the left primary somatosensory cortex (S1), the left S1—the right premotor cortex and supplementary motor area (PMC & SMA), and the left S1—the left PMC&SMA showed an increasing trend (0.05 < pFDR < 0.1). The F wave amplitude was significantly lower than before intervention, and the difference was significant (p < 0.05).ConclusionAcupuncture combined with cTBS can relieve upper limb spasticity, enhance motor function, improve daily living ability, and reduce excessive spinal cord excitability. It can also increase HbO2 concentration in the cerebral cortex. However, large-sample studies are still needed to prove the effect of this therapy on brain networks.SignificanceThis study provides evidence for the potential of combined cTBS and acupuncture in stroke rehabilitation.Clinical trial registrationidentifier ChiCTR2400083631.
format Article
id doaj-art-9bfb7cf72c6d4bdd865ddd3dd5b80ba1
institution OA Journals
issn 1664-2295
language English
publishDate 2025-06-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Neurology
spelling doaj-art-9bfb7cf72c6d4bdd865ddd3dd5b80ba12025-08-20T02:24:04ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-06-011610.3389/fneur.2025.15424891542489Modulation of cerebral cortex activity by acupuncture combined with continuous theta-burst stimulation in post-stroke upper limb spasticity: an fNIRS studyJunfeng Zhang0Junfeng Zhang1Junfeng Zhang2Meng Wang3Hao Chen4Shiyu Fan5Shiyu Fan6Shiyu Fan7Rongshan Sun8Rongshan Sun9Rongshan Sun10Lin Wang11Shan Cong12Shan Cong13Shan Cong14Tao Yu15Tao Yu16Yulin Qian17Rehabilitation Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaGraduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaRehabilitation Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaGraduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaRehabilitation Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaGraduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaRehabilitation Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaGraduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaRehabilitation Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaRehabilitation Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaGraduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaRehabilitation Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaRehabilitation Department, Tianjin Xiqing District Hospital of Traditional Chinese Medicine, Tianjin, ChinaRehabilitation Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaObjectiveTo observe the modulation and clinical efficacy of acupuncture combined with continuous theta-burst stimulation (cTBS) on cerebral cortical activity in post-stroke upper limb spasticity.MethodsPatients with upper limb spasticity after stroke were randomly divided into two groups. The control group (n = 15) received acupuncture treatment, and the experimental group (n = 15) received cTBS treatment of the premotor cortex of the healthy side in addition to acupuncture. The efficacy was evaluated before and after the first treatment and 2 weeks after treatment. MAS, FMA, MBI, fNIRS and F wave evaluation were observed in the two groups.ResultsAfter treatment, there were significant differences between the two groups in MAS, FMA-UE, MBI, F-wave amplitude, and the F/M amplitude ratio index of the experimental group (p < 0.05). Comparison between groups, the MAS-elbow flexor in the experimental group decreased significantly after the first treatment and 2 weeks after treatment. After 2 weeks of treatment, the HbO2 concentration in the CH4 channel exercise phase in the experimental group increased compared with the control group (pFDR <0.05). The strength of functional connection in the left primary motor area (M1)—the left primary somatosensory cortex (S1), the left S1—the right premotor cortex and supplementary motor area (PMC & SMA), and the left S1—the left PMC&SMA showed an increasing trend (0.05 < pFDR < 0.1). The F wave amplitude was significantly lower than before intervention, and the difference was significant (p < 0.05).ConclusionAcupuncture combined with cTBS can relieve upper limb spasticity, enhance motor function, improve daily living ability, and reduce excessive spinal cord excitability. It can also increase HbO2 concentration in the cerebral cortex. However, large-sample studies are still needed to prove the effect of this therapy on brain networks.SignificanceThis study provides evidence for the potential of combined cTBS and acupuncture in stroke rehabilitation.Clinical trial registrationidentifier ChiCTR2400083631.https://www.frontiersin.org/articles/10.3389/fneur.2025.1542489/fullcontinuous theta burst stimulationacupuncturestrokespasticityfNIRSF-wave
spellingShingle Junfeng Zhang
Junfeng Zhang
Junfeng Zhang
Meng Wang
Hao Chen
Shiyu Fan
Shiyu Fan
Shiyu Fan
Rongshan Sun
Rongshan Sun
Rongshan Sun
Lin Wang
Shan Cong
Shan Cong
Shan Cong
Tao Yu
Tao Yu
Yulin Qian
Modulation of cerebral cortex activity by acupuncture combined with continuous theta-burst stimulation in post-stroke upper limb spasticity: an fNIRS study
Frontiers in Neurology
continuous theta burst stimulation
acupuncture
stroke
spasticity
fNIRS
F-wave
title Modulation of cerebral cortex activity by acupuncture combined with continuous theta-burst stimulation in post-stroke upper limb spasticity: an fNIRS study
title_full Modulation of cerebral cortex activity by acupuncture combined with continuous theta-burst stimulation in post-stroke upper limb spasticity: an fNIRS study
title_fullStr Modulation of cerebral cortex activity by acupuncture combined with continuous theta-burst stimulation in post-stroke upper limb spasticity: an fNIRS study
title_full_unstemmed Modulation of cerebral cortex activity by acupuncture combined with continuous theta-burst stimulation in post-stroke upper limb spasticity: an fNIRS study
title_short Modulation of cerebral cortex activity by acupuncture combined with continuous theta-burst stimulation in post-stroke upper limb spasticity: an fNIRS study
title_sort modulation of cerebral cortex activity by acupuncture combined with continuous theta burst stimulation in post stroke upper limb spasticity an fnirs study
topic continuous theta burst stimulation
acupuncture
stroke
spasticity
fNIRS
F-wave
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1542489/full
work_keys_str_mv AT junfengzhang modulationofcerebralcortexactivitybyacupuncturecombinedwithcontinuousthetaburststimulationinpoststrokeupperlimbspasticityanfnirsstudy
AT junfengzhang modulationofcerebralcortexactivitybyacupuncturecombinedwithcontinuousthetaburststimulationinpoststrokeupperlimbspasticityanfnirsstudy
AT junfengzhang modulationofcerebralcortexactivitybyacupuncturecombinedwithcontinuousthetaburststimulationinpoststrokeupperlimbspasticityanfnirsstudy
AT mengwang modulationofcerebralcortexactivitybyacupuncturecombinedwithcontinuousthetaburststimulationinpoststrokeupperlimbspasticityanfnirsstudy
AT haochen modulationofcerebralcortexactivitybyacupuncturecombinedwithcontinuousthetaburststimulationinpoststrokeupperlimbspasticityanfnirsstudy
AT shiyufan modulationofcerebralcortexactivitybyacupuncturecombinedwithcontinuousthetaburststimulationinpoststrokeupperlimbspasticityanfnirsstudy
AT shiyufan modulationofcerebralcortexactivitybyacupuncturecombinedwithcontinuousthetaburststimulationinpoststrokeupperlimbspasticityanfnirsstudy
AT shiyufan modulationofcerebralcortexactivitybyacupuncturecombinedwithcontinuousthetaburststimulationinpoststrokeupperlimbspasticityanfnirsstudy
AT rongshansun modulationofcerebralcortexactivitybyacupuncturecombinedwithcontinuousthetaburststimulationinpoststrokeupperlimbspasticityanfnirsstudy
AT rongshansun modulationofcerebralcortexactivitybyacupuncturecombinedwithcontinuousthetaburststimulationinpoststrokeupperlimbspasticityanfnirsstudy
AT rongshansun modulationofcerebralcortexactivitybyacupuncturecombinedwithcontinuousthetaburststimulationinpoststrokeupperlimbspasticityanfnirsstudy
AT linwang modulationofcerebralcortexactivitybyacupuncturecombinedwithcontinuousthetaburststimulationinpoststrokeupperlimbspasticityanfnirsstudy
AT shancong modulationofcerebralcortexactivitybyacupuncturecombinedwithcontinuousthetaburststimulationinpoststrokeupperlimbspasticityanfnirsstudy
AT shancong modulationofcerebralcortexactivitybyacupuncturecombinedwithcontinuousthetaburststimulationinpoststrokeupperlimbspasticityanfnirsstudy
AT shancong modulationofcerebralcortexactivitybyacupuncturecombinedwithcontinuousthetaburststimulationinpoststrokeupperlimbspasticityanfnirsstudy
AT taoyu modulationofcerebralcortexactivitybyacupuncturecombinedwithcontinuousthetaburststimulationinpoststrokeupperlimbspasticityanfnirsstudy
AT taoyu modulationofcerebralcortexactivitybyacupuncturecombinedwithcontinuousthetaburststimulationinpoststrokeupperlimbspasticityanfnirsstudy
AT yulinqian modulationofcerebralcortexactivitybyacupuncturecombinedwithcontinuousthetaburststimulationinpoststrokeupperlimbspasticityanfnirsstudy