An fMRI study of somatosensory-implicated acupuncture points in stable somatosensory stroke patients

Purpose: To assess differences In brain responses between stroke patients and controls to tactile and electrical acupuncture stimulation using functional MRI (fMRI). Materials and Methods: A total of 12 male, clinically stable stroke patients with left side somatosensory deficits, and 12 age-matched male control subjects were studied. fMRI was performed with two different paradigms; namely, tactile stimuli and electrical stimulation at acupuncture points LI4 and LI11 on the affected side of the body. fMRI data were analyzed using SPM99. Results: Tactile stimulation in both patients and controls produced significant activation in primary and secondary sensory and motor cortical areas and cerebellum. Greater activation was present In patients than controls in the somatosensory cortex with both the tactile task and the acupuncture point (acupoint) stimulation. Activation was greater during the tactile task than the acupuncture stimulation in patients and normal controls. Conclusion: Differences observed between patients and controls on both tasks may indicate compensatory over recruitment of neocortical areas involved in somatosensory perception in the stroke patients. The observed differences between patients and controls on the acupoint stimulation task may also indicate that stimulation of acupoints used therapeutically to enhance recovery from stroke, selectively activates areas thought to be involved in mediating recovery from stroke via functional plasticity. fMRI of acupoint stimulation may illustrate the functional substrate of the therapeutically beneficial effect of acupuncture in stroke rehabilitation.