Abstract

Objectives: Acupuncture has been specially applied on the rehabilitation after stroke in Asia for thousands of years. It was reported that acupuncture increased cerebral blood supply and stimulated the functional activity of brain nerve cells by using brain image techniques. This study was to evaluate the effect of GB 34-GB 39 electro-acupuncture (EA) on regional cerebral blood flow (rCBF) in stroke patients and normal volunteers using Single Photon Emission Computed Tomography (SPECT). Methods: The study procedure was divided into two part; patients and volunteers study. For patients study, ten ischemic stroke patients(3 males, 7 females, mean age 68.5±8.9 years old) were selected. Baseline brain SPECT was done with triple head gamma camera (MultiSPECT3, Siemens, USA) after intravenous administration of 1,110 MBq of 99mTc-ECD. Fifteen-minute EA at GB 34 and GB 39 were applied on affected limb. The same dose of 99mTc-ECD was injected during the EA, and the second SPECT images were obtained. Using the computer software (ICON 7.1, Siemens, USA), 3 SPECT slices (upper, middle, lower) surrounding the brain lesion were selected and each slice was divided by 10-16 brain regions. Asymmetry indexes (AI) were analyzed in each brain region. We regarded over 10% changes of AI between before and after EA as significance. For volunteers study, 10 healthy human volunteers (5 males, 5 females, mean age 28.1±6 years old) were selected. In the resting state, 99mTc-ECD brain SPECT scans were performed. On the 7th day after the resting examination, 15 minute EA was applied at GB 34 and GB 39 on the right side of the subjects. Immediately after EA, the second SPECT images were obtained with the same manner as the resting state. Significant increases and decreases of rCBF after EA were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by statistical parametric mapping with a threshold of p = 0.01, uncorrected (extent threshold: k=100 voxels). Results: In stroke patients, six(75%) of eight had significantly increased perfusion in post-acupunture scans compared to baseline state. In normal volunteers, GB 34-GB 39 EA increased rCBF in both hemisphere including right ventral posterior cingulate(Brodmann area (BA) 23), left superior temporal, anterior transverse temporal(BA 22, 41), left parastriate, peristriate(BA 18, 19), right occipitotemporal, angular(BA 37, 39), left rostral postcentral, caudal postcentral and preparietal(BA 2, 3, 5). However GB 34-GB 39 EA decreased rCBF in right hemisphere including triangular and middle frontal lobes. Conclusions: The results demonstrated that GB 34-GB 39 EA increased cerebral perfusion in ischemic stroke patients also increased rCBF grossly in temporal lobes in normal volunteer. It is also suggested that there may be a correlation between GB meridian and the territory of middle cerebral artery.