Brain Imaging Behav. 2026 Oct 30;20(6):144. doi: 10.1007/s11682-026-01155-5.
ABSTRACT
Motor aphasia is the most prevalent type of aphasia following ischemic stroke (IS). This study aims to evaluate the therapeutic efficacy and underlying neural mechanisms of acupuncture-rehabilitation (A-R) therapy on motor aphasia after IS. Twenty-six patients with post-IS motor aphasia were randomly assigned to either the A-R group or the Conventional Rehabilitation (CR) group in a 1:1 ratio, and matched by age and gender with 26 healthy controls (HCs). The CR group received standard treatment and language training, while the A-R group additionally underwent scalp acupoint cluster acupuncture. Behavioral assessments and Blood Oxygenation Level Dependent functional Magnetic Resonance Imaging (BOLD-fMRI) scans were conducted before and after the four-week intervention to evaluate therapeutic outcomes and underlying mechanisms. Compared to HCs, patients exhibited decreased Amplitude of Low Frequency Fluctuations (ALFF) in the right precuneus (p < 0.05) and reduced Regional Homogeneity (ReHo) in the left precuneus/postcentral gyrus (p < 0.05). Enhanced functional connectivity (FC) was observed in regions including the left Broca's area and right superior temporal gyrus, left Broca's area and right inferior frontal orbitalis gyrus, left Broca's area and right precentral gyrus, left Broca's area and right postcentral gyrus (p < 0.05). After intervention, significant improvements were observed in Aphasia Quotient (AQ) scores and sub-item performance in both patient groups (p < 0.05), with the A-R group showing greater gains in AQ and spontaneous speech scores compared to the CR group (p < 0.05). FMRI results indicated a significant increase in mean ALFF (mALFF) in the left inferior temporal gyrus after A-R treatment (p < 0.05) compared to before, and higher szReHo in the left anterior central gyrus compared to the CR group (p < 0.05). FC between the left Broca's area and right precentral gyrus decreased in the A-R group (p < 0.05). Additionally, a negative correlation was observed between the right anterior central gyrus and listening comprehension (r = -0.574, p = 0.020). The findings suggest that both A-R and CR therapies enhance language function in patients with motor aphasia post-IS, with A-R therapy demonstrating superior efficacy. The therapeutic mechanism of A-R likely involves activating left hemisphere brain regions, suppressing right hemisphere activity, and restoring hemispheric balance to facilitate functional recovery.
PMID:42961600 | DOI:10.1007/s11682-026-01155-5