Acupuncture Modulates Disrupted Whole-Brain Network after Ischemic Stroke: Evidence Based on Graph Theory Analysis
Xiao Han, Jin He, Kuangshi Li, Yanzhe Ning, Lan Jiang, Pei Chen, Hongwei Liu, Yong Zhang, Hua Zhang, Zhongjian Tan, Fangyuan Cui, Yi Ren, Lijun Bai, Yihuai Zou
Abstract
Background . Stroke can lead to disruption of the whole-brain network in patients. Acupuncture can modulate the functional network on a large-scale level in healthy individuals. However, whether and how acupuncture can make a potential impact on the disrupted whole-brain network after ischemic stroke remains elusive. Methods . 26 stroke patients with a right hemispheric subcortical infarct were recruited. We gathered the functional magnetic resonance imaging (fMRI) from patients with stroke and healthy controls in the resting state and after acupuncture intervention, to investigate the instant alterations of the large-scale functional networks. The graph theory analysis was applied using the GRETNA and SPM12 software to construct the whole-brain network and yield the small-world parameters and network efficiency. Results . Compared with the healthy subjects, the stroke patients had a decreased normalized small-worldness (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mi>σ</mml:mi></mml:math>), global efficiency (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:msub><mml:mrow><mml:mi>E</mml:mi></mml:mrow><mml:mrow><mml:mtext>g</mml:mtext></mml:mrow></mml:msub></mml:math>), and the mean local efficiency (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:msub><mml:mrow><mml:mi>E</mml:mi></mml:mrow><mml:mrow><mml:mtext>loc</mml:mtext></mml:mrow></mml:msub></mml:math>) of the whole-brain network in the resting state. There was a correlation between the duration after stroke onset and<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:msub><mml:mrow><mml:mi>E</mml:mi></mml:mrow><mml:mrow><mml:mtext>loc</mml:mtext></mml:mrow></mml:msub></mml:math>. Acupuncture improved the patients’ clustering coefficient (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M5"><mml:msub><mml:mrow><mml:mi>C</mml:mi></mml:mrow><mml:mrow><mml:mtext>p</mml:mtext></mml:mrow></mml:msub></mml:math>) and<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M6"><mml:msub><mml:mrow><mml:mi>E</mml:mi></mml:mrow><mml:mrow><mml:mtext>loc</mml:mtext></mml:mrow></mml:msub></mml:math>but did not make a significant impact on the<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M7"><mml:mi>σ</mml:mi></mml:math>and<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M8"><mml:msub><mml:mrow><mml:mi>E</mml:mi></mml:mrow><mml:mrow><mml:mtext>g</mml:mtext></mml:mrow></mml:msub></mml:math>. The postacupuncture variables of the whole-brain network had no association with the time of onset. Conclusion . The poststroke whole-brain network tended to a random network with reduced network efficiency. Acupuncture was able to modulate the disrupted patterns of the whole-brain network following the subcortical ischemic stroke. Our findings shed light on the potential mechanisms of the functional reorganization on poststroke brain networks involving acupuncture intervention from a large-scale perspective.