Meta-analysis Of Acupuncture Treatment Of Aphasia After Stroke And Research On Resting Brain Function Network

Acupuncture for post stroke aphasia-a meta-analysisOBJECTIVE:To assess the effectiveness of acupuncture for post stroke aphasia in adults.METHODS:We applied electric search to MEDLINE(OVID)?EMBASE(OVID)?CENTRAL?AMED(OVID)?SinoMed?CNKI?VIP?Wanfang database,respectively from inception to 2016-02-21.Randomized controlled clinical trials(RCT)that compare the effectiveness of acupuncture for aphasia were included.We extracted data on outcomes and assessed the quality of included studies.A summary MD or SMD was calculated based on continuous results.Heterogeneity was assessed by 12 and we conduct subgroup analysis to explained it.RESULTS:25 articles were included into quantitative analysis.Totally we included 1515 patients,767 in treatment group and 748 in control group.The results showed that compares to control group,acupuncture could improve functional communication(P<0.000001,SMD=0.87,95%CI-0.52 to 1.22),aphasia severity(P<0.001,SMD=0.57,95%CI-0.31 to 0.82),auditory comprehension(P<0.0001,SMD=0.81,95%CI-0.42 to 1.20),repetition(P<0.00001,SMD=1.01,95%CI-0.64 to 1.38).naming(P<0.03,SMD=0.54,95%CI-0.04 to 1.05)and reading(P<0.0001,SMD=1.56,95%CI-0.83 to 2.29).The test of heterogeneity showed that the studies that measured language ability by aphasia battery of Chinese(ABC)and Chinese aphasia examination(CAE)are the main reason of heterogeneity.CONCLUSIONS:Acupuncture is effective for post stroke aphasia,acupuncture could improve functional communication,aphasia severity,auditory comprehension,repetition and reading.But poor quality of included studies need to be considered,this conclusion should be modestly treated.Thus,we argued for more well-designed,double blinded RCTs with standardized protocols and outcome measures.Resting-state functional connectivity research of basal ganglion aphasia patientsOBJECTIVE:Explore the relationship between basal ganglion aphasia and resting state network(RSN),based on resting state MRI data of 12 basal ganglion aphasia patients before and after treatment of acupuncture combined with language rehabilitation.METHODS:We included 12 basal ganglion stroke patients that suffered aphasia.Acupuncture combined with language rehabilitation therapy were conducted.In the meantime,we matched 12 health controls with age,gender,and handedness.Before and after one month of treatment,resting state functional magnetic resonance imaging(fMRI)was assessed,Boston Diagnostic Aphasia Examination(BDAE)was used to evaluate the severity of aphasia,and Western Aphasia Battery was used to assess language function.Based on the data above,we applied independent component analysis(ICA)to extract brain resting state networks(RSN),.and compare RSNs between health controls and patients before and after treatment.Then we conducted Pearson correlation analysis to explore the relation between the change of RSNs and the change of language abilities.RESULTS:All the 12 patients shows improvement in WAB-AQ,information content,fluency,auditory comprehension,repetition and naming.Totally we exact 6 RSNs,include anterior Default Mode Network(aDMN),posterior Default Mode Network(pDMN),left Frontoparietal Network(1FPN),right Frontoparietal Network(rFPN),Executive Control Network(ECN)and Auditory Network(AN).Compared to health controls,the patients shows decrease of functional connectivity in both rFPN and 1FPN,and increase in AN,the region of decrease mainly located at left inferior frontal gyrus and both side of medial frontal gyrus,the region of increase was located at right central anterior gyrus.After treatment,the patients shows increase of connectivity in AN and ECN,which mainly located at left paracentral lobule,right medial frontal gyrus and right superior frontal gyrus.The results of Pearson correlation analysis did not show any relation between RSNs and language abilities.CONCLUSIONS:The results indicate that the development of basal ganglion aphasia is connected to the decreased connectivity in both side of FPN,while the recovery of basal ganglion aphasia might be connected to the increased connectivity in AN and ECN.All of the regions we found that might played a role in the development and recovery of aphasia were located in fronto-parietal area,which provide more evidence for the importance of fronto-parietal area to language.But we didn't find any relation between RSNs and language abilities.The future researches should expand the sample size and conduct correlation analysis to explore the detail relations between RSNs and language abilities.