Share:
Share this content in WeChat
X
Review
Research progress on evaluating the therapeutic mechanism of acupuncture for ischemic stroke based on functional magnetic resonance imaging
CAO Xinyuan  HAN Mingyuan  ZHONG Sitong  LIANG Ji  LIU Shaopeng  XU Xiaoxuan  SUN Zhongren  YIN Hongna 

Cite this article as: CAO X Y, HAN M Y, ZHONG S T, et al. Research progress on evaluating the therapeutic mechanism of acupuncture for ischemic stroke based on functional magnetic resonance imaging[J]. Chin J Magn Reson Imaging, 2025, 16(10): 124-129, 176. DOI:10.12015/issn.1674-8034.2025.10.020.


[Abstract] Ischemic stroke (IS) is a common cerebrovascular disease in clinical practice. After its onset, specific changes occur in brain function, leading to a series of clinical manifestations of neurological deficits in patients. With the wide application of acupuncture treatment and the development of functional magnetic resonance imaging (fMRI) technology, the research on the pathogenesis of ischemic stroke and the mechanism of acupuncture intervention has received increasing attention. Based on fMRI technology, this article reviews the specific changes in brain function after ischemic stroke and the application progress of acupuncture intervention mechanisms, points out the current research deficiencies, and discusses the future research directions, in order to promote further in-depth fMRI research on the neuro-pathological changes of ischemic stroke and the mechanism of acupuncture intervention, and improve the effectiveness and scientific nature of acupuncture treatment.
[Keywords] ischemic stroke;functional magnetic resonance imaging;magnetic resonance imaging;acupuncture;intervention mechanisms

CAO Xinyuan1   HAN Mingyuan1   ZHONG Sitong1   LIANG Ji1   LIU Shaopeng2   XU Xiaoxuan1   SUN Zhongren1   YIN Hongna3*  

1 The Second Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin 150040, China

2 Department of Rehabilitation, Xi'an Municipal Hospital of Traditional Chinese Medicine, Xi'an 710000, China

3 Department of Acupuncture, Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin 150000, China

Corresponding author: YIN H N, E-mail: hljtcmacu@163.com

Conflicts of interest   None.

Received  2025-07-07
Accepted  2025-10-08
DOI: 10.12015/issn.1674-8034.2025.10.020
Cite this article as: CAO X Y, HAN M Y, ZHONG S T, et al. Research progress on evaluating the therapeutic mechanism of acupuncture for ischemic stroke based on functional magnetic resonance imaging[J]. Chin J Magn Reson Imaging, 2025, 16(10): 124-129, 176. DOI:10.12015/issn.1674-8034.2025.10.020.

[1]
LI C, LUO Y, LI S. Mechanistic insights of neuronal death and neuroprotective therapeutic approaches in stroke[J]. Neural Regen Res, 2026, 21(3): 869-886. DOI: 10.4103/NRR.NRR-D-24-01324.
[2]
GUO L, HUANG Z, HUANG L, et al. Surface-modified engineered exosomes attenuated cerebral ischemia/reperfusion injury by targeting the delivery of quercetin towards impaired neurons[J/OL]. J Nanobiotechnology, 2021, 19(1): 141 [2025-07-07]. https://pubmed.ncbi.nlm.nih.gov/34001136/. DOI: 10.1186/s12951-021-00879-4.
[3]
ZHANG J, MU Y, ZHANG Y. Effects of Acupuncture and Rehabilitation Training on Limb Movement and Living Ability of Patients with Hemiplegia after Stroke[J/OL]. Behav Neurol, 2022, 2022(1): 2032093 [2025-07-07]. https://pubmed.ncbi.nlm.nih.gov/35530165/. DOI: 10.1155/2022/2032093.
[4]
OUYANG W, DENG Z, LI Y, et al. Traditional Chinese medicine in cerebral infarction: Integrative strategies and future directions[J/OL]. Phytomedicine, 2025, 143: 156841 [2025-07-07]. https://pubmed.ncbi.nlm.nih.gov/40393244/. DOI: 10.1016/j.phymed.2025.156841.
[5]
LI C, LUO Y, LI S. Mechanistic insights of neuronal death and neuroprotective therapeutic approaches in stroke[J]. Neural Regen Res, 2026, 21(3): 869-886. DOI: 10.4103/NRR.NRR-D-24-01324.
[6]
JINHAI W, LIANG T, ZHENCHANG Z, et al. Scalp-acupuncture for patients with hemiplegic paralysis of acute ischaemic stroke: a randomized controlled clinical trial[J]. J Tradit Chin Med, 2020, 40(5): 845-854. DOI: 10.19852/j.cnki.jtcm.2020.05.015.
[7]
LV Q, XU G, PAN Y, et al. Effect of Acupuncture on Neuroplasticity of Stroke Patients With Motor Dysfunction: A Meta‐Analysis of fMRI Studies[J/OL]. Neural Plast, 2021, 2021: 8841720 [2025-07-07]. https://pubmed.ncbi.nlm.nih.gov/34188677/. DOI: 10.1155/2021/8841720.
[8]
VAN DEN BERG L, RAMSEY N, RAEMAEKERS M. Enhancing fMRI quality control[J/OL]. J Neurosci Methods, 2025, 415: 110337 [2025-07-07]. https://pubmed.ncbi.nlm.nih.gov/39622453/. DOI: 10.1016/j.jneumeth.2024.110337.
[9]
KLOHS J, CHEN W C, ARAKI R. Advanced preclinical functional magnetic resonance imaging of the brain[J/OL]. NPJ Imaging, 2025, 3(1): 27 [2025-07-07]. https://pubmed.ncbi.nlm.nih.gov/40603606/. DOI: 10.1038/s44303-025-00085-z.
[10]
YANG J, GOHEL S, VACHHA B. Current methods and new directions in resting state fMRI[J]. Clin Imaging, 2020, 65: 47-53. DOI: 10.1016/i.clinimag.2020.04.004.
[11]
LIU H H, ZHENG J O. Research Progress of Resting-State Functional Magnetic Resonance Methodology[J]. Medical Review, 2016, 22(1): 136-140. DOI: 10.3969/i.issn.1006-2084.2016.01.039.
[12]
WU H, SONG Y, YANG X, et al. Functional and structural alterations of dorsal attention network in preclinical and early‐stage Alzheimer's disease[J]. CNS Neurosci Ther, 2023, 29(6): 1512-1524. DOI: 10.1111/cns.14092.
[13]
VESELINOVIĆ T, RAJKUMAR R, AMORT L, et al. Connectivity patterns in the core resting-state networks and their influence on cognition[J]. Brain Connect, 2022, 12(4): 334-347. DOI: 10.1089/brain.2020.0943.
[14]
WANG Z, CHEN L, JIANG T, et al. Research status and trends of functional magnetic resonance imaging technology in the field of acupuncture: a bibliometric analysis over the past two decades[J/OL]. Front Neurosci, 2025, 19: 1489049 [2025-07-07]. https://pubmed.ncbi.nlm.nih.gov/39949895/. DOI: 10.3389/fnins.2025.1489049.
[15]
KE C, SHI W, ZHOU Z, et al. Overview of evidence-based research on acupuncture for stroke treatment using magnetic resonance imaging technology[J/OL]. Front Neurosci, 2024, 18: 1495435 [2025-07-07]. https://pubmed.ncbi.nlm.nih.gov/39654647/. DOI: 10.3389/fnins.2024.1495435.
[16]
WANG Q, WANG C, DENG Q, et al. Alterations of regional spontaneous brain activities in anxiety disorders: A meta-analysis[J]. J Affect Disord, 2022, 296: 233-240. DOI: 10.1016/j.jad.2021.09.062.
[17]
WANG X, WANG C, LIU J, et al. Altered static and dynamic spontaneous neural activity in patients with ischemic pontine stroke[J/OL]. Front Neurosci, 2023, 17: 1131062 [2025-07-07]. https://pubmed.ncbi.nlm.nih.gov/37008224/. DOI: 10.3389/fnins.2023.1131062.
[18]
DING J R, LI Y, HUA B, et al. Study on Local Consistency Changes in Brain Functional Activity and Cognitive Dysfunction in Patients with Ischemic Stroke[J]. Chin J Magn Reson Imaging, 2023, 14(9): 7-12. DOI: 10.12015/issn.1674-8034.2023.09.002.
[19]
LI Q, HU S, MO Y, et al. Regional homogeneity alterations in multifrequency bands in patients with basal ganglia stroke: a resting-state functional magnetic resonance imaging study[J/OL]. Front Aging Neurosci, 2022, 14: 938646 [2025-07-07]. https://pubmed.ncbi.nlm.nih.gov/36034147/. DOI: 10.3389/fnagi.2022.938646.
[20]
ZHANG J, LU C, WU X, et al. Neuroplasticity of acupuncture for stroke: An evidence‐based review of MRI[J/OL]. Neural Plast, 2021, 2021(1): 2662585 [2025-07-07]. https://pubmed.ncbi.nlm.nih.gov/34456996/. DOI: 10.1155/2021/2662585.
[21]
TIAN C L. Clinical Research and Brain Mechanism Exploration of Acupuncture Treatment for Limb Dysfunction in Ischemic Stroke[D]. Tianjin: Tianjin University of Traditional Chinese Medicine, 2024. DOI: 10.27368/d.cnki.gtzyy.2024.000614.
[22]
CHEN S, CAI D, CHEN J, et al. Altered brain regional homogeneity following contralateral acupuncture at Quchi (LI 11) and Zusanli (ST 36) in ischemic stroke patients with left hemiplegia: an fMRI study[J]. Chinese Journal of Integrative Medicine, 2020, 26(1): 20-25. DOI: 10.1007/s11655-019-3079-6.
[23]
ZHAO C, LI Q G, SHAN Y, et al. The influence of resting-state functional MRI whole-brain signals on low-frequency amplitude in patients with cerebral infarction in the left basal ganglia region [J]. Chinese Journal of Medical Imaging Technology, 2021, 37(10): 1558-1562. DOI: 10.13929/j.issn.1003-3289.2021.10.029.
[24]
WANG X, WANG C, LIU J, et al. Altered static and dynamic spontaneous neural activity in patients with ischemic pontine stroke[J/OL]. Front Neurosci, 2023, 17: 1131062 [2025-07-07]. https://pubmed.ncbi.nlm.nih.gov/37008224/. DOI: 10.3389/fnins.2023.1131062.
[25]
ZHANG Y. The influence of acupuncture combined with PT on lower extremity motor function and ALFF in rsfMRI of patients with ischemic stroke[D]. Tianjin: Tianjin University of Traditional Chinese Medicine, 2023. DOI: 10.27368/d.cnki.gtzyy.2022.000171.
[26]
WEN Z Y, CHEN J, SONG X L, et al. To explore the fMRI brain function mechanism of scalp acupuncture combined with rehabilitation training in the treatment of motor dysfunction in ischemic stroke based on low-frequency amplitude technology[J]. Journal of Clinical Radiology, 2023, 42(8):1227-1232. DOI: 10.13437/j.cnki.jcr.2023.08.001.
[27]
WANG Y, WANG C, WEI Y, et al. Abnormal functional connectivities patterns of multidomain cognitive impairments in pontine stroke patients[J]. Hum Brain Mapp, 2022, 43(15): 4676-4688. DOI: 10.1002/hbm.25982.
[28]
WANG P, ZANG Z, ZHANG M, et al. Longitudinal Changes of Sensorimotor Resting‐State Functional Connectivity Differentiate between Patients with Thalamic Infarction and Pontine Infarction[J/OL]. Neural Plast, 2021, 2021(1): 7031178 [2025-07-07]. https://pubmed.ncbi.nih.gov/34659397/. DOI: 10.1155/2021/7031178.
[29]
WEI Y, WANG C, LIU J, et al. Longitudinal gray matter atrophy and accompanied functional connectivity alterations in patients with pontine infarction[J]. Neurol Res, 2022, 44(8): 667-676. DOI: 10.1080/01616412.2021.2018122.
[30]
LI X, CAI L, JIANG X, et al. Resting‐state fMRI in studies of acupuncture[J/OL]. Evid Based Complement Alternat Med, 2021, 2021: 6616060 [2025-07-07]. https://pubmed.ncbi.nlm.nih.gov/33859708/. DOI: 10.1155/2021/6616060.
[31]
LIU R Y. A multimodal magnetic resonance study based on brain connection to explore the mechanism of acupuncture in treating stroke hemiplegia[D]. Beijing: Beijing University of Chinese Medicine, 2023. DOI: 10.26973/d.cnki.gbjzu.2023.000038.
[32]
LIN D, GAO J, LU M, et al. Scalp acupuncture regulates functional connectivity of cerebral hemispheres in patients with hemiplegia after stroke[J/OL]. Front Neurol, 2023, 14: 1083066 [2025-07-07]. https://pubmed.ncbi.nlm.nih.gov/37305743/. DOI: 10.3389/fneur.2023.1083066.
[33]
ZHAO H, CAI H, MO F, et al. Genetic mechanisms underlying brain functional homotopy: a combined transcriptome and resting-state functional MRI study[J]. Cereb Cortex, 2023, 33(7): 3387-3400. DOI: 10.1093/cercor/bhac279.
[34]
CHEN J, SUN D, SHI Y, et al. Altered static and dynamic voxel-mirrored homotopic connectivity in subacute stroke patients: a resting-state fMRI study[J]. Brain Imaging Behav, 2021, 15(1): 389-400. DOI: 10.1007/s11682-020-00266-x.
[35]
LIU H, JIANG Y, WANG N, et al. Scalp acupuncture enhances local brain regions functional activities and functional connections between cerebral hemispheres in acute ischemic stroke patients[J]. Anat Rec (Hoboken), 2021, 304(11): 2538-2551. DOI: 10.1002/ar.24746.
[36]
CHEN T, CHEN T, ZHANG Y, et al. Bilateral effect of acupuncture on cerebrum and cerebellum in ischaemic stroke patients with hemiparesis: a randomised clinical and neuroimaging trial[J]. Stroke Vasc Neurol, 2024, 9(3): 306-317. DOI: 10.1136/svn-2023-002785.
[37]
GREGORICH M, SIMPSON S L, HEINZE G. Flexible parametrization of graph‐theoretical features from individual‐specific networks for prediction[J]. Stat Med, 2024, 43(13): 2592-2606. DOI: 10.1002/sim.10091.
[38]
FAN L H, WEI W, CHEN Y Y, et al. Graph Theory Analysis of Alzheimer's Disease Patients Based on Gray Matter Structure Covariant Network[J]. Chin J Magn Reson Imaging, 2025, 16(6): 27-33. DOI: 10.12015/issn.1674-8034.2025.06.004.
[39]
HUANG Q, LIN D, HUANG S, et al. Brain functional topology alteration in right lateral occipital cortex is associated with upper extremity motor recovery[J/OL]. Front Neurol, 2022, 13: 780966 [2025-07-07]. https://pubmed.ncbi.nlm.nih.gov/35309550/. DOI: 10.3389/fneur.2022.780966.
[40]
PUNDIK S, SKELLY M M, MCCABE J P, et al. Resting‐State Functional Connectivity of Sensorimotor and Default Mode Networks and Lower Limb Performance in Chronic Stroke: A Cross‐Sectional Study[J/OL]. Brain and Behavior, 2025, 15(5): e70519 [2025-07-07]. https://pubmed.ncbi.nlm.nih.gov/40329808/. DOI: 10.1002/brb3.70519.
[41]
SHEN D, YANG B, LI J, et al. The potential associations between acupuncture sensation and brain functional network: a EEG study[J]. Cogn Neurodyn, 2025, 19(1): 1-14. DOI: 10.1007/s11571-025-10233-1.
[42]
HAN X, JIN H, LI K, et al. Acupuncture modulates disrupted whole‐brain network after ischemic stroke: Evidence based on graph theory analysis[J/OL]. Neural Plast, 2020, 2020: 8838498 [2025-07-07]. https://pubmed.ncbi.nlm.nih.gov/32922447/. DOI: 10.1155/2020/8838498.
[43]
SEEWOO B J, JOOS A C, FEINDEL K W. An analytical workflow for seed-based correlation and independent component analysis in interventional resting-state fMRI studies[J]. Neurosci Res, 2021, 165: 26-37. DOI: 10.1016/j.neures.2020.05.006.
[44]
LEE J, KIM Y H. Exploring the interrelationship of intra-and inter-network alteration in motor recovery after stroke[J/OL]. Sci Rep, 2025, 15(1): 12906 [2025-07-07]. https://pubmed.ncbi.nlm.nih.gov/40234467/. DOI: 10.1038/s41598-025-87164-8.
[45]
LU M X. Study on mechanism of acupuncture effect after stroke hemiplegia based on multimodal magnetic resonance and machine learning[D]. Beijing: Beijing University of Chinese Medicine, 2023. DOI: 10.26973/d.cnki.gbjzu.2023.000017.
[46]
CHEN C, LI K S, YU X, et al. Immediate effect of Yanglingquan acupuncture on functional connectivity of brain network in patients with stroke and hemiplegia[J]. Information Journal of Chinese Medicine, 2024, 31(3): 149-154. DOI: 10.19879/j.cnki.1005-5304.202304529.
[47]
QIAN X, ZHANG H, PENG J, et al. Acupuncture modulates group neural activity in patients with post stroke sensory impairment: An fMRI study based on inter-subject correlation and inter-subject functional connectivity[J/OL]. Brain Res Bull, 2025, 222: 111259 [2025-07-07]. https://pubmed.ncbi.nlm.nih.gov/39956399/. DOI: 10.1016/j.brainresbull.2025.111259.

PREV Progress in MRI assessment of brain structural characteristics in patients with rheumatoid arthritis and its association with immune-inflammatory indicators
NEXT Research progress of imaging evaluation of hemorrhagic transformation after thrombolysis in acute ischemic stroke
  



Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn