Stroke

Stroke is defined as a neurological deficit of sudden onset which results from cerebrovascular disease and persists for longer than 24 hours. Stroke is very common, with, for example, around 110,000 people each year in England alone experiencing a first or recurrent episode. Consequences of stroke can include disability and early death.

In general, acupuncture is believed to stimulate the nervous system and cause the release of neurochemical messenger molecules. The resulting biochemical changes influence the body’s homeostatic mechanisms, thus promoting physical and emotional well-being.

There have been numerous physiological studies on acupuncture and stroke, largely from China; examples from the last three years are presented in the table below. They indicate multiple possible mechanisms by which acupuncture treatment may help in the management of stroke:

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  • Harnessing the anti-inflammatory effects of acetylcholine receptor activation

  • Protecting the brain from ischaemic injury by increasing cerebral blood flow

  • Alleviating cerebral oedema after cerebral ischaemia 

  • Preventing the impairment of cortical GABAergic neurons 

  • Regulating differential expression of multiple serum proteins involved in stroke, and enhancing muscle strength recovery

  • increasing production of glyco-metabolic enzymes and hence improving post-stroke cognition

  • Improving motor cortical excitability, and facilitating motor function recovery after focal cerebral ischaemic injury

  • Restoring the expression of Na(v)1.1 and Na(v)1.6 (sodium channel sub-unit genes that are down-regulated in cerebral ischaemia) thus reducing infarction volume and decreasing stroke damage 

  • Up-regulating bcl-2 , hence reducing the expression of caspase-3, one of the enzymes involved in programmed cell death in stroke 

  • Promoting neuroprotective effects against focal cerebral ischaemia 

  • Modulating brain glutamate release (excessive glutamate in the ischaemic zone is neuro-toxic) 

  • Increasing the production of endocannabinoid 2-arachidonylglycerol and N-arach-idonoylethanolamine-anandamide, which elicits protective effects against transient cerebral ischaemia through CB1 receptors 

  • Acting on areas of the brain known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the ‘analytical’ brain, which is responsible for anxiety and worry 

  • Increasing the release of adenosine, which has antinociceptive properties 

  •  Reducing inflammation, by promoting release of vascular and immunomodulatory factors