Objective To explore the effect of acupuncture combined with repetitive transcranial magnetic stimulation (rTMS) on motor cortex excitability and clinical function recovery detected by transcranial magnetic stimulation combined with electromyography (TMS-EMG) during rehabilitation of patients with ischemic stroke. Methods A total of 200 patients who received rehabilitation treatment after ischemic stroke in the Second People’s Hospital of Anhui Province from January 2023 to June 2024 were retrospectively selected. According to the treatment plan, they were divided into a study group ( n = 108, receiving acupuncture combined with rTMS treatment + routine rehabilitation) and a control group ( n = 92, only receiving routine rehabilitation treatment). The general baseline data, neuroelectrophysiological indexes, functional evaluation indexes, peripheral blood laboratory indexes, emotional state indexes, and adverse reactions of all patients before and after 4 weeks of treatment were collected and compared. Pearson correlation analysis was used to analyze the correlation between the improvement value of the Fugl-Meyer motor function-upper limb (FMA-UE) score and the change value of the neuroelectrophysiological index. Results After 4 weeks of treatment, the study group exhibited the following changes: RMT (43.35 ± 4.22 %MSO), motor evoked potential (MEP) amplitude (2.49 ± 0.50 mV), central motor conduction time (CMCT) (12.23 ± 3.08 ms), FMA-UE score (48.65 ± 7.18), Barthel index (BI) score (68.99 ± 9.52), brain-derived neurotrophic factor (BDNF) (31.73 ± 2.84 pg/mL), nerve growth factor (NGF) (33.70 ± 4.83 pg/mL), tumor necrosis factor-α (TNF-α) (11.97 ± 3.48 pg/mL), interleukin-6 (IL-6) (7.89 ± 1.89 pg/mL), Hamilton Anxiety Rating Scale (HAMA) score (12.76 ± 4.04), and Hamilton Depression Rating Scale (HAMD) score (6.37 ± 2.03) were significantly greater than in the control group ( P 0.05). Pearson correlation analysis showed that there was a significant correlation between the changes of neuroelectrophysiological indexes and the improvement of FMA-UE (all P < 0.05). Conclusion Acupuncture combined with rTMS and conventional rehabilitation therapy can improve excitability in the affected motor cortex of patients in the chronic phase of ischemic stroke, enhance upper limb motor function and activities of daily living, upregulate neurotrophic factors, downregulate inflammatory factors, and alleviate anxiety and depressive symptoms. The incidence of adverse reactions for this combined approach is comparable to conventional rehabilitation, demonstrating good safety.
Zhang et al. (Mon,) studied this question.
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