Acupuncture shows promise for poststroke motor aphasia

When combined with language training and conventional treatment, a 6-week course of acupuncture helps improve outcomes, including language function, in stroke survivors with motor aphasia, as shown in a study.

Compared with sham acupuncture, actual acupuncture led to significant increases in the primary endpoints of the aphasia quotient (AQ) of the Western Aphasia Battery (WAB) and the Chinese Functional Communication Profile (CFCP). The respective mean between-group differences in AQ and CFCP scores were 7.99 (95 percent confidence interval [CI], 3.42–12.55; p=0.001) and 23.51 (95 percent CI, 11.10–35.93; p<0.001) points at the end of the intervention at week 6 and 10.34 (95 percent CI, 5.75–14.93; p<0.001) and 27.43 (95 percent CI, 14.75–40.10; p<0.001) points at 6 months following aphasia onset. [JAMA Netw Open 2024;7:e2352580]

Participants who received acupuncture vs the sham procedure achieved higher scores on all components of WAB such as spontaneous speech (mean difference, 1.78 points; p<0.001), auditory verbal comprehension (mean difference, 14.22 points; p=0.001), repetition (mean difference, 9.10 points; p=0.005), and naming (mean difference, 7.06 points; p=0.02) at week 6.

Acupuncture also had more favourable effects on neurological function (National Institutes of Health Stroke Scale [NIHSS] score: mean difference, -2.22 points; p=0.01) and quality of life (Stroke-Specific Quality of Life Scale [SS-QOL] score: mean difference, 11.55 points; p=0.008) at week 6 compared with the sham procedure. These improvements were observed through 6 months after aphasia onset.

In terms of safety, only six adverse reactions were documented overall, three each in the acupuncture and sham groups.  These adverse reactions were transient and included pain after acupuncture, subcutaneous hematoma, and aural vertigo. None of the participants had any serious adverse events.

“The study results confirmed that poststroke motor aphasia was the dominant condition affected by the acupuncture treatment, indicating that acupuncture might serve as an adjunctive treatment for patients with poststroke motor aphasia,” the investigators said. [BMJ 2022;376:e067475]

“In addition, the clinical effects and safety results provide evidence for policymakers, clinicians, and patients regarding the management of poststroke aphasia with acupuncture,” they added.

The investigators postulated that acupuncture's benefits for poststroke motor aphasia involve a combination of factors, including targeting the right condition, administering sufficient “acupuncture dose” (ie, 30 sessions), strictly adhering to protocol, increasing activation in brain regions involved in language function, improving blood flow in the injured area of the brain, and stimulating neuroplasticity.

A total of 231 participants (mean age, 60.4 years; male, 79.2 percent) with poststroke motor aphasia in China were included in the study, of which 125 received acupuncture and 127 received sham acupuncture. Both interventions were performed for 30 30-minute sessions over 6 consecutive weeks (5 sessions per week).