Summary
Objective
In this meta-analysis the authors evaluated the effectiveness of acupuncture in improving functional communication and language function in post-stroke aphasia (PSA) patients.
Methods
Data sources: MEDLINE, EMBASE, CENTRAL, AMED, SinoMed, CNKI, VIP, and Wanfang databases, ICTRP, ISRCTN, EUCTR, ClinicalTrials.gov, and Stroke Trials Registries. A search was carried out for randomized controlled trials (RCTs) investigating the effects of acupuncture compared with no treatment or placebo acupuncture on post-stroke aphasia (PSA). The searched records were independently screened by two authors, who extracted the data, and assessed risk of bias of the included RCTs. Data aggregation and risk of bias evaluation were conducted on Review Manager Version 5.3. The protocol was registered in the PROSPERO database (CRD42016037543).
Results
A total of 28 RCTs involving 1747 patients (883 patients in the treatment group and 864 patients in the control group) were included in the quantitative synthesis. The results demonstrated significant effects of acupuncture in improving PSA functional communication (P < 0.00001, standardized mean difference (SMD) = 1.01 [0.81, 1.20]), severity of impairment (P < 0.0001, SMD = 0.64 [0.45, 0.84]), spontaneous speech (P = 0.0002, SMD = 1.51 [0.71, 2.32]), auditory comprehension (P < 0.0001, SMD = 0.84 [0.43, 1.26]), repetition (P < 0.00001, SMD = 1.13 [0.75, 1.52]), naming (P = 0.03, SMD = 0.65 [0.08, 1.23]), reading (P < 0.0001, SMD = 1.56 [0.83, 2.29]), and writing (P = 0.009, SMD = 1.03 [0.25, 1.80]).
Conclusion
Acupuncture seems to be effective in improving PSA functional communication and language function.
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References
Vos T, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, GBD 2016 Disease and Injury Incidence and Prevalence Collaborators, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1211–59.
Davis GA. Aphasiology: Disorders and clinical practice. 2nd ed. Boston: Pearson; 2006.
Gottesman RF, Hillis AE. Predictors and assessment of cognitive dysfunction resulting from ischaemic stroke. Lancet Neurol. 2010;9:895–905.
Inatomi Y, Yonehara T, Omiya S, Hashimoto Y, Hirano T, Uchino M. Aphasia during the acute phase in ischemic stroke. Cerebrovasc Dis. 2008;25:316–23.
Engelter ST, Gostynski M, Papa S, et al. Epidemiology of aphasia attributable to first ischemic stroke: Incidence, severity, fluency, etiology, and thrombolysis. Stroke. 2006;37:1379–84.
Brady MC, Kelly H, Godwin J, Enderby P, Campbell P. Speech and language therapy for aphasia following stroke. Cochrane Database Syst Rev. 2016; https://doi.org/10.1002/14651858.cd000425.pub4.
Elsner B, Kugler J, Pohl M, Mehrholz J. Transcranial direct current stimulation (tDCS) for improving aphasia in patients with aphasia after stroke. Cochrane Database Syst Rev. 2015; https://doi.org/10.1002/14651858.cd009760.pub3.
Berthier ML, Pulvermuller F, Davila G, Casares NG, Gutierrez A. Drug therapy of post-stroke aphasia: A review of current evidence. Neuropsychol Rev. 2011;21:302–17.
Zhang S, Wu B, Liu M, et al. Acupuncture efficacy on ischemic stroke recovery: Multicenter randomized controlled trial in China. Stroke. 2015;46:1301–6.
Peng L, Zhang C, Zhou L, Zuo HX, He XK, Niu YM. Traditional manual acupuncture combined with rehabilitation therapy for shoulder hand syndrome after stroke within the Chinese healthcare system: A systematic review and meta-analysis. Clin Rehabil. 2018;32:429–39.
Chang J, Gao Y, Li S, Wang J. Effect of acupuncture and speech rehabilitation on motor aphasia after stroke. Chin J Rehabil Theory Pract. 2010;16(1):58–9.
Jiang H, Zhou Y, Liang X. Integrative analysis of clinical efficacy in patients with motor aphasia and its impact on the quality of the language of daily life after stroke. Chin Arch Tradit Chin Med. 2015;33:1235–7.
Wang M. Combining scalp acupuncture, tongue acupuncture and language rehabilitation for post-acute-stroke aphasia. J Bethune Med Sci. 2016;14:740–1.
Glass GV. Research, primary secondary and Meta-analysis. Educ Res. 1976;5:3–8.
Armstrong E, Ferguson A. Language, meaning, context, and functional communication. Aphasiology. 2010;24:480–96.
Zhu D, Gao Y, Chang J, Kong J. Placebo acupuncture devices: Considerations for acupuncture research. Evid Based Complement Alternat Med. 2013;2013:1–9. https://doi.org/10.1155/2013/628907.
Gialanella B. Aphasia assessment and functional outcome prediction in patients with aphasia after stroke. J Neurol. 2011;258:343–9.
Marini A, Andreetta S, del Tin S, Carlomagno S. A multi-level approach to the analysis of narrative language in aphasia. Aphasiology. 2011;25:1372–92.
Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0. 2011. http://handbook-5-1.cochrane.org/..
Shi X, Wang H, Wang L, et al. Can tongue acupuncture enhance body acupuncture? First results from heart rate variability and clinical scores in patients with depression. Evid Based Complement Alternat Med. 2014. https://doi.org/10.1155/2014/329746.
Wang WW, Xie CL, Lu L, Zheng GQ. A systematic review and meta-analysis of Baihui (GV20)-based scalp acupuncture in experimental ischemic stroke. Sci Rep. 2014;4(1) https://doi.org/10.1038/srep03981.
Liu J, Song KH, You MJ, Son DS, Cho SW, Kim DH. The effect of oculo-acupuncture on recovery from ethylene glycol-induced acute renal injury in dogs. Am J Chin Med. 2007;35:241–50.
Zhou Y. The clinical efficacy of scalp electro-acupuncture combined with aphasia (uygur) training system treating for the uygur patients with aphasia. Xinjiang: Xinjiang Medical University; 2015.
Li A, Xiao W, Wang Y. A follow-up study of poststroke aphasia recovery using acupuncture and donepezfil. J New Med. 2013;44:832–5.
Ren YL, Guo TP, Du HB, et al. A survey of the practice and perspectives of chinese acupuncturists on deqi. Evid Based Complement Alternat Med. 2015. https://doi.org/10.1155/2015/684708.
Zhang H. Clinical treatment of apoplectic Aphemia with multi-needle puncture of scalp-points in combination with visual-listening-speech training. Chen Tzu Yen Chiu. 2007;32(3):190–4.
Lu Q, Kang B. Clinical observation of acupuncture combined with language rehabilitation for poststroke aphasia. 2010. pp. 179–81.
Zheng Q, Yu B, Li Y. Clinical study of acupuncture with language training for aphasia after stroke. J Liaoning Univ Tcm. 2011;13(1):105–7.
Xie Z. Clinical Research of acupuncture combined head and body language rehabilitation after stroke motor aphasia. Guangzhou: Guangzhou University of Chinese Medicine; 2014.
Hu X, Zhou W. Clinical Observation of puncturing meridians therapy for post stroke ganglion aphasia. Lishizhen Med Materia Medica Res. 2010;21:2084–2085.
Li Y. Clinical research on aphasia from apoplexy treated by acupuncture needling integrated with language training. Hunan: Hunan University of Chinese Medicine; 2009.
Sun Q, Ji X, Cui Z. Observation on the therapeutic effect of scalp acupuncture, plum-blossom needle combined with speech rehabilitation training on aphasia of ischemic apoplexy. World J Acupunct Moxibustion. 2010;20:13–8.
Wang G, Liu L, Li L, Dong B, Wang S. Clinic observation on motor aphasia after stroke by acupuncture and psychological intervention combined with rehabilitation training. J Liaoning Univ Tcm. 2015;17:5–8.
Zhou Y, Song J, Li X, Li X. Sichong point Yinzhong Yinyang acupuncture combined with Schuell language training for aphasia after Ischemic stroke. J Clin Acupunct Moxibustion. 2015;32(7):26–8.
Yang L, Guo Y. Clinical study of scalp electroacupuncture combined with language training on post-stroke aphasia patients. Chin J Rehabil Med. 2017;32:305–8.
Tan J, Zhang H, Han G, Ai K, Deng S. Acupuncture for aphasia: A retrospective analysis of clinical literature. Zhongguo Zhen Jiu. 2016;36:431–6.
Zhang Y, Fu L, Zhu Y, Xue P. Acupuncture treatment for aphasia after stroke: A systematic review. J Clin Acupunct Moxibustion. 2014;31:62–5.
Pan D. A meta analysis of acupuncture for post stroke aphasia. Shandong Med J. 2013;53:87–9.
Sun Y, Xue SA, Zuo Z. Acupuncture therapy on apoplectic aphasia rehabilitation. J Tradit Chin Med. 2012;32:314–21.
Pang Y, Wu LB, Liu DH. Acupuncture therapy for apoplectic aphasia: A systematic review. Zhongguo Zhen Jiu. 2010;30:612–6.
Li YF, Kurabayashi Y, Zhao SH, et al. Meta analysis on acupuncture treatment of aphasia. zhen Ci Yan Jiu. 2010;35:468–73.
Jiang Y, Zhou Y, Wang B, Tang S, Niu W. The efficacy of acupuncture on treating aphasia following stroke: A Meta-analysis. Xinjiang Med J. 2016;46:1237–41.
Gao S. Aphasia. Beijing: Peking University Medical Press; 2005.
Gao S, Zhe Y, Shi S. The research of the standardization of aphasia battery of Chinese. Chin Ment Health J. 1992;6(3):125–8.
Dong B. Study of the combination of scalp acupuncture and body acupuncture in treating acute ischemic stroke patients with Broca aphasia. Beijing: Beijing University of Chinese Medicine; 2011.
Gu Y. Clinical research on acupuncture in Jinjinyuye point with speech therapy for Broca aphasia following stroke. Fujian: Fujian University of Chinese Medicine; 2009.
Stroke Foundation. Clinical guidelines for stroke management 2017. 2017. https://informme.org.au/en/Guidelines/Clinical-Guidelines-for-Stroke-Management-2017..
Winstein CJ, Stein J, Arena R, et al. Guidelines for adult stroke rehabilitation and recovery: A guideline for Healthcare professionals from the American heart association/American stroke association. Stroke. 2016;47:e98–e169.
Zhang T. Chinese guideline of stroke rehabilitation. Chin J Rehabil Theory Pract. 2012;18:301–18.
Wu Q, Hu X, Wen X, Li F, Fu W. Clinical study of acupuncture treatment on motor aphasia after stroke. Technol Health Care. 2016;24(Suppl 2):691–6.
Tao J, Fang Y, Wu Z, et al. Community-applied research of a traditional Chinese medicine rehabilitation scheme on Broca’s aphasia after stroke: Study protocol for a randomized controlled trial. Trials. 2014;15:290.
Chang J, Zhang H, Tan Z, Xiao J, Li S, Gao Y. Effect of electroacupuncture in patients with post-stroke motor aphasia: Neurolinguistic and neuroimaging characteristics. Wien Klin Wochenschr. 2017;129:102–9.
Li G, Yang ES. An fMRI study of acupuncture-induced brain activation of aphasia stroke patients. complementary Ther Med. 2011;19(Suppl 1):S49–59.
Chau AC, Fai Cheung RT, Jiang X, Au-Yeung PK, Li LS. An fMRI study showing the effect of acupuncture in chronic stage stroke patients with aphasia. J Acupunct Meridian Stud. 2010;3:53–7.
Xian Y, Chen J. Effect of acupuncture plus language function training on language function in patients with post-stroke aphasia. J China Prescr Drug. 2016;14:1–2.
Wang N, Li Y. Therapeutic observation of cluster needling at anterior oblique line of vertex-temporal plus speech training for motor aphasia after cerebral infarction. shanghai J Acu-mox. 2015;34:412–4.
Shao B. Clinical research on acupuncture in root and end and appearance and substance of kidney meridian associated with language training for Broca aphasia following the stroke. Fujian: Fujian University of Chinese Medicine; 2012.
Wang L, Liu S, Liu M. Post-stroke speech disorder treated with acupuncture and psychological intervention combined with rehabilitation training: A randomized controlled trial. Chin Acupunct Moxibustion. 2011;31:481–6.
Luo W, Huang H, Zhu J. Clinical research on Broca aphasia from Ischemic apoplexy treated by acupuncture Associtated with language training. Chin Arch Tradit Chin Med. 2010;29:2451–4.
Mu J, Fu L, Lu Y. Clinical observation on the Xingnao Kaiqiao acupuncture plus language rehabilitation training for motor aphasia caused by cerebral infarction: A report of 30 cases. J Tradit Chin Med. 2010;30:428–31.
Wu F, Yang W, Zhao N. Influence of Tongli acupuncture combined with speech function rehabilitation training on speech Functionon in patients with motor aphasia after cerebral infarction. Chin J Integr Med Cardio-cerebrovascular Dis. 2010;8:290–2.
Luo W, Tan J, Huang H. Clinical observation on treatment of cerebral infarction-induced broca aphasia by Tiaoshen Fuyin acupuncture therapy combined with language training. Chin Acupunct Moxibustion. 2008;28(3):171–5.
Liu L, Guo R, Feng S. Clinical research of acupuncture combined with language rehabilitation for early stroke aphasia. Chin Arch Tradit Chin Med. 2006;24:2256–9.
Wang Y. Clinical research on aphasia from apoplexy treated by skull slot needling integrated with language training. Fujian: Fujian University of Chinese Medicine; 2006.
Zhang B. Treating Nonfluent aphasia following stroke by scalp acupuncture with speech therapy. Fujian: Fujian University of Chinese Medicine; 2005.
Acknowledgements
We would like to thank Professor Jian Kong for his great help in improving this manuscript.
Funding
This project was supported by the Special Public Welfare Industry and Scientific Research from State Administration of Traditional Chinese Medicine (project No. 201407001-9) and the National Science Foundation of China (project No. 81473654).
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B. Zhang, Y. Han, X. Huang, Z. Liu, S. Li, J. Chang and Y. Gao declare that they have no competing interests.
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Zhang, B., Han, Y., Huang, X. et al. Acupuncture is effective in improving functional communication in post-stroke aphasia. Wien Klin Wochenschr 131, 221–232 (2019). https://doi.org/10.1007/s00508-019-1478-5
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DOI: https://doi.org/10.1007/s00508-019-1478-5