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An fMRI Study Showing the Effect of Acupuncture in Chronic Stage Stroke Patients With Aphasia
Anson C.M. Chau,Xianyong Jiang,Paul K.M. Au-Yeung,Leonard S.W. Li,Raymond Tak Fai Cheung 사단법인약침학회 2010 Journal of Acupuncture & Meridian Studies Vol.3 No.1
Acupuncture is used as a treatment in stroke patients with aphasia, yet the underlying neural mechanisms are unknown. This study aims to examine the relationship between changes in language function and brain activation using functional magnetic resonance imaging in chronic stroke patients with aphasia who underwent an 8-week acupuncture protocol. Seven chronic stroke patients were identified from a stroke database of a regional acute hospital in Hong Kong between January and July 2007. Patients were treated three times a week over a period of 8 weeks. Four acupoints were stimulated on the weak side of the patient’s body. No other rehabilitation was given during the study period. Changes in language function were measured by aphasia quotient (AQ) of Cantonese Aphasia Battery (CAB). Functional magnetic resonance imaging blood oxygen level dependent signals were used to demonstrate the correlation between changes in AQ and brain activation after treatment. The patients were divided into well-recovered and poorlyrecovered groups based on their CAB scores at entry. The well-recovered group showed significant improvement in CAB scores after receiving acupuncture treatment. A significant correlation between changes in AQ and blood oxygen level dependent activation in the lesioned Wernicke’s speech area was found. These preliminary results suggest that acupuncture may be beneficial to language recovery in chronic stroke patients.
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Migraine Disability Awareness Campaign in Asia: Migraine Assessment for Prophylaxis
Wang, Shuu-Jiun,Chung, Chin-Sang,Chankrachang, Siwaporn,Ravishankar, K.,Merican, Julia Shahnaz,Salazar, Gerard,Siow, Charles,Cheung, Raymond Tak-Fai,Phanthumchinda, Kammant,Sakai, Fumihiko Blackwell Publishing Inc 2008 Headache Vol.48 No.9
<P>Objectives.—</P><P>This study aimed to survey the headache diagnoses and consequences among outpatients attending neurological services in 8 Asian countries.</P><P>Methods.—</P><P>This survey recruited patients who consulted neurologists for the first time with the chief complaint of headache. Patients suffering from headaches for 15 or more days per month were excluded. Patients answered a self-administered questionnaire, and their physicians independently completed a separate questionnaire. In this study, the migraine diagnosis given by the neurologists was used for analysis. The headache symptoms collected in the physician questionnaire were based on the diagnostic criteria of migraine proposed by the International Classification of Headache Disorders, second edition (ICHD-2).</P><P>Results.—</P><P>A total of 2782 patients (72% females; mean age 38.1 ± 15.1 years) finished the study. Of them, 66.6% of patients were diagnosed by the neurologists to have migraine, ranging from 50.9% to 85.8% across different countries. Taken as a group, 41.4% of those patients diagnosed with migraine had not been previously diagnosed to have migraine prior to this consultation. On average, patients with migraine had 4.9 severe headaches per month with 65% of patients missing school, work, or household chores. Most (87.5%) patients with migraine took medications for acute treatment. Thirty-six percent of the patients had at least one emergency room consultation within one year. Only 29.2% were on prophylactic medications. Neurologists recommended pharmacological prophylaxis in 68.2% of patients not on preventive treatment. In comparison, migraine prevalence was the highest with ICHD-2 “any migraine” (ie, migraine with or without migraine and probable migraine) (73.3%) followed by neurologist-diagnosed migraine (66.6%) and ICHD-2 “strict migraine” (ie, migraine with or without aura only) (51.3%). About 88.6% patients with neurologist-diagnosed migraine fulfilled ICHD-2 any migraine but only 67.1% fulfilled the criteria of ICHD-2 strict migraine.</P><P>Conclusions.—</P><P>Migraine is the most common headache diagnosis in neurological services in Asia. The prevalence of migraine was higher in countries with higher referral rates of patients to neurological services. Migraine remains under-diagnosed and under-treated in this region even though a high disability was found in patients with migraine. Probable migraine was adopted into the migraine diagnostic spectrum by neurologists in this study.</P>
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