Researchers find acupuncture highly effective and that scalp acupuncture is particularly important for post-stroke patients. Scalp acupuncture significantly boosts the effectiveness of body style acupuncture for the treatment of post-stroke facial paralysis. In a randomized controlled trial, researchers determined that the addition of scalp acupuncture to a standard acupuncture therapeutic regimen increases positive patient outcomes by over 20%. In the investigation, body style acupuncture achieved a 71.4% total effective rate. The addition of scalp acupuncture to the treatment protocol increased the total effective rate to 93.1%. Based on the data, the researchers conclude that scalp acupuncture optimizes patient outcomes for patients with post-stroke facial paralysis.

Fujian Ningde Hospital researchers (Ding et al.) conducted a double-arm trial with 60 patients diagnosed with post-stroke paralysis between August 2014 and August 2016. All patients were diagnosed in accordance with standards set by the Fourth Academic Conference for Cerebrovascular Disease. Causative lesions were detected by CT or MRI and extraneous pathological causes were ruled out.

Patients were randomly divided into two groups of thirty. Both patient groups received identical body style acupuncture and were also given routine neurological drugs and received facial physiotherapy. In addition, one treatment group received scalp acupuncture. Treatment was administered once per day, five times per week, for four consecutive weeks. The following body style acupoints were administered for all paricipants (afflicted side):

Qianzheng (N-HN-20: 0.5–1 cun anterior to the auricular lobe)
Yangbai (GB14)
Zanzhu (BL2)
Yingxiang (LI20)
Dicang (ST4)
Jiache (ST6)
Quchi (LI11)
Hegu (LI4)
Waiguan (TB5)
Zusanli (ST36)
Xuehai (SP10)
Fenglong (ST40)

A perpendicular, transverse, or oblique insertion technique was used for the aforementioned acupoints, dependent upon location. The acupuncture needles were manipulated with reinforcement and attenuation methods (Ping Bu Ping Xie). After insertion of all needles, a needle retention time of 30 minutes was observed.

For the group receiving scalp acupuncture, 3–4 needles were inserted along the lower 2/5 portion of the motor line. Needles were inserted with a transverse-oblique angle of 30°. After insertion, the needles were rotated at a rate of 200 times per minute for two minutes. The stimulation was applied until the patient reported a sensation of tightness or fullness in the scalp region. Next, a 30 minute needle retention time was observed. During needle retention, the aforementioned needle stimulation techniques were readministered every ten minutes.

The scalp acupuncture combined with body style acupuncture protocol achieved a 93.1% total effective rate, boosting patient outcomes by over 20% with the addition of scalp acupuncture to the therapeutic regimen. In related findings, laboratory research confirms that acupuncture supports brain repair after a stroke. Yang et al. note that acupuncture "promote[s] the proliferation and differentiation of neural stem cells in the brain … accelerate angiogenesis and inhibit[s] apoptosis." The researchers note that needling the Ren and Du channels "prevent[s] and treat[s] neural injuries following cerebral ischemia."

The researchers note that GV20 (Baihui) and GV26 (Shuigou) regulate cells, which "increase the release of nerve growth factors (NGFs) to make nerve cells survive and axons grow, synthesize neurotransmitters, [and] metabolize toxic substances." The research notes that needling CV24 (Chengjiang), CV4 (Guanyuan), GV26 (Shuigou), and GV20 (Baihui) "inhibit[s] excessive proliferation of the hippocampal astrocytes and promote cellular differentiation." The research indicates that electroacupuncture on the Ren channel increases growth factor proliferation. Electroacupuncture increased growth factors bFGF, EGF, and NGF mRNA in the sub-ventricular zone and the hippocampal dentate gyrus. Needling acupuncture points CV24 (Chengjiang), CV4 (Guanyuan), and CV3 (Qihai) up-regulated bFGF, EGF, and NGF.

In another investigation, researchers concluded that electroacupuncture "significantly ameliorated neurological deficits and cerebral infarction" in cases of cerebral injuries. The researchers find that electroacupuncture significantly increases phosphorylation levels of extracellular signal-related kinase (an important protein in cell proliferation) and protein expression of Ras, cyclin D1, and cyclin-dependent kinase. All of these findings led to the conclusion that acupuncture "exerts a neuroprotective effect in ischemic stroke."

The beneficial effects of acupuncture for the treatment of post-stroke syndrome are confirmed across multiple investigations. However, access to care is limited in the USA. Most hospitals do not provide acupuncture services by licensed acupuncturists and the effectiveness of acupuncture is linked to the immediacy of care. There is no shortage of data proving the clinical and biological benefits of immediate access to acupuncture after a stroke. However, barriers to care include underinsurance, non-ambulatory patients with transportation issues, and hospitals lacking provisions for acupuncturists to provide acupuncture therapy for in-patients.

References
1. Ding JH, Chen YX, Lin ZL. Efficacy observation of head acupuncture in treating facial palsy after stroke [J]. Chinese and Foreign Medical Research, 2017, 15(9): 135-136.

2. National 4th Academic Conference for Neurological Disease. Diagnostic criteria for various neurological diseases [J]. Chinese Journal of Neurology, 1996, 29(6): 379.

3. Research advances in treatment of cerebral ischemic injury by acupuncture of conception and governor vessels to promote nerve regeneration. Zhou-xin Yang, Peng-dian Chen, Hai-bo Yu, Wen-shu Luo, Yong-Gang Wu, Min Pi, Jun-hua Peng, Yong-feng Liu, Shao-yun Zhang, Yan-hua Gou. Journal of Chinese Integrative Medicine, Jan. 2012. vol. 10, 1. Department of Acupuncture and Moxibustion, Shenzhen Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine.

4. Xie, Guanli, Shanli Yang, Azhen Chen, Lan Lan, Zhicheng Lin, Yanlin Gao, Jia Huang et al. "Electroacupuncture at Quchi and Zusanli treats cerebral ischemia?reperfusion injury through activation of ERK signaling." Experimental and Therapeutic Medicine 5, no. 6 (2013): 1593-1597.