Based on fNIRS Technology: The Effects of Scalp Acupuncture Combined with iTBS on Cognitive Function After Stroke

Background: Stroke is recognized as the second primary cause of mortality and disability worldwide. Cognitive dysfunction often remains a residual issue post-stroke. Objective: To explore the impact of integrating scalp acupuncture with iTBS therapy on cognitive impairments post-stroke. Methods: This study was a randomized, controlled, single-blind trial. Fifty-four patients completed the study and were allocated into the SA group, iTBS group, and combined group using a random number table method. The SA group received scalp acupuncture treatment for 4 weeks, the iTBS group underwent intermittent theta burst stimulation for 4 weeks, and the combined group received both scalp acupuncture and iTBS treatments for 4 weeks. All enrolled patients also received standard pharmacological and conventional rehabilitation treatments, six days a week, for four weeks in total. Cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) before treatment (baseline) and after treatment (4 weeks). Additionally, changes in cerebral hemodynamics during the experiment were measured using functional near-infrared spectroscopy (fNIRS). Results: Scalp acupuncture therapy, iTBS therapy, and the combination of scalp acupuncture with iTBS therapy all significantly activated the cortical regions of the frontal and temporal lobes in patients with Post-Stroke Cognitive Impairment No Dementia (PSCIND) (P < 0.05). Compared to scalp acupuncture or iTBS therapy alone, the combined therapy activated more channels, with more significant activation in the right Superior Temporal Cortex (r-STC), right Ventrolateral Prefrontal Cortex (r-VLPFC), Medial Prefrontal Cortex (mPFC), left Ventrolateral Prefrontal Cortex (l-VLPFC), right Superior Frontal Cortex (r-SFC), and left Dorsolateral Prefrontal Cortex (l-DLPFC) (P < 0.05). The combined therapy enhances cognitive functions in PSCIND patients, exhibiting superior clinical effectiveness compared to either scalp acupuncture or iTBS therapy when used individually (P < 0.05). Conclusion: The combination of scalp acupuncture with iTBS therapy represents a novel and promising neurorehabilitation treatment technique for post-stroke cognitive impairment. Future clinical research is needed to explore its therapeutic mechanisms and further refine this technique.