Study on the Efficacy and Mechanism of Electroacupuncture Combined with Transcranial Magnetic Stimulation in Treating Dystonia in Stroke Patients

Abstract

Objective: To evaluate the clinical efficacy and neural mechanism of electroacupuncture (EA) combined with transcranial magnetic stimulation (TMS) in patients with lower extremity dystonia after stroke. Methods: Fifty patients with post-stroke lower extremity dystonia admitted from January 2024 to January 2025 were randomly divided into two groups (n=25 each). The control group received routine rehabilitation plus sham EA and sham TMS. The treatment group received EA (on antagonist muscles) combined with repetitive TMS (rTMS) on the basis of routine rehabilitation. Before and after treatment, the modified Ashworth Scale (MAS), Fugl-Meyer Assessment for lower extremity (FMA-L), Postural Assessment Scale for Stroke (PASS), Functional Ambulation Category (FAC), and Stroke-Specific Quality of Life (SS-QOL) scale were used to evaluate functional improvements. Functional near-infrared spectroscopy (fNIRS) was used to detect changes in oxyhemoglobin concentration in motor-related brain regions, including the primary motor cortex (SMC), supplementary motor area (SMA), premotor cortex (PMC), and prefrontal cortex (PFC). Results: After treatment, the treatment group was significantly superior to the control group in all functional indicators (all P<0.05). The MAS score was significantly decreased (muscle tone improved by ≥1 grade), and FMA-L, PASS, FAC, and SS-QOL scores were significantly increased. fNIRS showed that the activation range of motor-related brain regions (SMC, SMA, PMC, PFC) was significantly expanded in the treatment group (P<0.05), whereas no significant changes were observed in the control group (P>0.05). Conclusion: On the basis of routine rehabilitation, EA combined with rTMS can effectively activate and expand motor-related brain regions in stroke patients, significantly reduce lower extremity muscle tone, improve motor function, walking ability and quality of life, with clear value for clinical promotion.