Effects of scalp acupuncture on the limb function recovery of hemiplegia after moderate to severe traumatic brain injury

Background: Hemiplegia, a common neurological consequence of moderate to severe traumatic brain injury (TBI) significantly impacts patients' motor and daily living functions. In China, standard treatments for hemiplegia include physical rehabilitation and traditional acupuncture. Scalp acupuncture, rooted in traditional Chinese medicine, has gained attention as a potential alternative. This study compared the efficacy of scalp acupuncture combined with conventional therapy versus conventional therapy alone in improving limb function recovery in patients with hemiplegia after moderate to severe TBI. Methods: This open-label, single-site, parallel-group randomized trial included 117 patients with hemiplegia post-TBI. Patients were randomized into a control group (n = 58) receiving conventional interventions, and a scalp acupuncture group (n = 59) receiving scalp acupuncture in addition to conventional care. Scalp acupuncture was administered daily for 8 weeks using standardized acupuncture points. Outcome measures included the Brunnstrom Hemiplegia Motor Function Scale, the Fugl-Meyer Assessment (FMA) scale, the modified Barthel Index (MBI), cerebral blood flow assessment (via color Doppler ultrasonography), and serum brain-derived neurotrophic factor (BDNF) levels. Results: The scalp acupuncture group demonstrated significantly greater improvements in Brunnstrom scale scores, with higher proportions of patients achieving advanced recovery levels (P = 0.015). FMA and MBI scores showed superior improvements in motor function and daily living abilities in the scalp acupuncture group compared to controls (P < 0.05). Enhanced cerebral blood flow velocities and volumes were observed in the scalp acupuncture group, particularly in the anterior and middle cerebral arteries (P < 0.01). Serum BDNF levels were significantly elevated in the scalp acupuncture group post-treatment, suggesting enhanced neural repair. Conclusions: This study provides evidence that scalp acupuncture combined with conventional therapy can significantly improve motor function, daily living abilities, and neural recovery markers in patients with hemiplegia following moderate to severe TBI. These findings warrant larger, multicenter trials to evaluate the long-term efficacy of scalp acupuncture and to determine its role as a potential gold standard for hemiplegia treatment in neurological rehabilitation.