Acupuncture Activates PI3K/Akt Pathway to Promote Spinal Microglial M2 Polarization and Alleviate Spastic Hemiplegia Following Ischemic Stroke.

Researchers investigated whether acupuncture could help reduce muscle stiffness and spasticity that often occurs after stroke. Many stroke survivors experience tight, stiff muscles on one side of the body (spastic hemiplegia), which makes movement difficult and affects quality of life. This stiffness is thought to be related to inflammation in the spinal cord. The study used rats that had experienced strokes causing spastic hemiplegia. Researchers applied acupuncture to the Yanglingquan point (GB34), located on the outer lower leg, using a specific technique called waggle needling that involves gentle movement of the needle. They compared acupuncture treatment to various control groups and examined both behavioral changes and molecular processes in the spinal cord. The results showed that acupuncture significantly reduced muscle stiffness and improved motor function in the stroke-affected rats. The treatment worked by activating a specific biological pathway (PI3K/Akt) in the spinal cord and changing the behavior of immune cells called microglia. Normally after stroke, these cells promote inflammation and worsen spasticity. Acupuncture shifted these cells into an anti-inflammatory state, reducing harmful inflammatory chemicals while increasing protective ones. The treatment also helped restore normal nerve signaling balance in the spinal cord, which is disrupted in spasticity. For stroke survivors experiencing muscle stiffness, this research suggests acupuncture may offer a promising treatment option by targeting inflammation at the spinal level rather than just the brain. If considering acupuncture for post-stroke spasticity, seek treatment from a licensed acupuncturist with experience in neurological conditions.

This rat model study investigated acupuncture's mechanism for treating post-stroke spastic hemiplegia following permanent middle cerebral artery occlusion (p-MCAO). Researchers applied waggle needling technique at GB34 (Yanglingquan) and assessed outcomes through behavioral tests, TTC staining, H-reflex measurements, and molecular analyses. Pharmacological interventions included minocycline (microglial inhibitor), LY294002 (PI3K inhibitor), and 740Y-P (PI3K activator) to elucidate mechanisms. Results demonstrated that acupuncture significantly activated the spinal PI3K/Akt pathway and promoted microglial M2 polarization, shifting from pro-inflammatory M1 phenotype. Treatment reduced pro-inflammatory cytokines (IL-6, TNF-α) while increasing anti-inflammatory markers (IL-10, TGF-β). Acupuncture attenuated spinal hyperexcitability via H-reflex normalization and restored excitatory/inhibitory balance by regulating vGluT1/vGAT synaptic markers and glutamate/GABA levels. Minocycline produced similar effects, while LY294002 partially blocked acupuncture's benefits and 740Y-P only partially mimicked them, confirming PI3K/Akt pathway involvement. Clinical implications suggest GB34 acupuncture may effectively treat post-stroke spasticity through spinal-level neuroimmune modulation rather than solely cerebral mechanisms. The PI3K/Akt pathway represents a potential therapeutic target for spasticity management.