Interactive Dynamic Scalp Acupuncture Enhances Cerebello-Temporal Activity to Improve Post-Stroke Balance in Chronic Basal Ganglia Ischemia

Background : Post-stroke balance dysfunction in chronic basal ganglia ischemic stroke (BGIS) involves poorly characterized neural mechanisms. We aimed to identify dysregulated brain regions and evaluate neuromodulatory effects of interactive dynamic scalp acupuncture (IDSA). Methods : Resting-state fMRI (rs-fMRI) was performed in 120 participants (40 hemiplegic BGIS, 40 non-hemiplegic basal ganglia lacunar infarction, 40 healthy controls). ReHo analysis and Berg Balance Scale (BBS) correlations were assessed pre- and post-IDSA targeting the antero-temporal oblique line (MS6). Results : Patients exhibited increased ReHo in the right cerebellar lobule VIII (Cerebellum_8_R: t = 5.78, p < 0.001) and right inferior temporal gyrus (Temporal_Inf_R: t = 4.00, p = 0.003), alongside decreased ReHo in right cerebellar Crus I (Crus1_R: t = -3.66, p = 0.011) and bilateral middle temporal gyri (Temporal_Mid_R/L: t = -4.75 to -5.58, p < 0.001). ReHo in Cerebellum_8_R ( r = 0.65, p < 0.0001) and Temporal_Mid_L ( r = 0.74, p < 0.0001) strongly correlated with BBS scores. Post-IDSA, patients showed significant ReHo increases in Cerebellum_8_R (ΔReHo = +12.3%, p = 0.001) and Temporal_Mid_L (ΔReHo = +8.5%, p = 0.011), with no changes in controls ( p > 0.1). Conclusions : Balance impairment in BGIS reflects cerebello-temporal network dysregulation, combining compensatory hyperactivity (cerebellar lobule VIII) and functional suppression (Crus I/middle temporal gyri). IDSA selectively enhances activity in these regions, supporting neuroplasticity-driven recovery. These findings provide imaging-based evidence for IDSA’s therapeutic potential, though longitudinal validation is warranted. Sample Size: Total sample: 120; Sample size per group: 40