Abstract

Introduction The use of electroacupuncture (EA) in post-ischemic stroke and rehabilitation has been the subject of numerous studies; however, the effect of EA on cholesterol metabolites has not been thoroughly investigated. The inflammatory response in stroke has been associated with serum cholesterol, low HDL-Cc, and high LDL-Cc levels, and early intervention has been linked to improved post-stroke rehabilitation. This study aimed to assess the impact of EA on early ischemic stroke as a modulator of total cholesterol, HDL-c, and LDL-c in the blood, its anti-inflammatory effect, and its effect on pain and stroke scales in patients in the first few days after the onset of stroke.

Data Access Statement The datasets generated during the current study are available from the corresponding author on reasonable request

Material and Method A total of 90 patients with acute ischemic stroke and a first-time diagnosis of stroke will be randomized into one of three groups: an EA group, a sham EA group, and a sensory control group. All patients will receive the interventions three times a week for a total of six sessions over two weeks. Outcome measurements will include blood tests for total cholesterol, triglycerides, HDL with HDL-c cholesterol, LDL and LDL-c cholesterol, along with Visual Analog Scale (VAS), National Institutes of Health Stroke Scale (NIHSS), and Barthel Index (BI).

Expected Outcome This study will help determine the effect of EA on ischemic stroke recovery, focusing on metabolic changes in patients with early stage stroke. EA treatment might modify risk indices (HDL-c), maintain or control (LDL-c), and generate localized reperfusion of the vascular areas involved in stroke.

Discussion This randomized controlled trial will determine the ability of EA to support early stroke ischemic injury and neuro-endothelium damage, which could lead to a faster stroke recovery in stroke scales, and reveal whether the mechanism of EA is associated with a reduced inflammatory process via modulation of the levels of total cholesterol, HDL-c, LDL-c, and triglycerides. The results of this study will be of significant value in the treatment of ischemic stroke and could lead to more effective and personalized stroke rehabilitation therapies.

Competing Interest Statement

The authors have declared no competing interest.

Clinical Trial

Trial registry: registered study protocol on www.clinicaltrial.gov (NCT05734976)

Funding Statement

This study was partially supported by a grant from the Department of Medical Research of, China Medical University (DMR-112-005).

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Not Applicable

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

board (IRB) of China Medical University Hospital (CMUH111-REC1-132)

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

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I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

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Data Availability

Data Access Statement: The datasets generated during the current study are available from the corresponding author on reasonable request

ABBREVIATIONSCHOL-tTotal cholesterol levelHDL-chigh-density lipoproteins levelLDL-cLow-density lipoprotein levelBMIBody Mass IndexOx-LDLMacrophage uptake of oxidized low-density lipoproteinsEAElectroacupunctureCMUHChina Medical University HospitalNONitric oxide (NO) is a signaling molecule that plays a key role in the pathogenesis of inflammation. NO is considered a pro-inflammatory mediator that induces inflammation by overproduction in abnormal situations.NADPHNADPH is the reduced form of NADP+; used in anabolic reactions, such as the synthesis of lipids and nucleic acids.MPO/HOClsystem plays an important role in the elimination of microbes by neutrophils. Furthermore, MPO has been shown to be a local mediator of tissue damage and resulting inflammation in various inflammatory diseases.LOOHthe accumulation of lipid hydroperoxidesVSMCvascular smooth muscle cellIL-6interleukin-6 is implicated in a large number of acute and chronic diseases associated with inflammation.ANSautonomic nervous systemeNOSendothelial nitric oxide synthase enzymeIRBInstitutional Review Board