The efficacy and cerebral hemodynamics mechanisms of acupuncture on the posterior circulation ischemic stroke with vertigo: study protocol for a multicenter, randomized, controlled trial

Introduction: Posterior circulation ischemic stroke (PCIS) with vertigo is a common central vertigo disease that significantly hinders patients' motivation for rehabilitation and increases the recurrence rate and mortality among stroke patients due to recurrent episodes of vertigo. Acupuncture has shown promising therapeutic effects in the treatment of PCIS with vertigo, but its underlying mechanisms remain unclear. This study is designed to investigate the impact of acupuncture on cerebral hemodynamics and brain structure in PCIS patients vertigo, and to evaluate its clinical effectiveness in managing this condition. Methods and design: hypothesis that acupuncture improves dizziness by modulating posterior circulation hemodynamics and regional cerebral perfusion in vestibular-related brain regions, cerebral hemodynamics and brain imaging changes will be assessed using transcranial Doppler (TCD), structural magnetic resonance imaging (sMRI), and arterial spin labeling MRI (ASL-MRI) at baseline (Week 0) and post-treatment (Week 3). We specifically hypothesize that acupuncture will increase mean flow velocity (MFV) and reduce resistance index (RI) in the vertebral arteries, basilar artery, and posterior cerebral arteries, enhance regional cerebral perfusion in vestibular-related brain areas, and induce structural changes associated with vestibular compensation. Discussion: This study will provide robust evidence on the safety and efficacy of acupuncture for vertigo with PCIS. In addition, it will test a prespecified biological hypothesis that acupuncture may relieve dizziness by improving vertebrobasilar hemodynamics and regional perfusion within vestibular-related brain networks, with corresponding imaging changes associated with clinical improvement. This research aims to offer novel insights into acupuncture as a potential therapeutic approach for vertigo following PCIS. Clinical trial registration: [chictr.org.cn], identifier [ChiCTR2400087030].