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. 2024 May 1;10(9):e30522.
doi: 10.1016/j.heliyon.2024.e30522. eCollection 2024 May 15.

Acupuncture for cognitive impairment after stroke: A systematic review and meta-analysis

Weijie Wu  1   2 , Chengning Song  1   2 , Yang Yang  1 , Yi Hu  1 , Haibo Lin  1   2
Affiliations

Acupuncture for cognitive impairment after stroke: A systematic review and meta-analysis

Weijie Wu et al. Heliyon. .

Abstract

Objective: Acupuncture as an alternative therapy for post-stroke cognitive impairment (PSCI) has emerged as a research focus. The inclusion of additional external treatments in many previous studies prevents a clear, direct assessment of acupuncture's impact on PSCI. In order to prevent patients from developing hypersensitivity to other treatments and misinterpreting acupuncture's true therapeutic value, this study establish stricter intervention criteria and exclude therapies beyond acupuncture. The review aimed to offering a clearer evaluation of acupuncture's efficacy and safety in PSCI treatment.

Methods: This research involved a comprehensive search for randomized controlled trials (RCTs) across eight databases, adhering to the Cochrane Systematic Reviewer's Handbook 5.1.0 for risk-of-bias and quality assessments. A meta-analysis was conducted using RevMan 5.3 software.

Results: The inclusion of 18 publications, totaling 1361 patients, was achieved. The meta-analysis demonstrated a significantly higher overall efficacy of acupuncture for PSCI compared to controls (OR = 4.06, 95 % CI 2.86-5.76, Z = 7.82). Notable statistical differences were observed in the Montreal Cognitive Assessment scores (MD = 2.32, 95 % CI 1.68-2.97, Z = 7.10) and the Mini-Mental State Examination scores (MD = 2.02, 95 % CI 1.06-2.98, Z = 4.13) between the groups. Improvements in the Barthel Index scores were noted for the experimental group (MD = 5.70, 95 % CI 4.68-6.72, Z = 10.92).

Conclusion: Integrating acupuncture with Western medications offers significant benefits for treating PSCI over Western medications alone. However, the long-term efficacy of acupuncture in PSCI treatment and its potential in reducing recurrence rates remain undetermined. Further high-standard RCTs are essential to explore acupuncture's effectiveness in PSCI treatment more thoroughly.

Keywords: Cognitive impairment; Meta-analysis; Stroke; Systematic review; acupuncture.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flow chart of the literature screening of acupuncture for poststroke cognitive impairment.
Fig. 2
Fig. 2
Methodological quality evaluation of the included literature on acupuncture for poststroke cognitive impairment.
Fig. 3
Fig. 3
Forest plot of the meta-analysis of clinical efficacy.
Fig. 4
Fig. 4
Meta forest plot of MoCA score.
Fig. 5
Fig. 5
Meta forest plot of MoCA score session subgroup analysis.
Fig. 6
Fig. 6
Meta forest plot of MMSE score.
Fig. 7
Fig. 7
Meta forest plot of MMSE score session subgroup analysis.
Fig. 8
Fig. 8
Meta forest plot of MMSE score drug subgroup analysis.
Fig. 9
Fig. 9
Meta forest plot of Barthel score.
Fig. 10
Fig. 10
Clinical efficacy funnel chart.
Fig. 11
Fig. 11
MoCA funnel chart.
Fig. 12
Fig. 12
MMSE funnel chart.
See this image and copyright information in PMC

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