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. 2025 Mar 4:16:1523050.
doi: 10.3389/fpsyt.2025.1523050. eCollection 2025.

Acupuncture therapies for post-stroke depression: the evidence mapping of clinical studies

Zhuo Zhou  1 , Chao Ke  1 , Wenying Shi  1 , Yang Cao  1 , Zhengrong Xie  1 , Xi Zhao  1 , Zeli Hu  1 , Yilin Zhou  1 , Wei Zhang  1
Affiliations

Acupuncture therapies for post-stroke depression: the evidence mapping of clinical studies

Zhuo Zhou et al. Front Psychiatry. .

Abstract

Background: Acupuncture-related therapies have been widely used in previous studies, of which the ones for post-stroke depression (PSD) is on the rise. This study aims to map the current clinical research landscape and identifies gaps to provide direction and information for future research.

Methods: Eight databases were searched on acupuncture-related therapies for PSD from inception until April 2024. The publication profile, study objects, intervention categories, outcome indexes were graphically displayed. The Cochrane Collaboration's bias risk assessment tool was used to independently assess randomized controlled trials (RCTs) quality, and the methodological quality of the systematic reviews were assessed using the AMSTAR 2 checklist.

Results: A total of 666 clinical studies and 34 systematic reviews/Meta-analyses (SRs/MAs) were included in the evidence map, and the earliest report was found in 1996. The studies were mostly from China, and 89% of the evidence of the studies were of the RCTs. Body acupuncture and electroacupuncture were the most commonly used interventions. Most of the intervention durations were 2-4 weeks, and few patients were followed up. The main outcome was measured by effective rate and the Hamilton Rating Scale for Depression (HAMD). Evidences from clinical studies and SRs/MAs suggest that acupuncture has significant advantages in improving PSD, but the overall quality of studies could be improved.

Conclusions: Acupuncture-related therapies have great prospect in relieving the clinical symptoms of PSD, although there are some design and methodological defects in the current studies. In the future, the quality of research needs to be improved for the robustness of clinical evidence.

Keywords: acupuncture therapies; evidence mapping; evidence-based analysis; moxibustion; post-stroke depression.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram representing the process of literature screening (20).
Figure 2
Figure 2
Basic characteristics of the source of evidence.
Figure 3
Figure 3
Annual trends and geographical distribution map of publication. (A) Year of publication of acupuncture-related therapies in PSD. (B) Regional distribution of articles on acupuncture and moxibustion related therapy intervention for PSD.
Figure 4
Figure 4
Basic characteristics of the study population. (A) Types of included studies; (B) Included in primary studies classification. Different colors indicate different study types; (C) Stroke population classification of clinical studies; (D) Overview of the clinical studies group; (E) Sample size of the clinical studies.
Figure 5
Figure 5
Overview of randomized controlled study design. (A) Design of intervention and control groups. (B) Study design to evaluate the efficacy of acupuncture versus other therapies; (C) Study design to evaluate the synergistic effects of acupuncture with other therapies; (D) Study designs to evaluate the effects of different acupuncture therapies.
Figure 6
Figure 6
Distribution map of intervention measures categories in RCTs.
Figure 7
Figure 7
Evidence Characteristics of Outcome indicators.
Figure 8
Figure 8
Bubble plot of clinical studies.
Figure 9
Figure 9
Evidence map of systematic reviews.
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