Acupuncture for post-stroke cognitive impairment: a systematic review and meta-analysis

Area of Science:

• Neurology
• Integrative Medicine
• Evidence-Based Medicine

Background:

• Post-stroke cognitive impairment (PSCI) is a common and debilitating condition.
• Effective treatments for PSCI are limited, highlighting the need for further research.

Purpose of the Study:

• To evaluate the effectiveness and safety of acupuncture for treating PSCI.
• To synthesize evidence from randomized controlled trials (RCTs) on acupuncture for PSCI.

Main Methods:

• A systematic review and meta-analysis of RCTs were conducted.
• Searched multiple databases including Cochrane Library, Embase, Medline, CNKI, VIP, Wanfang, and CBM up to April 10, 2019.
• Assessed cognitive function using Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) scales.
• Evaluated risk of bias (ROB) and used Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria.

Main Results:

• Included 28 trials with 2144 participants; 86% had high ROB.
• Evidence quality for MoCA and MMSE was very low.
• Acupuncture groups showed potential benefits in MoCA (MD: 2.66) and MMSE (MD: 2.97) scores compared to non-acupuncture groups.
• Heterogeneity decreased in subgroup and sensitivity analyses; adverse events were mild.

Conclusions:

• Acupuncture may be effective and safe for PSCI.
• Results must be interpreted cautiously due to high ROB and very low evidence quality.
• Further high-quality RCTs are needed to confirm these findings.