Acupuncture for post-stroke depression: a systematic review and network meta-analysis

Area of Science:

• Neurology
• Integrative Medicine
• Psychiatry

Background:

• Post-stroke depression (PSD) significantly impacts patient recovery and daily life.
• Acupuncture (AC) is a popular option for managing depression symptoms, but its comparative effectiveness for PSD is not well-established.
• This review evaluates AC's role in alleviating PSD and compares its efficacy against pharmacotherapies and non-pharmacotherapies.

Purpose of the Study:

• To explore the impact of acupuncture in alleviating post-stroke depression symptoms.
• To compare the effectiveness of acupuncture combined with pharmacotherapies versus various non-pharmacotherapies for PSD.
• To identify the optimal therapeutic strategy for managing PSD.

Main Methods:

• A Bayesian network meta-analysis of 62 randomized clinical trials involving 5308 participants was conducted.
• Studies compared needle-based acupuncture with pharmacotherapy, other non-pharmacotherapies, or usual care.
• Efficacy was assessed using depression rating scales, with secondary outcomes including neurological function and quality of life.

Main Results:

• Acupuncture alone or combined with therapies like repetitive transcranial magnetic stimulation (RTMS) and Traditional Chinese Medicine (TCM) demonstrated superiority over Western medicine (WM) in reducing depression symptoms.
• Compared to usual care, acupuncture (alone or combined) significantly decreased Hamilton Depression Rating Scale scores.
• Acupuncture plus RTMS showed the highest probability (49.43%) of improving depressive symptoms.

Conclusions:

• Acupuncture, whether used alone or in conjunction with other therapies, is effective for improving depression symptoms in stroke survivors.
• Combinations of acupuncture with RTMS, TCM, or WM were more effective than WM alone for PSD.
• Acupuncture combined with RTMS emerged as the most promising treatment for post-stroke depression.