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Acupuncture in ischemic stroke: from local neuromodulation to metabolic reprogramming
Shuhui Kan1, Pengcheng Li2, Lina Lu3
1The Tenth Hanan Acupuncture Ward, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China.
Frontiers in Neurology
|June 29, 2026
Summary
Acupuncture may aid ischemic stroke recovery by addressing metabolic issues, showing promise for swallowing, mood, and cognition, but not overall disability. Future research should focus on metabolic pathways and specific patient types.
Area of Science:
- Neurology
- Metabolic Medicine
- Integrative Medicine
Background:
- Ischemic stroke causes significant global death and disability.
- Current stroke management includes rehabilitation and secondary prevention.
- Acupuncture's role in stroke rehabilitation is debated due to inconsistent findings.
Purpose of the Study:
- To review acupuncture's role in ischemic stroke recovery through the lens of metabolic reprogramming.
- To explore potential mechanisms by which acupuncture influences post-stroke metabolic changes.
- To suggest future research directions for clarifying acupuncture's efficacy.
Main Methods:
- Narrative review of existing clinical and mechanistic studies.
- Analysis of acupuncture's effects on metabolic pathways post-stroke.
- Examination of clinical evidence for acupuncture's impact on specific stroke outcomes.
Main Results:
- Acupuncture shows more consistent benefits in dysphagia, depressive symptoms, and cognitive impairment than in global disability.
- Preclinical evidence suggests acupuncture may modulate mitochondrial function, lactate signaling, ferroptosis, and gut microbiota metabolism.
- Heterogeneity in post-stroke metabolic phenotypes may contribute to inconsistent clinical results.
Conclusions:
- Acupuncture may offer adjunctive benefits in specific aspects of ischemic stroke recovery, particularly related to metabolic pathways.
- Understanding metabolic sensitivity in different post-stroke phenotypes is crucial.
- Future research requires biomarker-anchored, phenotype-specific, and rigorously controlled trials for definitive conclusions.
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