Traditional Chinese medicine interventions for post-stroke cognitive impairment: an evidence mapping

Post-stroke cognitive impairment (PSCI) is a major rehabilitation concern. Traditional Chinese medicine (TCM) shows promise, yet a comprehensive, evidence-based evaluation of existing systematic reviews is lacking.

This study aimed to map and evaluate the evidence on TCM interventions for PSCI, identifying strengths and gaps to inform clinical and research guidance.

We searched PubMed, the Cochrane Library, Embase (via Ovid), and Web of Science, as well as Chinese databases including CNKI, Wanfang Database, the Chinese Medicine Database, and VIP Database (from their inception to December 2024) for systematic reviews or meta-analyses of TCM for PSCI. Two reviewers assessed methodological quality using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). The results were synthesized using the population-intervention-comparison-outcome (PICO) framework and visualized as bubble plots in R software.

A total of 36 systematic reviews (all from China) were included, covering acupuncture, herbal medicine, moxibustion, auricular stimulation, and TCM exercises. AMSTAR 2 rated 33 as "critically low" and 3 as "low." TCM demonstrated multidimensional benefits: cognitive function (36/36 beneficial), activities of daily living (26/27 beneficial), neurological function (5/5 beneficial), and overall effect (33 beneficial, 1 probably beneficial).

TCM interventions may offer multidimensional benefits for PSCI, but the evidence is severely limited by critically low methodological quality. These findings should be considered hypothesis-generating. High-quality, prospectively registered systematic reviews and rigorous primary studies are urgently needed.

CRD420251178410 (PROSPERO).