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Peer-reviewedCC BY 4.0Frontiers in Neurology

Integrative approaches to acupuncture therapies for post-stroke mild cognitive impairment: a systematic review and network meta-analysis

  • Shi-Le Huang1
  • You-Yi Hui2
  • Wei Zhang2
  • Xing Tang3
  • Fu Peng4
  • Zhen-Yan Liu5
  • Hui Zheng6
  • Yan Zhai7
7 affiliations
  1. 1Department of Acupuncture-Moxibustion, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine
  2. 2Department of Hepatopathy, Xi’an Daxing Hospital
  3. 3Department of Traditional Chinese Medicine Rehabilitation, Chongqing Emergency Medical Center (Chongqing University Central Hospital)
  4. 4West China School of Pharmacy, Sichuan University
  5. 5Department of Rehabilitation Medicine, Sichuan Tianfu New District People's Hospital
  6. 6School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine
  7. 7Department of Traditional Chinese Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University
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Abstract

Background: Post-stroke mild cognitive impairment (PSMCI) frequently occurs after stroke and substantially restricts patients’ functional restoration and overall quality of life. Acupuncture has been widely adopted as an adjunctive intervention; however, the relative efficacy and safety profiles among different acupuncture modalities for PSMCI have not been clearly established.

Objective: To assess the comparative effectiveness and safety of multiple acupuncture therapies for treating PSMCI via network meta-analysis.

Methods: RCTs on acupuncture for PSMCI published from their inception to October 2025 were retrieved from nine databases and four clinical trial registries. Study quality was assessed via the Cochrane risk of bias tool. Meta-analysis was performed with ReviewManager and Stata software.

Results: In total, 47 RCTs featuring 3,680 participants and 15 types of acupuncture-related interventions were included. Electroacupuncture combined with Moxibustion showed the highest efficacy in improving both MoCA score [MD = 5.42, 95%CI (2.10, 8.74)] and total effective rate. Electroacupuncture plus HBOT [MD = 8.00, 95%CI (5.19, 10.82)] and manual acupuncture plus rTMS [MD = 3.42, 95%CI (0.87, 5.97)] were most effective in improving MMSE. Manual acupuncture plus donepezil [MD = 8.67, 95%CI (5.47, 11.88)] and Electroacupuncture plus cognitive training [MD = −8.09, 95%CI (−10.56, −5.62)] achieved the greatest improvement in Barthel index. Moreover, the adverse events of these interventions were acceptable.

Conclusion: This study suggested that acupuncture was effective and safe for PSMCI treatment. However, the poor methodological quality and uneven evidence quality of existing studies warrant further rigorously designed trials to confirm our findings.

Systematic review registration: https://www.crd.york.ac.uk/prospero/ , identifier CRD420251165945.

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Cite

BibTeXRIS
BibTeX
@article{huang2026integrative,
  title = {{Integrative approaches to acupuncture therapies for post-stroke mild cognitive impairment: a systematic review and network meta-analysis}},
  author = {Shi-Le Huang and You-Yi Hui and Wei Zhang and Xing Tang and Fu Peng and Zhen-Yan Liu and Hui Zheng and Yan Zhai},
  journal = {Frontiers in Neurology},
  year = {2026},
  month = nov,
  doi = {10.3389/fneur.2026.1954073},
  url = {https://www.frontiersin.org/articles/10.3389/fneur.2026.1954073/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Integrative approaches to acupuncture therapies for post-stroke mild cognitive impairment: a systematic review and network meta-analysis
AU  - Shi-Le Huang
AU  - You-Yi Hui
AU  - Wei Zhang
AU  - Xing Tang
AU  - Fu Peng
AU  - Zhen-Yan Liu
AU  - Hui Zheng
AU  - Yan Zhai
PY  - 2026
DA  - 2026/11/02
JO  - Frontiers in Neurology
DO  - 10.3389/fneur.2026.1954073
UR  - https://www.frontiersin.org/articles/10.3389/fneur.2026.1954073/full
AB  - Background: Post-stroke mild cognitive impairment (PSMCI) frequently occurs after stroke and substantially restricts patients’ functional restoration and overall quality of life. Acupuncture has been widely adopted as an adjunctive intervention; however, the relative efficacy and safety profiles among different acupuncture modalities for PSMCI have not been clearly established.  Objective: To assess the comparative effectiveness and safety of multiple acupuncture therapies for treating PSMCI via network meta-analysis.  Methods: RCTs on acupuncture for PSMCI published from their inception to October 2025 were retrieved from nine databases and four clinical trial registries. Study quality was assessed via the Cochrane risk of bias tool. Meta-analysis was performed with ReviewManager and Stata software.  Results: In total, 47 RCTs featuring 3,680 participants and 15 types of acupuncture-related interventions were included. Electroacupuncture combined with Moxibustion showed the highest efficacy in improving both MoCA score [MD = 5.42, 95%CI (2.10, 8.74)] and total effective rate. Electroacupuncture plus HBOT [MD = 8.00, 95%CI (5.19, 10.82)] and manual acupuncture plus rTMS [MD = 3.42, 95%CI (0.87, 5.97)] were most effective in improving MMSE. Manual acupuncture plus donepezil [MD = 8.67, 95%CI (5.47, 11.88)] and Electroacupuncture plus cognitive training [MD = −8.09, 95%CI (−10.56, −5.62)] achieved the greatest improvement in Barthel index. Moreover, the adverse events of these interventions were acceptable.  Conclusion: This study suggested that acupuncture was effective and safe for PSMCI treatment. However, the poor methodological quality and uneven evidence quality of existing studies warrant further rigorously designed trials to confirm our findings.  Systematic review registration: https://www.crd.york.ac.uk/prospero/ , identifier CRD420251165945.
SN  - 1664-2295
ER  -