Specific combined acupuncture modalities showed significant improvements in cognitive performance and daily functioning among patients experiencing post-stroke mild cognitive impairment, according to a systematic review and network meta-analysis published in Frontiers in Neurology. The investigation, which synthesized evidence across 47 randomized controlled trials involving 3,680 participants, evaluated 15 distinct acupuncture-related interventions to determine their comparative effectiveness and safety profiles.
Post-stroke mild cognitive impairment frequently occurs after stroke, substantially restricting patients’ functional restoration and overall quality of life. Although acupuncture has been widely adopted in clinical practice as an adjunctive intervention for rehabilitation, the relative efficacy and safety profiles across different acupuncture modalities had not been clearly established prior to this comprehensive network analysis.
To evaluate these comparative outcomes, a research team from Chengdu University of Traditional Chinese Medicine, Sichuan University West China School of Pharmacy, Sichuan Tianfu New District People’s Hospital, and The Second Affiliated Hospital of Xi’an Jiaotong University conducted an extensive literature search. The investigators queried nine databases and four clinical trial registries for randomized controlled trials published from their inception through October 2025.
Methodological quality across the 47 included trials was assessed using the Cochrane risk of bias tool. To compare direct and indirect evidence across the 15 distinct intervention modalities, the authors performed their network meta-analysis using ReviewManager and Stata statistical software, measuring primary cognitive outcomes alongside physical functioning metrics and clinical response rates.
In cognitive assessments using the Montreal Cognitive Assessment, electroacupuncture combined with moxibustion demonstrated the highest efficacy among all evaluated approaches, achieving a mean difference of 5.42 points with a 95 percent confidence interval from 2.10 to 8.74, while also yielding the highest total effective rate. When cognitive recovery was assessed via the Mini-Mental State Examination, electroacupuncture combined with hyperbaric oxygen therapy proved most effective with a mean difference of 8.00 points (95 percent confidence interval: 5.19 to 10.82), followed by manual acupuncture combined with repetitive transcranial magnetic stimulation, which achieved a mean difference of 3.42 points (95 percent confidence interval: 0.87 to 5.97).
Patient independence in daily living activities, evaluated through the Barthel index, also differed notably across combination therapies. Manual acupuncture paired with the medication donepezil produced the greatest improvement, showing a mean difference of 8.67 points (95 percent confidence interval: 5.47 to 11.88), while electroacupuncture combined with cognitive training registered an improvement with a mean difference of -8.09 points (95 percent confidence interval: -10.56 to -5.62). Across the range of evaluated intervention modalities, the researchers reported that adverse events were acceptable.
The investigators concluded that acupuncture therapies appear effective and safe for managing post-stroke mild cognitive impairment, but they emphasized critical caveats regarding the underlying evidence base. The authors cautioned that poor methodological quality and uneven evidence quality across the existing randomized controlled trials limit the strength of these findings, warranting further rigorously designed clinical trials to confirm the comparative benefits of these therapeutic combinations.
Subject of Research: Comparative effectiveness and safety of acupuncture therapies for post-stroke mild cognitive impairment
Article Title: Integrative approaches to acupuncture therapies for post-stroke mild cognitive impairment: a systematic review and network meta-analysis
Article References: Huang, S.-L., Hui, Y.-Y., Zhang, W., Tang, X., Peng, F., Liu, Z.-Y., Zheng, H., & Zhai, Y. (2026). Integrative approaches to acupuncture therapies for post-stroke mild cognitive impairment: a systematic review and network meta-analysis. Frontiers in Neurology, 17, Article 1954073. https://doi.org/10.3389/fneur.2026.1954073
Image Credits: AI Generated
DOI: 10.3389/fneur.2026.1954073
Keywords: post-stroke mild cognitive impairment, acupuncture therapies, electroacupuncture, moxibustion, manual acupuncture, network meta-analysis, systematic review, randomized controlled trials, Montreal Cognitive Assessment, Mini-Mental State Examination, Barthel index, hyperbaric oxygen therapy, repetitive transcranial magnetic stimulation, donepezil, cognitive training, neurorehabilitation, stroke recovery
News Source: Cassandra Pierce. (November 15, 2026). Electroacupuncture Plus Moxibustion Improves Post-Stroke Cognitive Scores in Network Meta-Analysis. Scienmag.
