SYSTEMATIC REVIEW article
Front. Neurol.
Sec. Experimental Therapeutics
Efficacy and safety of electroacupuncture in the treatment of Post-stroke cognitive impairment: a systematic review and meta-analysis
Provisionally accepted
- Zhejiang Chinese Medical University, Hangzhou, China
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Objective The objective of this research was to assess whether electroacupuncture is an effective and safe intervention for post-stroke cognitive impairment (PSCI). Methods Our team systematically searched eight academic databases, including the Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database(SinoMed), Wanfang Data, and Database of Chinese sci-tech periodicals (VIP).This study conducted a systematic review of randomized controlled trials (RCTs) investigating electroacupuncture for PSCI, covering all available literature from database inception until December 31, 2024.The quality of the included studies was assessed using the Cochrane Risk of Bias tool (RoB 2), and the evidence quality for all outcomes was graded employing the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework. All statistical analyses were performed using R software (version 4.0.0) with the 'meta' package. In this study, the Mini-Mental State Examination (MMSE) was used as the primary outcome, while the Montreal Cognitive Assessment (MoCA), the Barthel Index and the Activities of Daily Living (ADL) were used as secondary outcome indicators. Results This meta-analysis comprised 24 studies with 1769 patients. The results indicated that after 2 to 8 weeks of electroacupuncture treatment, electroacupuncture was more effective in improving PSCI than the control group and significantly improved post-treatment MMSE (MD=2.62, 95% CI=1.74-3.51, p < 0.0001, I2 = 95.9%), MoCA (MD=3.01, 95% CI=2.12-3.91,p < 0.0001, I2 = 87.0%), Barthel Index (MD=5.86, 95% CI=2.71-9.00, p = 0.0017, I2 = 67.7%), and ADL (MD=5.82, 95% CI=0.70-10.94, p = 0.0016,I2 = 84.4%) scale scores in patients with PSCI. Subgroup analyses indicated that stroke type might be a potential source of heterogeneity for the MMSE and Barthel Index, while treatment duration might contribute to heterogeneity in MoCA scores. Sensitivity analyses revealed that the pooled effect sizes for MMSE, MoCA, and Barthel outcomes remained stable without significant fluctuations. However, the ADL outcome demonstrated lower robustness. Egger's test suggested potential publication bias for the MoCA index (p = 0.0016). Conclusion This systematic review indicates that electroacupuncture may improve cognitive function in patients with PSCI within a short-term period. However, its long-term efficacy and safety profile require further validation through higher-quality evidence.
Keywords: cognitive dysfunction, Electroacupuncture, post-stroke cognitive impairment, Stroke, Systematic review
Received: 30 Sep 2025; Accepted: 08 Dec 2025.
Copyright: © 2025 Zhu, Ying, Huang, Zhang, He and MA. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: RUIJIE MA
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