An Updated Meta-Analysis of the Efficacy and Safety of Acupuncture Treatment for Vascular Cognitive Impairment Without Dementia

Deng, Min; Xu-Feng, Wang

doi:10.2174/1567202613666160530150525

Cited by 16 publications

(8 citation statements)

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“…A systematic review tested the interest of Chinese herbal medicine as an adjunctive and even though some data suggest that this approach could improve cognitive impairment and enhance immediate response and quality of life in VCI patients, limitations of methodological quality warn to improve the design of clinical studies [86, 87]. A recent meta-analysis also suggests a potential effect of acupuncture, but a better definition of trial design is mandatory [88, 89]. …”

Section: Methodsmentioning

confidence: 99%

Towards the concept of disease-modifier in post-stroke or vascular cognitive impairment: a consensus report

Bordet

Ihl

Korczyn

et al. 2017

BMC Med

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BackgroundVascular cognitive impairment (VCI) is a complex spectrum encompassing post-stroke cognitive impairment (PSCI) and small vessel disease-related cognitive impairment. Despite the growing health, social, and economic burden of VCI, to date, no specific treatment is available, prompting the introduction of the concept of a disease modifier.Consensus and suggestionsWithin this clinical spectrum, VCI and PSCI remain advancing conditions as neurodegenerative diseases with progression of both vascular and degenerative lesions accounting for cognitive decline. Disease-modifying strategies should integrate both pharmacological and non-pharmacological multimodal approaches, with pleiotropic effects targeting (1) endothelial and brain–blood barrier dysfunction; (2) neuronal death and axonal loss; (3) cerebral plasticity and compensatory mechanisms; and (4) degenerative-related protein misfolding. Moreover, pharmacological and non-pharmacological treatment in PSCI or VCI requires valid study designs clearly stating the definition of basic methodological issues, such as the instruments that should be used to measure eventual changes, the biomarker-based stratification of participants to be investigated, and statistical tests, as well as the inclusion and exclusion criteria that should be applied.ConclusionA consensus emerged to propose the development of a disease-modifying strategy in VCI and PSCI based on pleiotropic pharmacological and non-pharmacological approaches.

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Section: Methodsmentioning

confidence: 99%

Towards the concept of disease-modifier in post-stroke or vascular cognitive impairment: a consensus report

Bordet

Ihl

Korczyn

et al. 2017

BMC Med

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“…8–10 However, these acupuncture trials provided insufficient evidence to determine the efficacy of acupuncture to improve cognitive symptoms in VCIND because of limitations in quality and precision. 11 Thus, there is a need for a multicenter randomized clinical trial on the effectiveness of acupuncture in this condition.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of acupuncture for vascular cognitive impairment no dementia: a randomized controlled trial

et al. 2019

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Objective: To evaluate the effectiveness of acupuncture in patients with vascular cognitive impairment no dementia (VCIND) in comparison with citicoline, an agent for cognitive disturbances associated with chronic cerebral disorders. Design: A randomized controlled multicenter trial. Setting: In three hospitals in Beijing, China. Subjects: A total of 216 patients with VCIND were recruited. Interventions: Patients with VCIND (mean age of 65.4 years) were randomized to receive acupuncture (two sessions per week) or oral citicoline (100 mg three times daily) over three months. Main measures: The primary outcome was the change from baseline to three months in cognitive symptom, measured by Alzheimer’s disease Assessment Scale, cognitive subscale (ADAS-cog). Secondary outcomes included changes from baseline to six months in ADAS-cog, executive function measured by the Clock Drawing Test (CDT), and functional disability measured by the Ability of Daily Living (ADL) scale at three and six months. Results: At three months, the acupuncture group had a greater decrease in mean ADAS-cog score (−2.33 ± 0.31) than the citicoline group (−1.38 ± 0.34) with a mean difference of −0.95 (95% CI, −1.84 to −0.07, P = 0.035). The mean change from baseline to six months in ADAS-cog also significantly favored acupuncture treatments (acupuncture change −2.61 vs citicoline −1.25, difference: −1.36 points; 95% CI, −2.20 to −0.51; P = 0.002). There was no difference between the two groups on CDT and ADL scores at either time point. Conclusion: Compared with citicoline, acupuncture has comparable and even superior efficacy with improved cognitive and daily living performance as a complementary and alternative medicine treatment for VCIND.

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“…Neuroprotective effect of GV20+ST36 on CCH has been demonstrated in several preclinical studies [ 18 , 26 – 28 ] which were consistent with the current study. Although the combination GV20+ST36 is one of the most frequent combinations for VaD treatment [ 29 ], high quality clinical trials are needed to further demonstrate the clinical effect of the combination [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Acupuncture Rescues Cognitive Impairment and Upregulates Dopamine-β-Hydroxylase Expression in Chronic Cerebral Hypoperfusion Rats

Xiao

Yang

Wang

et al. 2018

BioMed Research International

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Alteration of dopamine (DA) and noradrenaline (NA) contributes to cognitive function. Acupuncture has been shown to affect DA and NA in chronic cerebral hypoperfusion (CCH) rats. However, the effect of acupuncture on DA-β-hydroxylase (DBH), the biosynthetic enzyme of NA, remains unknown. In CCH rats we established chronic hypoperfusion by bilateral common carotid artery occlusion (two-vessel occlusion, 2VO) and treated them with acupuncture. Acupuncture displayed beneficial effects on hippocampus-dependent memory impairments, including nonspatial and spatial memory. That is also reflected in hippocampus long-term-potentiation (LTP). Moreover, DBH expression in the hippocampus and DBH activity in cerebrospinal fluid were upregulated after acupuncture treatment. In conclusion, these in vivo findings suggest that acupuncture exerts a therapeutic effect on hippocampus-dependent memory and hippocampus LTP in CCH rats, which may be partially related to the modulation of DBH in the hippocampus.

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An Updated Meta-Analysis of the Efficacy and Safety of Acupuncture Treatment for Vascular Cognitive Impairment Without Dementia

Cited by 16 publications

References 0 publications

Towards the concept of disease-modifier in post-stroke or vascular cognitive impairment: a consensus report

Towards the concept of disease-modifier in post-stroke or vascular cognitive impairment: a consensus report

Effectiveness of acupuncture for vascular cognitive impairment no dementia: a randomized controlled trial

Acupuncture Rescues Cognitive Impairment and Upregulates Dopamine-β-Hydroxylase Expression in Chronic Cerebral Hypoperfusion Rats

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