Evaluation of the recovery outcome of poststroke cognitive impairment after cluster needling of scalp acupuncture therapy based on functional near‐infrared spectroscopy

Abstract

Background Cognitive impairment often arises in patients suffered from stroke. Acupuncture is a recommended treatment option for stroke by the World Health Organization (WHO) and has been shown to improve the cognitive function of patients with poststroke cognitive impairment (PSCI). Methods In the present study, we assessed the efficacy of scalp acupuncture with cluster needling on PSCI patients. Fifty six PSCI patients were randomly separated into the reference group who received drug treatment only and the treatment group who received cluster needling of scalp acupuncture on top of drug treatment. Cognitive function was compared between the two groups before and after treatment. We also took the advantage of functional near‐infrared spectroscopy to assess the cerebral hemoglobin levels. Results We reveal that applying cluster needling of scalp acupuncture on top of drug treatment can significantly improve the cognitive function and elevate the cerebral hemoglobin levels compared to patients treated with drug only. Conclusions Our results suggest that cluster needling of scalp acupuncture is an effective treatment against PSCI and shed light on its application on other neurological disorders.

Effectiveness and Safety of Acupuncture for Vascular Cognitive Impairment: A Systematic Review and Meta-Analysis

“…One trial (Li and Jiao, 2014) might be the likely source of heterogeneity, which did not change the sensitivity analysis result when it was excluded from the pooled process (see Supplementary Table 4). When comparing acupuncture plus WM with WM alone, a statistically significant difference was also revealed without an apparent degree of heterogeneity (SMD −0.34, 95% CI −0.52 to −0.16, I 2 = 0%, p = 0.0003, five studies, see Figure 6B) (Chu et al, 2008;Zhang et al, 2008;Shi et al, 2009;Yang et al, 2016;Chen et al, 2020). One study (Xiong et al, 2020) showed that acupuncture plus UC got a better ADL Scale score than the UC alone group (MD −5.43, 95% CI −7.27 to −3.59, p < 0.0001, see Figure 6C).…”

“…As a result, 48 RCTs, published from 1992 to 2020, involving 3,778 patients with VCI met the eligible criteria and were synthesized in the final quantitative meta-analysis (Huang et al, 1992;Mo et al, 2000a,b;Zhao et al, 2000Zhao et al, , 2009Jiang et al, 2003Jiang et al, , 2019Liu et al, 2006;Niu and Liu, 2007;Chu et al, 2008;Liu Y. et al, 2008;Liu Z. B. et al, 2008;Zhang et al, 2008Zhang et al, , 2015Zhang et al, , 2019Chen et al, 2009Chen et al, , 2015Chen et al, , 2020Li et al, 2009Li et al, , 2019Meng et al, 2009Meng et al, , 2020Shi et al, 2009;Yin et al, 2011;Lin et al, 2012;Li P. et al, 2012;Li S. et al, 2012;Li W. et al, 2012;Teng and Lai, 2012;Pan and Ai, 2013;Zhao and Xu, 2013;Cao et al, 2014;Li and Jiao, 2014;Cui et al, 2015;Luo et al, 2015;Yang et al, 2016Yang et al, , 2019Tan et al, 2017;Wang and Wang, 2017a,b,c;Cheng et al, 2018;Feng et al, 2019;Hu et al, 2019;Qu et al, 2020;…”

“…Only one study (Zhang et al, 2019) reported that patients who received acupuncture treatment had a preferable effect in improving the MoCA score than those who received drug therapy (MD 3.16, 95% CI 1.5-4.82, p = 0.0002, see Supplementary Figure 2A). Using an RE model to pool together the results, four studies (Li et al, 2019;Chen et al, 2020;Meng et al, 2020;Qu et al, 2020) demonstrated that acupuncture combined with WM was more beneficial for patients with VCI than those with WM alone (MD 2.33, 95% CI 1.42-3.25, I 2 = 68%, p < 0.00001, see Supplementary Figure 2B). A trial (Qu et al, 2020) was screened out by sensitivity analysis that exacerbated heterogeneity.…”

“…12 RCTs (Chu et al, 2008;Liu Y. et al, 2008;Zhang et al, 2008Zhang et al, , 2015Shi et al, 2009;Lin et al, 2012;Zhao and Xu, 2013;Li and Jiao, 2014;Yang et al, 2016Yang et al, , 2019Chen et al, 2020;Xiong et al, 2020) with 13 comparison pairs concentrated on the effect for the ADL Scale, which is comprised of the physical self-maintenance scale and the instrumental ADL Scale. A significant decrease on the ADL Scale was observed within the acupuncture group compared to the WM group by an RE meta-analysis (MD −3.08, 95% CI −4.81 to −1.35, I 2 = 82%, p = 0.0005, seven studies, see Figure 6A) (Liu Y. et al, 2008;Zhang et al, 2008Zhang et al, , 2015Lin et al, 2012;Zhao and Xu, 2013;Li and Jiao, 2014;Yang et al, 2019).…”

“…As a non-pharmacological intervention with the intention to make patients recover to the postulated equilibrium state prior to illness (Endres et al, 2007), acupuncture has already been extensively used for VCI in plenty of Chinese medical institutions (Peng et al, 2007;Su et al, 2020a). A considerable number of emerging clinical trials demonstrated that acupuncture can serve as a promising treatment in improving the global cognitive status of patients with VCI (Chen et al, 2016(Chen et al, , 2020Yang et al, 2019). Meanwhile, various preclinical studies have also been conducted to explore the potential mechanisms of acupuncture via using the VCI animal model (Ye et al, 2017a;Du et al, 2018;Xiao et al, 2018).…”