Comparisons of acupuncture therapies combining conventional treatment in the management of vascular cognitive impairment: a systematic review and network meta-analysis.

Background: Vascular cognitive impairment (VCI) is the second most frequent form of cognitive disorder. It is mainly caused by a diseased cerebral vasculature and affects patients' cognition and activities of daily living (ADL). Previous studies have demonstrated that acupuncture therapy is a promis...

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Publicado en:Frontiers in Aging Neuroscience pp. 1 - 22
Autores principales: Liao, Yuan-Ling, Hsu, Pei-Shan, Lee, Chang-Ti, Su, Li-Jen, Shen, Yi-Ying, Tsou, Adam, Lan, Chou-Chin, Tzeng, I-Shiang, Liu, Guan-Ting, Hsieh, Po-Chun
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Frontiers Media S.A. 2025
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: Frontiers in Aging Neuroscience
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      dt: 2025
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      pub: Frontiers Media S.A.
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        10.3389/fnagi.2025.1559388
        186284530
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        atl: Comparisons of acupuncture therapies combining conventional treatment in the management of vascular cognitive impairment: a systematic review and network meta-analysis.
      aug:
        au:
          Liao, Yuan-Ling
          Hsu, Pei-Shan
          Lee, Chang-Ti
          Su, Li-Jen
          Shen, Yi-Ying
          Tsou, Adam
          Lan, Chou-Chin
          Tzeng, I-Shiang
          Liu, Guan-Ting
          Hsieh, Po-Chun
        affil: Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
      sug:
        subj:
          Cognition Disorders Therapy
          Acupuncture Methods
          Allopathic Medicine
          Activities of Daily Living
          Medical Practice, Evidence-Based
          Treatment Outcomes
          Human
          Funding Source
          Systematic Review
          PubMed
          Embase
          Cochrane Library
          Meta Analysis
          Descriptive Statistics
          Confidence Intervals
          P-Value
          Electroacupuncture
          Acupuncture, Ear
          Rehabilitation, Cognitive
          Quality of Health Care
          Quality Improvement
          Checklists
      ab: Background: Vascular cognitive impairment (VCI) is the second most frequent form of cognitive disorder. It is mainly caused by a diseased cerebral vasculature and affects patients' cognition and activities of daily living (ADL). Previous studies have demonstrated that acupuncture therapy is a promising complementary treatment that significantly improves cognitive status and ADL in VCI patients. This study aimed to investigate the effects of different types of acupuncture therapies and conventional treatments on cognitive status and ADL in VCI patients to provide evidence-based clinical recommendations. Methods: We searched seven electronic databases for randomized controlled trials comparing acupuncture therapies [including manual acupuncture (MA), scalp acupuncture (SA), electroacupuncture (EA), and auricular acupuncture (AA)] with conventional treatment [pharmacotherapy (P), cognitive rehabilitation (CR)] or standard care (SC) in patients with VCI. The primary outcome was cognitive improvement, while secondary outcomes included improvement in ADL and the risk of severe adverse effects. A frequentist random-effects network meta-analysis was performed under a consistency model. Study quality was assessed using the RoB 2.0 tool. Inconsistency was examined via node-splitting. Subgroup analysis, meta-regression, and sensitivity analysis were conducted to explore heterogeneity and assess robustness. Publication bias was evaluated using funnel plots and Egger's test. Results: Through stepwise exclusion of studies contributing to publication bias and inconsistency, a robust bias-adjusted network meta-analysis dataset was established. The results showed that among all interventions, SA+P+SC demonstrated the greatest efficacy in improving cognitive status compared to SC (SMD: 2.04; 95% CI: 1.21–2.86) with substantial heterogeneity (I2 = 71.0%), no significant inconsistency, and relative low publication bias (p = 0.7020). Conclusion: Acupuncture, particularly SA combined with P and SC, appears to be a safe and effective adjunctive treatment for patients with VCI. Future studies are warranted to establish VCI-specific MCID thresholds and to validate these findings through large-scale, high-quality RCTs. Systematic review registration: https://inplasy.com/inplasy-2023-5-0114/ , identifier INPLASY202350114.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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