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Electroacupuncture combined with Moxibustion shows highest efficacy for MoCA scores in post-stroke mild cognitive impairmentAcupuncture shows promise for cognitive issues after a stroke

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Key Takeaway
Consider acupuncture-related interventions as potentially effective and safe for improving cognitive outcomes in PSMCI.

This network meta-analysis evaluated 15 types of acupuncture-related interventions for patients with post-stroke mild cognitive impairment (PSMCI). The analysis included a total sample size of 3,680 patients to assess various cognitive and functional outcomes, including MoCA, MMSE, and Barthel index scores.

Key findings indicate that electroacupuncture combined with moxibustion showed the highest efficacy for MoCA scores (5.42; 95%CI 2.10, 8.74). For MMSE scores, electroacupuncture plus HBOT (8.00; 95%CI 5.19, 10.82) and manual acupuncture plus rTMS (3.42; 95%CI 0.87, 5.97) were identified as the most effective. Regarding the Barthel index, manual acupuncture plus donepezil (8.67; 95%CI 5.47, 11.88) and electroacupuncture plus cognitive training (-8.09; 95%CI -10.56, -5.62) achieved the greatest improvements.

The authors note that the evidence is limited by the poor methodological quality and uneven evidence quality of the existing studies. While acupuncture was found to be effective and safe for PSMCI treatment, the authors emphasize that these findings require further rigorously designed trials to confirm the results before clinical implementation.

How this fits prior evidence

This network meta-analysis addresses a gap in the management of post-stroke mild cognitive impairment (PSMCI) by evaluating various acupuncture-related interventions. While prior coverage noted that navigated rTMS yields modest motor and disability gains in subacute and chronic stroke, this study provides evidence for acupuncture-based interventions specifically targeting cognitive outcomes like MoCA and MMSE scores in the PSMCI population.

Living with a stroke can leave many people struggling with memory and thinking problems, a condition known as mild cognitive impairment. For these patients, finding effective ways to improve daily function and mental clarity is a major priority. A large review of data from 3,680 patients looked at 15 different types of acupuncture treatments to see which ones helped the most.

The review found that several combinations were effective. For example, electroacupuncture combined with moxibustion showed the highest improvement in MoCA scores, which measure cognitive function. Other combinations, like electroacupuncture with hyperbaric oxygen therapy, showed strong results on the MMSE scale. Additionally, combining manual acupuncture with donepezil or cognitive training helped improve scores on the Barthel index, which tracks daily living skills.

While the results are encouraging and the treatments were considered safe, the researchers noted some important cautions. The quality of the original studies used in this review was often low or inconsistent. Because the evidence is not perfectly uniform, more high-quality, strictly designed trials are needed to confirm these findings and determine the best path forward for patients.

What this means for you:
Specific acupuncture combinations may improve memory and daily living skills for people with post-stroke cognitive issues.

Common questions

Is acupuncture safe for people with memory issues after a stroke?

The study found that acupuncture was an acceptable and safe treatment for patients with post-stroke mild cognitive impairment. No serious adverse events were reported in the data, making it a potentially viable option for those seeking to improve their cognitive health.

Which specific acupuncture treatments worked best?

Different methods showed different benefits. Electroacupuncture combined with moxibustion showed the highest efficacy for MoCA scores. Other combinations, like manual acupuncture with donepezil or electroacupuncture with cognitive training, showed the greatest improvements for the Barthel index.

How certain are these results for stroke patients?

While the results are promising, the researchers noted that the quality of the original studies was often poor or uneven. Because of this, more high-quality, rigorously designed trials are needed to confirm these findings before they can be fully relied upon.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedNov 2026
View Original Abstract ↓
BackgroundPost-stroke mild cognitive impairment (PSMCI) frequently occurs after stroke and substantially restricts patients’ functional restoration and overall quality of life. Acupuncture has been widely adopted as an adjunctive intervention; however, the relative efficacy and safety profiles among different acupuncture modalities for PSMCI have not been clearly established.ObjectiveTo assess the comparative effectiveness and safety of multiple acupuncture therapies for treating PSMCI via network meta-analysis.MethodsRCTs on acupuncture for PSMCI published from their inception to October 2025 were retrieved from nine databases and four clinical trial registries. Study quality was assessed via the Cochrane risk of bias tool. Meta-analysis was performed with ReviewManager and Stata software.ResultsIn total, 47 RCTs featuring 3,680 participants and 15 types of acupuncture-related interventions were included. Electroacupuncture combined with Moxibustion showed the highest efficacy in improving both MoCA score [MD = 5.42, 95%CI (2.10, 8.74)] and total effective rate. Electroacupuncture plus HBOT [MD = 8.00, 95%CI (5.19, 10.82)] and manual acupuncture plus rTMS [MD = 3.42, 95%CI (0.87, 5.97)] were most effective in improving MMSE. Manual acupuncture plus donepezil [MD = 8.67, 95%CI (5.47, 11.88)] and Electroacupuncture plus cognitive training [MD = −8.09, 95%CI (−10.56, −5.62)] achieved the greatest improvement in Barthel index. Moreover, the adverse events of these interventions were acceptable.ConclusionThis study suggested that acupuncture was effective and safe for PSMCI treatment. However, the poor methodological quality and uneven evidence quality of existing studies warrant further rigorously designed trials to confirm our findings.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD420251165945.
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