Effects of multiple acupuncture therapies on cognitive function and quality of life in stroke patients: a systematic review and network meta-analysis.

Abstract

<h4>Objective</h4>To evaluate the comparative effectiveness of different acupuncture therapies in stroke rehabilitation using network meta-analysis.<h4>Methods</h4>We systematically searched major databases for RCTs (2016-2025) comparing six acupuncture interventions. Frequentist network meta-analysis was conducted in Stata 17.0, with interventions ranked by SUCRA values. Primary outcomes included NIHSS, BI, mRS, MoCA, and MMSE scores.<h4>Results</h4>Analysis of 120 RCTs (<i>n</i> = 15,848) demonstrated distinct efficacy profiles: EA ranked highest for neurological recovery (NIHSS SUCRA 95.7%) and BI improvement (74.8%); WNM was optimal for disability reduction (mRS SUCRA 100%) and comprehensive cognition (MoCA 94.9%); while SA excelled in MMSE improvement (86.1%).<h4>Conclusion</h4>Distinct acupuncture modalities exhibit unique advantages in the context of stroke rehabilitation. EA ranked first in the restoration of neurological function, whereas WNM and SA were identified as the optimal interventions for global disability and cognitive impairment, respectively. Given that the included studies originated exclusively from China, the external validity of the present findings in other populations warrants further verification.<h4>Systematic review registration</h4>https://www.crd.york.ac.uk/PROSPERO, CRD42025112036.