# Neuroimaging evidence of acupuncture in cognitive impairment following ischemic stroke: a systematic review

## TL;DR

This review summarizes neuroimaging studies showing acupuncture may help improve cognitive issues after stroke by affecting brain activity and connectivity.

## Contribution

The paper provides a systematic review of neuroimaging evidence on acupuncture's effects for post-stroke cognitive impairment and its potential mechanisms.

## Key findings

- Acupuncture may influence brain activity and functional connectivity in cognition-related regions.
- Neuroimaging suggests acupuncture could regulate neurochemical metabolites in cognition-related brain areas.
- Current evidence is preliminary and calls for more rigorous studies to confirm these effects.

## Abstract

This review aimed to summarize neuroimaging evidence on the effects of acupuncture in post-ischemic stroke cognitive impairment (PISCI) and to explore its potential neural mechanisms.

A systematic search was conducted across multiple databases, including China National Knowledge Infrastructure (CNKI), SinoMed (China Biology Medicine Disc), the Chinese Scientific Journal Database (VIP), Wanfang Data, PubMed, the Cochrane Library, Embase, and Web of Science. Studies were selected according to inclusion and exclusion criteria. Risk of bias was assessed for all eligible studies.

Eight studies met the inclusion criteria. These studies utilized resting-state functional magnetic resonance imaging (rs-fMRI) and magnetic resonance spectroscopy (MRS) to investigate the effects of acupuncture on brain activity and metabolic changes. The neuroimaging findings showed that all studies focused on the sustained effects of acupuncture on brain functional activity.

This review provides preliminary neuroimaging evidence supporting the potential benefits of acupuncture for PISCI. The findings suggest that the possible mechanisms of acupuncture for PISCI involve changes in the activity and enhanced functional connectivity of cognition-related brain regions. Additionally, acupuncture may influence brain networks and regulate neurochemical metabolites within cognition-related regions. However, as this field remains in its early stages, further validation is needed. Future studies should focus on well-designed, multicenter randomized controlled trials (RCTs) with large sample sizes and incorporate multiple neuroimaging techniques to better clarify and verify the neural mechanisms of acupuncture in PISCI.

PROSPERO, identifier: CRD420250652194.