Acupuncture for mild cognitive impairment: A systematic review with meta-analysis and trial sequential analysis
BackgroundThere is insufficient evidence to support the use of acupuncture for mild cognitive impairment (MCI), and there is no consensus on its efficacy. This review aimed to determine the acupuncture effect in patients with MCI.MethodsRelevant and potentially eligible randomized controlled trials...
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| Format: | Article |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.1091125/full |
| _version_ | 1828070352225304576 |
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| author | Zihan Yin Zihan Yin Yaqin Li Cheng Jiang Manze Xia Manze Xia Zhenghong Chen Zhenghong Chen Xinyue Zhang Xinyue Zhang Ling Zhao Ling Zhao Fanrong Liang Fanrong Liang |
| author_facet | Zihan Yin Zihan Yin Yaqin Li Cheng Jiang Manze Xia Manze Xia Zhenghong Chen Zhenghong Chen Xinyue Zhang Xinyue Zhang Ling Zhao Ling Zhao Fanrong Liang Fanrong Liang |
| author_sort | Zihan Yin |
| collection | DOAJ |
| description | BackgroundThere is insufficient evidence to support the use of acupuncture for mild cognitive impairment (MCI), and there is no consensus on its efficacy. This review aimed to determine the acupuncture effect in patients with MCI.MethodsRelevant and potentially eligible randomized controlled trials (RCTs) of acupuncture for MCI were obtained from four Chinese databases, four English databases, and additional resources up to 1 August 2022. The primary outcome was the improvement in overall cognitive function (OCF). Secondary outcomes were improved memory function (MF) and activities of daily living (ADLs). The revised Cochrane collaboration risk of bias (ROB) assessment tool (ROB 2.0) was applied to evaluate their methodological quality. The Review Manager software v 5.4 was used for analyses. Trial sequential analysis (TSA) 0.9.5.10 β software was used to estimate the required sample size and test the reliability of the pooled outcome. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool.ResultsThis meta-analysis included 11 RCTs with a total of 602 patients. The methodological quality of all trials was moderate. Low-quality evidence showed that acupuncture significantly improved OCF (Mini-Mental State Examination (MMSE): mean difference (MD) = 1.22, 95% confidence interval (CI): 0.78–1.66; the Montreal Cognitive Assessment Scale (MoCA): MD = 1.22, 95% CI: 0.47–1.97). In subgroup analyses, it was revealed that acupuncture significantly increased OCF in patients with MCI when compared to conventional medicine (CM) and sham acupuncture (SA). TSA's findings indicated that the evidence of improving OCF with acupuncture for patients with MCI was conclusive. Meanwhile, there is no statistical difference in the improvement of MF and ADL between acupuncture and CM. TSA showed that the evidence of improving MF and ADL for patients who had MCI and received acupuncture was inconclusive. The shreds of evidence of improving MF and ADL were ranked from low to critically low.ConclusionAcupuncture appears to be an effective clinical application method for improving OCF in patients with MCI. However, due to low-quality evidence, more relevant and high-quality research is needed in this field.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021291284, PROSPERO, No. CRD42021291284. |
| first_indexed | 2024-04-11T00:36:26Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-11T00:36:26Z |
| publishDate | 2023-01-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-dd33ca73625e427d8011258bd0cbf5372023-01-06T19:38:28ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-01-011310.3389/fneur.2022.10911251091125Acupuncture for mild cognitive impairment: A systematic review with meta-analysis and trial sequential analysisZihan Yin0Zihan Yin1Yaqin Li2Cheng Jiang3Manze Xia4Manze Xia5Zhenghong Chen6Zhenghong Chen7Xinyue Zhang8Xinyue Zhang9Ling Zhao10Ling Zhao11Fanrong Liang12Fanrong Liang13School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaAcupuncture Clinical Research Center of Sichuan Province, Chengdu, ChinaSchool of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaTraditional Chinese Medicine Department, Deyang People's Hospital, Deyang, ChinaSchool of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaAcupuncture Clinical Research Center of Sichuan Province, Chengdu, ChinaSchool of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaAcupuncture Clinical Research Center of Sichuan Province, Chengdu, ChinaSchool of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaAcupuncture Clinical Research Center of Sichuan Province, Chengdu, ChinaSchool of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaAcupuncture Clinical Research Center of Sichuan Province, Chengdu, ChinaSchool of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaAcupuncture Clinical Research Center of Sichuan Province, Chengdu, ChinaBackgroundThere is insufficient evidence to support the use of acupuncture for mild cognitive impairment (MCI), and there is no consensus on its efficacy. This review aimed to determine the acupuncture effect in patients with MCI.MethodsRelevant and potentially eligible randomized controlled trials (RCTs) of acupuncture for MCI were obtained from four Chinese databases, four English databases, and additional resources up to 1 August 2022. The primary outcome was the improvement in overall cognitive function (OCF). Secondary outcomes were improved memory function (MF) and activities of daily living (ADLs). The revised Cochrane collaboration risk of bias (ROB) assessment tool (ROB 2.0) was applied to evaluate their methodological quality. The Review Manager software v 5.4 was used for analyses. Trial sequential analysis (TSA) 0.9.5.10 β software was used to estimate the required sample size and test the reliability of the pooled outcome. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool.ResultsThis meta-analysis included 11 RCTs with a total of 602 patients. The methodological quality of all trials was moderate. Low-quality evidence showed that acupuncture significantly improved OCF (Mini-Mental State Examination (MMSE): mean difference (MD) = 1.22, 95% confidence interval (CI): 0.78–1.66; the Montreal Cognitive Assessment Scale (MoCA): MD = 1.22, 95% CI: 0.47–1.97). In subgroup analyses, it was revealed that acupuncture significantly increased OCF in patients with MCI when compared to conventional medicine (CM) and sham acupuncture (SA). TSA's findings indicated that the evidence of improving OCF with acupuncture for patients with MCI was conclusive. Meanwhile, there is no statistical difference in the improvement of MF and ADL between acupuncture and CM. TSA showed that the evidence of improving MF and ADL for patients who had MCI and received acupuncture was inconclusive. The shreds of evidence of improving MF and ADL were ranked from low to critically low.ConclusionAcupuncture appears to be an effective clinical application method for improving OCF in patients with MCI. However, due to low-quality evidence, more relevant and high-quality research is needed in this field.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021291284, PROSPERO, No. CRD42021291284.https://www.frontiersin.org/articles/10.3389/fneur.2022.1091125/fullacupuncturemild cognitive impairmentsystematic reviewmeta-analysistrial sequential analysis (TSA) |
| spellingShingle | Zihan Yin Zihan Yin Yaqin Li Cheng Jiang Manze Xia Manze Xia Zhenghong Chen Zhenghong Chen Xinyue Zhang Xinyue Zhang Ling Zhao Ling Zhao Fanrong Liang Fanrong Liang Acupuncture for mild cognitive impairment: A systematic review with meta-analysis and trial sequential analysis Frontiers in Neurology acupuncture mild cognitive impairment systematic review meta-analysis trial sequential analysis (TSA) |
| title | Acupuncture for mild cognitive impairment: A systematic review with meta-analysis and trial sequential analysis |
| title_full | Acupuncture for mild cognitive impairment: A systematic review with meta-analysis and trial sequential analysis |
| title_fullStr | Acupuncture for mild cognitive impairment: A systematic review with meta-analysis and trial sequential analysis |
| title_full_unstemmed | Acupuncture for mild cognitive impairment: A systematic review with meta-analysis and trial sequential analysis |
| title_short | Acupuncture for mild cognitive impairment: A systematic review with meta-analysis and trial sequential analysis |
| title_sort | acupuncture for mild cognitive impairment a systematic review with meta analysis and trial sequential analysis |
| topic | acupuncture mild cognitive impairment systematic review meta-analysis trial sequential analysis (TSA) |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.1091125/full |
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