PMID- 34421571 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230920 IS - 1663-4365 (Print) IS - 1663-4365 (Electronic) IS - 1663-4365 (Linking) VI - 13 DP - 2021 TI - Effectiveness and Safety of Acupuncture for Vascular Cognitive Impairment: A Systematic Review and Meta-Analysis. PG - 692508 LID - 10.3389/fnagi.2021.692508 [doi] LID - 692508 AB - Background: Acupuncture may be a promising complementary therapy for vascular cognitive impairment (VCI) and has been extensively applied in China. However, its potential effects remain uncertain, and the clinical findings are inconsistent. This review aimed to systematically appraise the overall effectiveness and safety of acupuncture in treating VCI. Methods: To investigate the effects of acupuncture on VCI from inception to February 28, 2021 using randomized clinical trials (RCTs), seven electro-databases [Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), VIP, and Wanfang] were searched. Two independent investigators identified the eligible RCTs and extracted data into predesigned forms. The risk of bias (ROB) within each individual trial was evaluated using the Cochrane Collaboration's tool. Meta-analyses were conducted for calculating comparative effects in the RevMan software (version 5.3). The strength of attained evidence was rated using the online GRADEpro approach. Results: A total of 48 RCTs involving 3,778 patients with VCI were included. The pooled data demonstrated that acupuncture was more beneficial for a global cognitive function [mean difference (MD) 1.86, 95% CI 1.19-2.54, p < 0.01] and activities of daily living (MD -3.08, 95% CI -4.81 to -1.35, p < 0.01) compared with western medicine (WM). The favorable results were also observed when acupuncture was combined with WM (MD 2.37, 95% CI 1.6-3.14, p < 0.01) or usual care (UC, MD 4.4, 95% CI 1.61-7.19, p = 0.002) in comparison with the corresponding control conditions. Meanwhile, the subgroup analysis did not indicate a statistical effect difference between manual acupuncture (MA) and electroacupuncture (EA) (inter-group I (2) < 50% and p > 0.1) when comparing acupuncture with WM. There were no significant differences in the occurrence of adverse events (AEs) between the acupuncture group and the control group (p > 0.05). Owing to the poor methodological quality and considerable heterogeneity among studies, the certainty of the evidence was low or very low. Conclusions: This review suggests that acupuncture as a monotherapy or an adjuvant therapy may play a positive role in improving the cognition and daily performance of VCI patients associated with few side effects. The difference in styles may not significantly influence its effectiveness. More rigorously designed and preregistered RCTs are highly desirable to verify the therapeutic benefits and determine an optimal acupuncture paradigm. The methodological and reporting quality of future researches should be enhanced by adhering to authoritative standardized statements. Systematic Review Registration: [PROSPERO], identifier [No. CRD42017071820]. CI - Copyright (c) 2021 Su, Sun, Zhang, Wang, Zou, Li, Yang, Shi and Liu. FAU - Su, Xin-Tong AU - Su XT AD - International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China. AD - Traditional Chinese Medicine (TCM) in the Prevention and Rehabilitation of Stroke Task Force, World Stroke Organization, Geneva, Switzerland. FAU - Sun, Ning AU - Sun N AD - Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China. FAU - Zhang, Na AU - Zhang N AD - School of Acupuncture-Moxibustion and Tuina, Shandong University of Chinese Medicine, Jinan, China. FAU - Wang, Li-Qiong AU - Wang LQ AD - International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China. FAU - Zou, Xuan AU - Zou X AD - International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China. FAU - Li, Jin-Ling AU - Li JL AD - International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China. FAU - Yang, Jing-Wen AU - Yang JW AD - International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China. FAU - Shi, Guang-Xia AU - Shi GX AD - International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China. FAU - Liu, Cun-Zhi AU - Liu CZ AD - International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China. AD - Traditional Chinese Medicine (TCM) in the Prevention and Rehabilitation of Stroke Task Force, World Stroke Organization, Geneva, Switzerland. LA - eng PT - Systematic Review DEP - 20210806 PL - Switzerland TA - Front Aging Neurosci JT - Frontiers in aging neuroscience JID - 101525824 PMC - PMC8377366 OTO - NOTNLM OT - Alzheimer's Disease Assessment Scale-Cognitive Subscale OT - Barthel ADL Index OT - Functional Activities Questionnaire OT - Hasegawa's Dementia Scale OT - Montreal Cognitive Assessment COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer LZ declared a shared affiliation, with no collaboration, with one of the authors NS to the handling editor at the time of the review. EDAT- 2021/08/24 06:00 MHDA- 2021/08/24 06:01 PMCR- 2021/01/01 CRDT- 2021/08/23 06:25 PHST- 2021/04/08 00:00 [received] PHST- 2021/06/28 00:00 [accepted] PHST- 2021/08/23 06:25 [entrez] PHST- 2021/08/24 06:00 [pubmed] PHST- 2021/08/24 06:01 [medline] PHST- 2021/01/01 00:00 [pmc-release] AID - 10.3389/fnagi.2021.692508 [doi] PST - epublish SO - Front Aging Neurosci. 2021 Aug 6;13:692508. doi: 10.3389/fnagi.2021.692508. eCollection 2021.