The Comparative Efficacy of Multiple Acupuncture for Alzheimer’s Disease: A Bayesian Network Meta-Analysis

Abstract

Background. Alzheimer’s disease (AD) is a progressive neurodegenerative disease. Numerous cases have illustrated that the acupuncture method could improve AD patients’ cognitive function and daily living ability. However, the optimal acupuncture treatments remain controversial. Therefore, we aimed to conduct a systematic review to compare the efficacy of multiple acupuncture therapies for AD and identify the optimal acupuncture intervention for delaying AD progression. Methods. To select potentially concerned randomized controlled trials (RCTs), we searched four English databases, four Chinese databases, and additional sources from 1 May 2021. Two independent reviewers conducted study screening, data extraction, and methodological quality assessment. The primary outcome was global cognitive function improvement. Pairwise and Bayesian network meta-analyses were performed using STATA v15.0 and ADDIS v1.16.8. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used to assess the quality of evidence. Results. This study included 34 RCTs with 2,071 participants. Regarding global cognitive function improvement, the pairwise meta-analysis confirmed that electronic acupuncture (EA) plus conventional medicine (CM) and manual acupuncture (MA) plus CM were statistically significantly different from CM, and EA plus CM was ranked as the best combination in the network meta-analysis. In terms of response rate, MA outperformed CM statistically significantly; warm acupuncture (WA) was ranked as the best in the network meta-analysis. Regarding activity of daily living improvement, EA plus CM, MA plus CM, and fire acupuncture plus CM, MA, and scalp acupuncture were statistically significantly different from CM, and EA plus CM was ranked as the best combination in the network meta-analysis. However, the evidences were ranked as low to critically low. Conclusions. Acupuncture, as a monotherapy or an adjuvant therapy, may have a beneficial effect on efficacy for AD. EA plus CM may be the optimal acupuncture therapy for AD and should be administered to AD patients. It may aid and support patient, operative, and societal decision-making. Due to the dearth of high-quality evidence, additional high-quality studies should be conducted to ensure these findings in the future. This study is registered with PROSPERO (CRD42021252305).

Modulation of entorhinal cortex–hippocampus connectivity and recognition memory following electroacupuncture on 3×Tg-AD model: Evidence from multimodal MRI and electrophysiological recordings

“…Increasing clinical and experimental studies have confirmed the efficacy of electroacupuncture (EA) on cognitive dysfunction (Wang et al, 2020;Yu et al, 2020;Yin et al, 2022). EA has been recognized as a crucial treatment in traditional Chinese medicine (TCM), which applies the inserted needles with an electric stimulating current to the acupoints.…”

Neuroimaging studies of acupuncture on Alzheimer’s disease: a systematic review

“…For instance, Huang et al [ 23 ] found that acupuncture was superior to conventional medicines. Moreover, Zhou et al [ 25 ] revealed that acupuncture plus herbal medicine might have advantages over Western drugs, and our previous study [ 28 ] illustrated that acupuncture, as a monotherapy or a complementary therapy, is effective against AD.…”

Research status, hotspots and trends of acupuncture and moxibustion in the treatment of Alzheimer’s disease: A bibliometric analysis

“…[13][14][15][16][17][18][19][20] Acupuncture and moxibustion (AM) have been widely used to ameliorate symptoms and improve the overall quality of life of patients with AD. [21][22][23][24][25][26][27][28][29] However, no study has explored the status, hotspots, and trends of AM in the treatment of AD. Therefore, this bibliometric analysis investigated the research status, hotspots, and trends of AM in the management of AD using VOSviewer and CiteSpace.…”