The effects and mechanisms of acupuncture for post-stroke cognitive impairment: progress and prospects

Abstract

Stroke is one of the important causes of both disability and death worldwide, which is very common in older adults. Post-stroke cognitive impairment (PSCI) is a common secondary damage of stroke, which is the main cause of long-term disability and decreased quality of life in stroke patients, which brings a heavy burden to society and families. Acupuncture, as one of the oldest and widely used worldwide techniques in Chinese medicine, is recommended by the World Health Organization (WHO) as an alternative and complementary strategy for improving stroke care. This review comprehensively summarizes literature from the last 25 years, showing that acupuncture can exert strong beneficial effect on PSCI. The mechanisms of acupuncture on PSCI involves anti-neuronal apoptosis, promoting synaptic plasticity, alleviating central and peripheral inflammatory reactions, and regulating brain energy metabolism disorders (including improving cerebral blood flow, glucose utilization and mitochondrial structure and function, etc.), etc. The effects and mechanisms of acupuncture on PSCI reviewed in this study provides scientific and reliable evidence for acupuncture application for PSCI.

Update on the mechanism of microglia involvement in post-stroke cognitive impairment

“…Further research has revealed that NF-κB activation is a feature of models of PSCI, and that inhibitors of NF-κB can notably enhance cognitive function by moderating cell apoptosis. This modulation of the apoptotic pathway serves to inhibit neuronal apoptosis, thereby ameliorating cognitive deficits post-stroke ( Liu et al, 2021 ; Li et al, 2023 ). Moreover, NF-κB plays a pivotal role in the neuroinflammatory response mediated by microglia.…”

“…Domestic research in the field of TCM has found that acupuncture therapy between different acupoints can significantly reduce the expression of Bax and Fas, the key downstream target genes of the NF-κB pathway in microglia, and inhibit NF-κB-mediated neuronal cell activation. Apoptosis, thereby regulating the apoptotic pathway, inhibiting neuronal apoptosis, and improving cognitive impairment after stroke ( Liu et al, 2021 ; Li et al, 2023 ). Although various drugs and TCM treatments currently bring new hope to the treatment of clinical patients.…”