Different acupuncture and moxibustion therapies for mild cognitive impairment: a network meta-analysis.

OBJECTIVE: To investigate the effectiveness of different acupuncture and moxibustion therapies in improving cognitive function in patients with mild cognitive impairment (MCI) to determine the optimal approach. This study aims to provide insights into the treatment of MCI patients for future randomized controlled trials (RCTs) and clinical decision-making. MATERIALS AND METHODS: RCT studies were retrieved from databases including PubMed, Embase, Cochrane Library, Web of Science, CNKI, WANFANG, VIP, and SinoMed. The Cochrane risk of bias tool was used to assess the risk of bias for eligible trials. Bayesian network meta-analysis was conducted using R4.2.3 software. RESULTS: A total of 46 RCTs with 3641 participants were included. The network meta-analysis showed that acupoint pressing + cognitive training + auricular point sticking, massage + western medicine treatment, and electroacupuncture + western medicine treatment ranked first, second, and third in improving MMSE score, respectively. Acupoint pressing + cognitive training, cognitive training + scalp acupuncture, and cognitive training + moxibustion ranked first, second, and third in improving MoCA score, respectively. CONCLUSION: This study showed that acupoint pressing alone or acupoint pressing + auricular point sticking may improve cognitive function in MCI patients and possibly be the most effective acupuncture interventions for the treatment of MCI.

Impact of leukoaraiosis severity on the association of outcomes of mechanical thrombectomy for acute ischemic stroke: a systematic review and a meta-analysis.

BACKGROUND: Leukoaraiosis (LA) severity is associated with poor outcome after mechanical thrombectomy (MT) for acute ischemic stroke (AIS) caused by large vessel occlusion. This meta-analysis aimed to assess the association of LA severity with AIS-related risk factors and outcomes of MT. METHODS: PubMed, Web of Science, EMBASE, and Cochrane Collaboration Database was searched for studies on MT for AIS with LA. We conducted a random-effects meta-analysis for the prevalence of stroke risk factors and the MT outcome in the absent to moderate LA and severe LA groups. RESULTS: We included seven cohort studies involving 1294 participants (1019 with absent to moderate LA and 275 with severe LA). The absent to moderate LA group had a significantly lower prevalence of coronary artery disease (odds ratio [OR] 0.43; 95% CI 0.29-0.66), atrial fibrillation (OR, 0.26; 95% CI 0.17-0.38), hypertension (OR, 0.39; 95% CI 0.24-0.61), and ischemic stroke (OR, 0.27; 95% CI 0.15-0.50) than the severe LA group. There were no significant between-group differences in symptom onset to recanalization time (364.4 versus 356.2 min, mean difference 19.4; 95% CI - 28.3 to 67.2), final recanalization rate (modified thrombolysis in cerebral infarction score of 2b/3; OR, 0.87; 95% CI 0.55-1.38), and symptomatic intracranial hemorrhage (OR, 0.62; 95% CI 0.34-1.11). The absent to moderate LA group had a higher good functional outcome (modified Rankin Scale score of 0-2 at 90 days; OR, 4.55; 95% CI 3.20-6.47) and a lower mortality rate (179/1019 vs 108/275; OR, 0.28; 95% CI 0.20-0.39). CONCLUSION: There are unique differences in the characteristics of risk factors and clinical outcomes of ischemic stroke across patients with LA of different severity. Patients with severe LA are more likely to be associated with risk factors for cerebrovascular disease and have a poor post-MT outcome.