AccScience Publishing / AN / Online First / DOI: 10.36922/AN025170041
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REVIEW ARTICLE

Facilitating recovery from post-stroke depression with acupuncture: A comprehensive analysis of systematic reviews

Pengyu Liu1 ,  Juju Shang1 ,  Luqi Wang2 ,  Zhi Qi3 ,  Zhaolan Liu4 ,  Yuan Sun4 ,  Xiaolei Lai1 ,  Alan Wang5,6,7,8*
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1 Department of Cardiology, Beijing Traditional Chinese Medicine Hospital, Capital Medical University, Beijing, China
2 Department of Traditional Chinese Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
3 Department of Ultrasound, Beijing Traditional Chinese Medicine Hospital, Capital Medical University, Beijing, China
4 Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
5 Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
6 Department of Anatomy and Medical Imaging, School of Medical Sciences, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
7 Centre for Brain Research, The University of Auckland, Auckland, New Zealand
8 Centre for Co-Created Ageing Research, The University of Auckland, Auckland, New Zealand
Advanced Neurology, 025170041 https://doi.org/10.36922/AN025170041
Received: 22 April 2025 | Revised: 7 June 2025 | Accepted: 7 July 2025 | Published online: 31 July 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Post-stroke depression (PSD) is the most common psychological complication among stroke survivors and is strongly associated with poor outcomes and increased mortality. Acupuncture has been proposed as a potential treatment for PSD. In this overview, 13 meta-analyses (MAs) of randomized controlled trials published up to August 2023 that evaluated acupuncture for PSD were identified. Across these MAs, acupuncture generally demonstrated greater efficacy than control interventions in alleviating depressive symptoms. However, methodological assessment using the A MeaSurement Tool to Assess Systematic Reviews 2 (AMSTAR-2) rated all included studies as having critically low quality, indicating pervasive design and reporting weaknesses. Reporting quality, as evaluated by the Preferred Reporting Items for Systematic Reviews and MAs guidelines, was relatively high, with over 90% of checklist items being rated “yes” or “partially yes.” When the quality of evidence was appraised through the grading of recommendations assessment, development, and evaluation system, only nine of 61 outcomes were classified as moderate quality, 29 as low quality, and the remainder as very low quality. Although acupuncture appears to be a safe and potentially beneficial option for managing PSD, the overall strength of evidence remains limited. Thus, these findings should be interpreted with caution. Future research should prioritize rigorous trial design, standardized intervention protocols, and comprehensive meta-analytic methods to enhance the reliability and clinical applicability of evidence on acupuncture for PSD.

Keywords
Acupuncture
Overview
Post-stroke depression
Systematic review
AMSTAR-2
GRADE
PRISMA
Treatment
Funding
This work was partially supported by the Health Research Council of New Zealand’s Project (21/144), the Marsden Fund Project (22-UOA-120), the Royal Society Catalyst: Seeding General Project (23-UOA-055-CSG), and the Hebei Provincial Science and Technology Program – International Science and Technology Cooperation Project (25292001D).
Conflict of interest
The authors declare that they have no competing interests.
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Advanced Neurology, Electronic ISSN: 2810-9619 Print ISSN: 3060-8589, Published by AccScience Publishing
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