Acupuncture therapy for post-stroke depression: A scoping review of randomized controlled trials

Abstract

The prevalence of post-stroke depression (PSD), a common complication following a stroke, is rising yearly. Due to the success in treating PSD, acupuncture therapy has gained in popularity in recent years. To provide clinicians with more referable recommendations, we undertook a scoping study to examine the clinical evidence and status of acupuncture for the treatment of PSD. This scoping review followed Arksey and O'Malley's framework. Six databases were systematically searched to identify randomized controlled trials (RCTs) published in English or Chinese language that evaluated any type of acupuncture, with or without co-interventions, for treating PSD. Data were analyzed using descriptive statistics and organized in response to review questions. Findings were presented in a visual and aggregate form as well as in a descriptive format aligning with the objectives and scope of this protocol. A total of 231 RCTs were included, of which 230 were conducted in China. The applied acupuncture-related therapies included manual acupuncture, electroacupuncture, head acupuncture, auricular acupuncture, abdominal acupuncture, press needle, pestle acupuncture, eye acupuncture, and wrist and ankle acupuncture. The most commonly used form of acupuncture was manual acupuncture (n=73, 31.60%), and DU20 (n=121, 52.38%) was the most frequently used acupuncture point. Only a small number of studies reported adverse events (n=30, 12.99%), with the main symptoms including subcutaneous bleeding, headache, and hematoma. Ninety-six of 149 studies reported an effectiveness rate of over 90%. A more standardized trial process is recommended to strengthen the clinical evidence and avoid irregularities in clinical trial methodology. Future studies should include populations from a wider range of countries to improve the generalisability of the evidence.