Skip to main content
Top
Published in: BMC Complementary Medicine and Therapies 1/2019

Open Access 01-12-2019 | Acupuncture | Research article

Cognitive improvement effects of electro-acupuncture for the treatment of MCI compared with Western medications: a systematic review and Meta-analysis

Authors: Hwan Kim, Hong Kyoung Kim, Si Yeon Kim, Young Il Kim, Ho Ryong Yoo, In Chul Jung

Published in: BMC Complementary Medicine and Therapies | Issue 1/2019

Login to get access

Abstract

Background

Almost half of mild cognitive impairment (MCI) patients progress to dementia, which is associated with decreased quality of life and obstacles to independent living. Relevant management is expected to prevent MCI patients from progressing to dementia. In recent years, electroacupuncture (EA) has been used to treat various kinds of neurological disorders including MCI. This study evaluates the use of EA for MCI patients to increase cognitive function through a comparison with Western medications.

Methods

Randomized controlled trials (RCT) or systematical reviews (SR) of EA versus Western medications for MCI were searched using the following 10 databases: Pubmed, Cochrane Library, CINAHL, EMBASE, China National Knowledge Infrastructure (CNKI), National Digital Science Library (NDSL), Journal of Oriental Neuropsychiatry (JON), Korean Medical Database (KMBASE), KoreaMed, and OASIS, from October 2007 to August 2017, without language restriction. A methodological quality assessment of RCTs or SRs that met inclusion criteria was conducted using Cochrane Risk of bias (RoB) tool and a meta-analysis by RevMan (Review Manager) 5.3.5 version of Cochrane collaboration.

Results

Five RCTs with 257 patients met inclusion criteria and those were randomly divided into two groups: the EA group (n = 103) and Western medications group (n = 154). The methodological quality of the included studies showed high risk or/and unclear of risk of bias. The meta-analysis of five studies reported that the EA group was better than the Western medications group, improving the Mini Mental State Examination (MMSE) score by 0.65 [95% CI 0.28~1.01] higher mean difference, Montreal Cognitive Assessment (MoCA) score by 0.66 [95% CI 0.00~1.32] higher mean difference. Adverse effects were not reported in the selected studies.

Conclusion

Electroacupuncture was an effective treatment for MCI patients by improving cognitive function. However, the included studies presented a low methodological quality and no adverse effects were reported. Thus, further comprehensive studies with a design in depth are needed to derive significant results.
Appendix
Available only for authorised users
Literature
1.
go back to reference Kelley BJ, Petersen RC. Alzheimer’s disease and mild cognitive impairment. Neurol Clin. 2007;25(3):577–609 v.CrossRef Kelley BJ, Petersen RC. Alzheimer’s disease and mild cognitive impairment. Neurol Clin. 2007;25(3):577–609 v.CrossRef
2.
go back to reference Petersen RC, Stevens JC, Ganguli M, Tangalos EG, Cummings JL, DeKosky ST. Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the quality standards Subcommittee of the American Academy of neurology. Neurology. 2001;56(9):1133–42.CrossRef Petersen RC, Stevens JC, Ganguli M, Tangalos EG, Cummings JL, DeKosky ST. Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the quality standards Subcommittee of the American Academy of neurology. Neurology. 2001;56(9):1133–42.CrossRef
3.
go back to reference Wentzel C, Rockwood K, MacKnight C, Hachinski V, Hogan DB, Feldman H, Ostbye T, Wolfson C, Gauthier S, Verreault R, et al. Progression of impairment in patients with vascular cognitive impairment without dementia. Neurology. 2001;57(4):714–6.CrossRef Wentzel C, Rockwood K, MacKnight C, Hachinski V, Hogan DB, Feldman H, Ostbye T, Wolfson C, Gauthier S, Verreault R, et al. Progression of impairment in patients with vascular cognitive impairment without dementia. Neurology. 2001;57(4):714–6.CrossRef
4.
go back to reference Hyo-yong Lee, Kyung-ah Kim. EARLY cognitive changes associated with dementia known as Mild Cognitive Impairment (MCI) has increased 4.3 times in 5 years. National Health Insurance Serv. 2015(8). Hyo-yong Lee, Kyung-ah Kim. EARLY cognitive changes associated with dementia known as Mild Cognitive Impairment (MCI) has increased 4.3 times in 5 years. National Health Insurance Serv. 2015(8).
5.
go back to reference Gauthier S, Reisberg B, Zaudig M, Petersen RC, Ritchie K, Broich K, Belleville S, Brodaty H, Bennett D, Chertkow H, et al. Mild cognitive impairment. Lancet. 2006;367(9518):1262–70.CrossRef Gauthier S, Reisberg B, Zaudig M, Petersen RC, Ritchie K, Broich K, Belleville S, Brodaty H, Bennett D, Chertkow H, et al. Mild cognitive impairment. Lancet. 2006;367(9518):1262–70.CrossRef
6.
go back to reference Maruff P, Collie A, Darby D, Weaver-Cargin J, Masters C, Currie J. Subtle memory decline over 12 months in mild cognitive impairment. Dement Geriatr Cogn Disord. 2004;18(3–4):342–8.CrossRef Maruff P, Collie A, Darby D, Weaver-Cargin J, Masters C, Currie J. Subtle memory decline over 12 months in mild cognitive impairment. Dement Geriatr Cogn Disord. 2004;18(3–4):342–8.CrossRef
7.
go back to reference Meyer JS, Xu G, Thornby J, Chowdhury MH, Quach M. Is mild cognitive impairment prodromal for vascular dementia like Alzheimer’s disease? Stroke. 2002;33(8):1981–5.CrossRef Meyer JS, Xu G, Thornby J, Chowdhury MH, Quach M. Is mild cognitive impairment prodromal for vascular dementia like Alzheimer’s disease? Stroke. 2002;33(8):1981–5.CrossRef
8.
go back to reference Luo Q, Du Y. Clinical research progress of acupuncture to treat Alzheimer’s disease. Liaoning J Tradit Chin Med. 2014;41. Luo Q, Du Y. Clinical research progress of acupuncture to treat Alzheimer’s disease. Liaoning J Tradit Chin Med. 2014;41.
9.
go back to reference Yuan-zheng SUN, Kun-shan LI. Clinical observation on the treatment of mild cognitive impairment by combined acupuncture and medication. Shanghai J Acupuncture Moxibustion. 2010;12;759-61. Yuan-zheng SUN, Kun-shan LI. Clinical observation on the treatment of mild cognitive impairment by combined acupuncture and medication. Shanghai J Acupuncture Moxibustion. 2010;12;759-61.
10.
go back to reference Sun ZL, Liu J, Guo W, Jiang T, Ma C, Li WB, Tang YL, Ling SH. Serum brain-derived neurotrophic factor levels associate with cognitive improvement in patients with schizophrenia treated with electroacupuncture. Psychiatry Res. 2016;244:370–5.CrossRef Sun ZL, Liu J, Guo W, Jiang T, Ma C, Li WB, Tang YL, Ling SH. Serum brain-derived neurotrophic factor levels associate with cognitive improvement in patients with schizophrenia treated with electroacupuncture. Psychiatry Res. 2016;244:370–5.CrossRef
11.
go back to reference Chen YS, Chen FQ, Zhao JX, Tian YX. Progression of theory and application of acupuncture on treatment of vascular dementia. Chin J Clin Rehabil. 2004;8:4664–6. Chen YS, Chen FQ, Zhao JX, Tian YX. Progression of theory and application of acupuncture on treatment of vascular dementia. Chin J Clin Rehabil. 2004;8:4664–6.
12.
go back to reference Chen ZH, Lai XS, Jiang GH. Effects of electro-acupuncture on electroencephalography in patients with vascular dementia. Zhongguo Zhong xi yi jie he za zhi. 2006;26(8):738–40.PubMed Chen ZH, Lai XS, Jiang GH. Effects of electro-acupuncture on electroencephalography in patients with vascular dementia. Zhongguo Zhong xi yi jie he za zhi. 2006;26(8):738–40.PubMed
13.
go back to reference Chou P, Chu H, Lin JG. Effects of electroacupuncture treatment on impaired cognition and quality of life in Taiwanese stroke patients. J Altern Complement Med. 2009;15(10):1067–107.PubMed Chou P, Chu H, Lin JG. Effects of electroacupuncture treatment on impaired cognition and quality of life in Taiwanese stroke patients. J Altern Complement Med. 2009;15(10):1067–107.PubMed
14.
go back to reference Guo T, Guo Z, Zhang W, Ma W, Yang X, Yang X, Hwang J, He X, Chen X, Ya T. Electroacupuncture and cognitive behavioural therapy for sub-syndromal depression among undergraduates: a controlled clinical trial. Acupunct Med. 2016;34(5):356–63.CrossRef Guo T, Guo Z, Zhang W, Ma W, Yang X, Yang X, Hwang J, He X, Chen X, Ya T. Electroacupuncture and cognitive behavioural therapy for sub-syndromal depression among undergraduates: a controlled clinical trial. Acupunct Med. 2016;34(5):356–63.CrossRef
15.
go back to reference Wang F, Sun L, Zhang XZ, Jia J, Liu Z, Huang XY, Yu SY, Zuo LJ, Cao CJ, Wang XM, et al. Effect and potential mechanism of Electroacupuncture add-on treatment in patients with Parkinson’s disease. Evid Based Complement Alternat Med. 2015;2015:692795.PubMedPubMedCentral Wang F, Sun L, Zhang XZ, Jia J, Liu Z, Huang XY, Yu SY, Zuo LJ, Cao CJ, Wang XM, et al. Effect and potential mechanism of Electroacupuncture add-on treatment in patients with Parkinson’s disease. Evid Based Complement Alternat Med. 2015;2015:692795.PubMedPubMedCentral
16.
go back to reference Kang-feng WANG. ZHANG Li-juan, CHEN Xin-yong: clinical observation on 36 cases of Alzheimer’s disease treated by electro-acupuncture Dazhui (GV 14) and Baihui (GV 20). China J Trad Chi Med Pharm. 2015;3:255-9. Kang-feng WANG. ZHANG Li-juan, CHEN Xin-yong: clinical observation on 36 cases of Alzheimer’s disease treated by electro-acupuncture Dazhui (GV 14) and Baihui (GV 20). China J Trad Chi Med Pharm. 2015;3:255-9.
17.
go back to reference Portet F, Ousset PJ, Visser PJ, Frisoni GB, Nobili F, Scheltens P, Vellas B, Touchon J. Mild cognitive impairment (MCI) in medical practice: a critical review of the concept and new diagnostic procedure. Report of the MCI working Group of the European Consortium on Alzheimer’s disease. J Neurol Neurosurg Psychiatry. 2006;77(6):714–8.CrossRef Portet F, Ousset PJ, Visser PJ, Frisoni GB, Nobili F, Scheltens P, Vellas B, Touchon J. Mild cognitive impairment (MCI) in medical practice: a critical review of the concept and new diagnostic procedure. Report of the MCI working Group of the European Consortium on Alzheimer’s disease. J Neurol Neurosurg Psychiatry. 2006;77(6):714–8.CrossRef
18.
go back to reference Liu Ing, Tian Geumju. The study of Correlation between chinese symptoms with cognitive ability standard of elderly people. Chin J Gerontol. 2003;6:347-8. Liu Ing, Tian Geumju. The study of Correlation between chinese symptoms with cognitive ability standard of elderly people. Chin J Gerontol. 2003;6:347-8.
19.
go back to reference ZHAO Yu, ZHANG Hong, ZHAO Ling: observations on the efficacy of electric scalp acupuncture in treating mild cognitive impairment. Journal of Sichuan of Traditional Chinese Medicine 2012(02). ZHAO Yu, ZHANG Hong, ZHAO Ling: observations on the efficacy of electric scalp acupuncture in treating mild cognitive impairment. Journal of Sichuan of Traditional Chinese Medicine 2012(02).
20.
go back to reference SUN Yuan-zheng, LI Kun-shan: Clinical observation on the treatment of mild cognitive impairment by combined acupuncture and medication. Shanghai Journal of Acupuncture and Moxibustion 2010(12). SUN Yuan-zheng, LI Kun-shan: Clinical observation on the treatment of mild cognitive impairment by combined acupuncture and medication. Shanghai Journal of Acupuncture and Moxibustion 2010(12).
21.
go back to reference Jie LIU, Zhi-yan LIU. Clinical observations on Electroacupuncture treatment for mild cognitive impairment of kidney essence deficiency type. Shanghai Journal of Acupuncture and Moxibustion. 2009;06. Jie LIU, Zhi-yan LIU. Clinical observations on Electroacupuncture treatment for mild cognitive impairment of kidney essence deficiency type. Shanghai Journal of Acupuncture and Moxibustion. 2009;06.
22.
go back to reference Liusopyeong, Liuji Yan, Lou Jian Yeo, Wang-Geonsaeng, Mi Yong, Machung, Zhao Hua, Zhangseol Yeong, Gang-Yeongpyeong: Electro-Acupuncture as intervention for the treatment of Mild Cognitive Impairment. Xinjiang Journal of Traditional Chinese Medicine 2010 (02). Liusopyeong, Liuji Yan, Lou Jian Yeo, Wang-Geonsaeng, Mi Yong, Machung, Zhao Hua, Zhangseol Yeong, Gang-Yeongpyeong: Electro-Acupuncture as intervention for the treatment of Mild Cognitive Impairment. Xinjiang Journal of Traditional Chinese Medicine 2010 (02).
23.
go back to reference Jian-guo XU, Cong-bin PENG. The clinical study of the electroacupuncture for treatment of amnestic mild cognitive impairment. Chin J Gen Pract. 2017;03. Jian-guo XU, Cong-bin PENG. The clinical study of the electroacupuncture for treatment of amnestic mild cognitive impairment. Chin J Gen Pract. 2017;03.
25.
go back to reference Doody RS, Ferris SH, Salloway S, Sun Y, Goldman R, Watkins WE, Xu Y, Murthy AK. Donepezil treatment of patients with MCI: a 48-week randomized, placebo-controlled trial. Neurology. 2009 May 5;72(18):1555–61.CrossRef Doody RS, Ferris SH, Salloway S, Sun Y, Goldman R, Watkins WE, Xu Y, Murthy AK. Donepezil treatment of patients with MCI: a 48-week randomized, placebo-controlled trial. Neurology. 2009 May 5;72(18):1555–61.CrossRef
26.
go back to reference Wang W, Wang LN, Zhang XH, Ma L, Li DJ. A nimodipine interventional study of patients with mild cognitive impairment. Zhonghua Nei Ke Za Zhi. 2006;45(4):274–6.PubMed Wang W, Wang LN, Zhang XH, Ma L, Li DJ. A nimodipine interventional study of patients with mild cognitive impairment. Zhonghua Nei Ke Za Zhi. 2006;45(4):274–6.PubMed
27.
go back to reference Lu X, Hongcai S, Jiaying W, Jing H, Jun X. Assessing the Quality of Reports about Randomized Controlled Trials of Acupuncture Treatment on Mild Cognitive Impairment. PLoS One. 2011;6(2):1–6. Lu X, Hongcai S, Jiaying W, Jing H, Jun X. Assessing the Quality of Reports about Randomized Controlled Trials of Acupuncture Treatment on Mild Cognitive Impairment. PLoS One. 2011;6(2):1–6.
29.
go back to reference Huijuan Cao, Yuyi Wang, Dennis Chang, Li Zhou, Jianping Liu: Acupuncture for vascular mild cognitive impairment: a systematic review of randomised controlled trials. 2013. Huijuan Cao, Yuyi Wang, Dennis Chang, Li Zhou, Jianping Liu: Acupuncture for vascular mild cognitive impairment: a systematic review of randomised controlled trials. 2013.
30.
go back to reference Folstein MF, Folstein SE. McHugh PR: “ini-mental state” a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98.CrossRef Folstein MF, Folstein SE. McHugh PR: “ini-mental state” a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98.CrossRef
31.
go back to reference Harvan JR, Cotter V. An evaluation of dementia screening in the primary care setting. J Am Acad Nurse Pract. 2006;18(8):351–60.CrossRef Harvan JR, Cotter V. An evaluation of dementia screening in the primary care setting. J Am Acad Nurse Pract. 2006;18(8):351–60.CrossRef
32.
go back to reference Mitchell AJ. A meta-analysis of the accuracy of the mini-mental state examination in the detection of dementia and mild cognitive impairment. J Psychiatr Res. 2011;24(1):33–8. Mitchell AJ. A meta-analysis of the accuracy of the mini-mental state examination in the detection of dementia and mild cognitive impairment. J Psychiatr Res. 2011;24(1):33–8.
33.
go back to reference Grut M, Fratiglioni L, Viitanen M, Winblad B. Accuracy of the mini-mental status examination as a screening test for dementia in a Swedish elderly population. Acta Neurol Scand. 1993;87(4):312–7.CrossRef Grut M, Fratiglioni L, Viitanen M, Winblad B. Accuracy of the mini-mental status examination as a screening test for dementia in a Swedish elderly population. Acta Neurol Scand. 1993;87(4):312–7.CrossRef
34.
go back to reference SN ML, Mathias JL, Brennan LC, Stewart S. Validity of the Montreal cognitive assessment (MoCA) as a screening test for mild cognitive impairment (MCI) in a cardiovascular population. J Geriatr Psychiatry Neurol. 2011;24(1):33–8.CrossRef SN ML, Mathias JL, Brennan LC, Stewart S. Validity of the Montreal cognitive assessment (MoCA) as a screening test for mild cognitive impairment (MCI) in a cardiovascular population. J Geriatr Psychiatry Neurol. 2011;24(1):33–8.CrossRef
35.
go back to reference Zadikoff C, Fox SH, Tang-Wai DF, Thomsen T, de Bie RM, Wadia P, Miyasaki J, Duff-Canning S, Lang AE, Marras C: A comparison of the mini mental state exam to the Montreal cognitive assessment in identifying cognitive deficits in Parkinson’s disease. Mov Disord 2008, 23(2):297–299. Zadikoff C, Fox SH, Tang-Wai DF, Thomsen T, de Bie RM, Wadia P, Miyasaki J, Duff-Canning S, Lang AE, Marras C: A comparison of the mini mental state exam to the Montreal cognitive assessment in identifying cognitive deficits in Parkinson’s disease. Mov Disord 2008, 23(2):297–299.
36.
go back to reference Chen Y, Zhou J, Li J, Yang SB, Mo LQ, Hu JH, Yuan WL. Electroacupuncture pretreatment prevents cognitive impairment induced by limb ischemia-reperfusion via inhibition of microglial activation and attenuation of oxidative stress in rats. Brain Res. 2012;1432:36–45.CrossRef Chen Y, Zhou J, Li J, Yang SB, Mo LQ, Hu JH, Yuan WL. Electroacupuncture pretreatment prevents cognitive impairment induced by limb ischemia-reperfusion via inhibition of microglial activation and attenuation of oxidative stress in rats. Brain Res. 2012;1432:36–45.CrossRef
37.
go back to reference Chen Y, Lei Y, Mo LQ, Li J, Wang MH, Wei JC, Zhou J. Electroacupuncture pretreatment with different waveforms prevents brain injury in rats subjected to cecal ligation and puncture via inhibiting microglial activation, and attenuating inflammation, oxidative stress and apoptosis. Brain Res Bull. 2016;127:248–59.CrossRef Chen Y, Lei Y, Mo LQ, Li J, Wang MH, Wei JC, Zhou J. Electroacupuncture pretreatment with different waveforms prevents brain injury in rats subjected to cecal ligation and puncture via inhibiting microglial activation, and attenuating inflammation, oxidative stress and apoptosis. Brain Res Bull. 2016;127:248–59.CrossRef
38.
go back to reference Chen YS, Chen FQ, Zhao JX, Tian YX. Effect of electroacupuncture on the superoxide dismutase, malondialdehyde and acetylcholinesterase in brain tissue of mice with vascular dementia. Chin J Clin Rehab. 2005;9(9):111–3. Chen YS, Chen FQ, Zhao JX, Tian YX. Effect of electroacupuncture on the superoxide dismutase, malondialdehyde and acetylcholinesterase in brain tissue of mice with vascular dementia. Chin J Clin Rehab. 2005;9(9):111–3.
39.
go back to reference Fang Y, Sui R. Electroacupuncture at the wangu acupoint suppresses expression of inflammatory cytokines in the hippocampus of rats with vascular Dementia. Afr J Tradit Complement Altern Med. 2016;13(5):17–24. Fang Y, Sui R. Electroacupuncture at the wangu acupoint suppresses expression of inflammatory cytokines in the hippocampus of rats with vascular Dementia. Afr J Tradit Complement Altern Med. 2016;13(5):17–24.
40.
go back to reference Dong W, Guo W, Zheng X, Wang F, Chen Y, Zhang W, Shi H. Electroacupuncture improves cognitive deficits associated with AMPK activation in SAMP8 mice. Metab Brain Dis. 2014. Dong W, Guo W, Zheng X, Wang F, Chen Y, Zhang W, Shi H. Electroacupuncture improves cognitive deficits associated with AMPK activation in SAMP8 mice. Metab Brain Dis. 2014.
41.
go back to reference Guo HD, Tian JX, Zhu J, Li L, Sun K, Shao SJ, Cui GH. Electroacupuncture suppressed neuronal apoptosis and improved cognitive impairment in the ad model rats possibly via downregulation of notch signaling pathway. Evid Based Complement Alternat Med. 2015;2015. Guo HD, Tian JX, Zhu J, Li L, Sun K, Shao SJ, Cui GH. Electroacupuncture suppressed neuronal apoptosis and improved cognitive impairment in the ad model rats possibly via downregulation of notch signaling pathway. Evid Based Complement Alternat Med. 2015;2015.
42.
go back to reference Guo HD, Zhu J, Tian JX, Shao SJ, Xu YW, Mou FF, Han XJ, Yu ZH, Chen JL, Zhang DY, et al. Electroacupuncture improves memory and protects neurons by regulation of the autophagy pathway in a rat model of Alzheimer’s disease. Acupunct Med. 2016;34(6):449–56.CrossRef Guo HD, Zhu J, Tian JX, Shao SJ, Xu YW, Mou FF, Han XJ, Yu ZH, Chen JL, Zhang DY, et al. Electroacupuncture improves memory and protects neurons by regulation of the autophagy pathway in a rat model of Alzheimer’s disease. Acupunct Med. 2016;34(6):449–56.CrossRef
43.
go back to reference Fan XW, Chen F, Chen Y, Chen GH, Liu HH, Guan SK, Deng Y, Liu Y, Zhang SJ, Peng WJ, et al. Electroacupuncture prevents cognitive impairments by regulating the early changes after brain irradiation in rats. PLoS One. 2015;10(4). Fan XW, Chen F, Chen Y, Chen GH, Liu HH, Guan SK, Deng Y, Liu Y, Zhang SJ, Peng WJ, et al. Electroacupuncture prevents cognitive impairments by regulating the early changes after brain irradiation in rats. PLoS One. 2015;10(4).
44.
go back to reference Zhao Ling, Zhang Hong, Zheng Zhong. The clinical research on scalp electric acupuncture improving the cognition function of 90 vascular dementia patients. J Sichuan Trad Chin Med. 2007;9:105-8. Zhao Ling, Zhang Hong, Zheng Zhong. The clinical research on scalp electric acupuncture improving the cognition function of 90 vascular dementia patients. J Sichuan Trad Chin Med. 2007;9:105-8.
Metadata
Title
Cognitive improvement effects of electro-acupuncture for the treatment of MCI compared with Western medications: a systematic review and Meta-analysis
Authors
Hwan Kim
Hong Kyoung Kim
Si Yeon Kim
Young Il Kim
Ho Ryong Yoo
In Chul Jung
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Complementary Medicine and Therapies / Issue 1/2019
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/s12906-018-2407-2

Other articles of this Issue 1/2019

BMC Complementary Medicine and Therapies 1/2019 Go to the issue