Just like a detective investigating different clues to solve a mystery, scientists conducted a network meta-analysis to compare the effectiveness of acupuncture therapies and drug treatments for vascular cognitive impairment with no dementia (VCIND). VCIND is considered the early stage of vascular dementia, and it has a slow and gradual onset. The study included 33 studies with 14 interventions and 2,603 participants. The findings indicated that manual acupuncture combined with herbal decoction showed the most promising results for improving cognitive function in VCIND patients. Interestingly, the combination of acupuncture and drug therapy seemed to be more beneficial than using either treatment alone. These results suggest that a multimodal approach may be effective in managing VCIND. However, further research is needed to confirm these findings and explore potential mechanisms underlying the benefits of acupuncture in VCIND. If you’re curious to dive deeper into this investigation, check out the original research article linked below!

Background and objectiveVascular cognitive impairment with no dementia (VCIND) is considered to be the prodromal stage of vascular dementia, characterized by insidious onset. Although acupuncture and drug therapies are effective, the optimal therapy for VCIND remains to be further determined. Therefore, we conducted a network meta-analysis to compare the effectiveness of acupuncture therapies and current common medicines for VCIND.MethodsWe searched eight electronic databases to identify eligible randomized controlled trials of patients with VCIND treated by acupuncture or drug therapies. The primary outcome was Montreal Cognitive Assessment, and the secondary outcome was Mini-Mental State Examination. We conducted the network meta-analysis within a Bayesian framework. Weighted mean difference with 95% confidence intervals were applied as effect sizes to continuous data for all outcomes. Sensitivity analysis was done to assess the robustness of the findings, and we also carried out a subgroup analysis based on age. We assessed the risk of bias using the Risk of Bias 2.0 tool and applied the Grade of Recommendation Assessment, Development and Evaluation (GRADE) to assess the quality of the outcomes. This study was registered with PROSPERO, number CRD42022331718.ResultsA total of 33 studies with 14 interventions were included, including 2603 participants. In terms of the primary outcome, manual acupuncture plus herbal decoction was considered to be the most effective intervention (P = 91.41%), followed by electroacupuncture (P = 60.77%) and manual acupuncture plus piracetam (P = 42.58%), whereas donepezil hydrochloride ranked the least efficacious intervention (P = 54.19%). For the secondary outcome, electroacupuncture plus nimodipine was considered to be the most effective intervention (P = 42.70%), followed by manual acupuncture plus nimodipine (P = 30.62%) and manual acupuncture (P = 28.89%), whereas nimodipine ranked the least efficacious intervention (P = 44.56%).ConclusionManual acupuncture plus herbal decoction might be the most effective intervention for VCIND. The combination of acupuncture and drug therapy had a tendency to perform better than monotherapy in terms of clinical outcomes.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=331718, identifier: CRD42022331718.

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