Evidence integration of acupuncture for prevention and treatment of Alzheimer’s disease and mild cognitive impairment from a neuroimaging perspective

Abstract

Background

Acupuncture has clinical potential in treating Alzheimer's disease (AD) and mild cognitive impairment (MCI), but there is a lack of systematic review and presentation of clinical evidence from the perspective of neuroimaging in this field.

Objective

To conduct a systematic review of clinical studies on acupuncture for AD and MCI from the perspective of neuroimaging, and to comprehend the evidence distribution of relevant research.

Methods

This article retrieved all the neuroimaging clinical studies on acupuncture treatment for AD and MCI that were published and included in the seven databases from their establishment until February 22, 2025. It analyzed and organized the data based on the PICOS (Population, Intervention, Comparison, Outcome, Study design) principle, and presented the quality and distribution of evidence.

Results

A total of 58 studies were included. The diagnostic criteria for the research subjects mainly refer to the standards of Western medicine. The task design was mostly two-arm before-and-after comparisons and single-group immediate studies, with the intervention measures mainly including hand acupuncture and electroacupuncture. The study employed 8 neuroimaging techniques and 29 outcome measures, with a primary focus on brain functional activation regions and brain functional connectivity. Included studies had high bias risk in blinding design/implementation; overall evidence quality was acceptable.

Conclusions

Acupuncture for AD and MCI demonstrates clear efficacy, which is supported by imaging evidence. In the future, more large-sample, multi-center joint clinical studies using neuroimaging methods will be needed to further investigate AD and MCI, providing more high-quality evidence-based medical evidence in this field.