JMIR Publications

ABSTRACT

Background:

Cognitive function, inhibitory control (IC), cognitive flexibility (CF), working memory (WM), and attention are higher-level executive control functions with a complex relationship. There is only limited evidence on the effectiveness of electroacupuncture at acupoints GV20 and GV24 to improve executive control function.

Objective:

This study aimed to evaluate the clinical effectiveness of electroacupuncture at acupoints GV20 and GV24 to alleviate deficits in executive control.

Methods:

A single-blind randomized controlled trial was conducted at the First Affiliated Hospital of Henan University of Chinese Medicine involving 76 patients with post-stroke cognitive impairment (PSCI) aged 18 to 74 years. The participants were randomly assigned to either the electroacupuncture group or the conventional treatment group at a 1:1 ratio, with 38 individuals in each group. In addition to receiving conventional treatment, the electroacupuncture group underwent electroacupuncture at acupoints GV20 and GV24 for 30 minutes, 5 times a week, for 4 weeks. Participants were assessed using the Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), Stroop Color Word Test (SCWT), and Stroke Specific Quality of Life Scale (SSQOL) both before and after intervention.

Results:

Using an intention-to-treat (ITT) analysis, both the electroacupuncture and control groups demonstrated significant improvements in executive control function, overall cognitive function, and activities of daily living compared to baseline. Specifically, the electroacupuncture group exhibited highly significant improvements in TMT-A (Z=−4.859, OR −23, 95% CI −29.50 to −17.50, P <.001), TMT-B (Z=−5.316, OR −34, 95% CI −42.50 to −28.00, P <.001), SCWT-W (Z=−5.375, OR −28, 95% CI −34.00 to −22.50, P <.001), and SCWT-CW scores (Z=−5.178, OR −44, 95% CI −59.00 to −34.50, P <.001). In the control group, significant improvements were observed in TMT-A (Z=−3.785, OR −8, 95% CI −11.00 to −4.50, P <.001) and SCWT-W scores (T=3.893, OR 8.158, 95% CI 3.912 to 12.404, P <.001), while TMT-B (Z=−2.882, OR −11.50, 95% CI −21.00 to −4.00, P =.004) and SCWT-CW scores (Z=−2.448, OR −12, 95% CI −21.00 to −2.00, P =.025) showed significant enhancements. Both groups experienced significant improvements in MoCA, and SS-QOL scores (P <.001) compared to baseline. Notably, when comparing the electroacupuncture group to the control group, the electroacupuncture group exhibited highly significant improvements in SCWT-W scores (Z=−3.414, OR 24, 95% CI 10 to 36, P <.001) and significant enhancements in MoCA (t=−2.908, OR −2.396, 95% CI −4.038 to −0.754, P =.005), SSQOL (T=−2.104, OR −13.921, 95% CI −27.103 to −0.739, P =.039), and SCWT-CW scores (Z=−2.244, OR 45, 95% CI 6 to 83, P =.025).

Conclusions:

Electroacupuncture at acupoints GV20 and GV24 demonstrated significant efficacy in ameliorating executive control deficits in PSCI patients. This intervention effectively restored key executive control functions, such as IC, CF, attention, and WM, while also enhancing overall cognitive function and the activities of daily living following a stroke. Clinical Trial: ChiCTR2300074400