Acupuncture and Moxibustion for Poststroke Depression: Systematic Review.

Abstract

Background: Poststroke depression (PSD) is a common complication following stroke. In recent years, several systematic reviews have evaluated the effects of moxibustion and acupuncture on PSD; however, their findings have been inconsistent.

Objective: This overview of systematic reviews aimed to assess the methodological quality, reporting quality, and strength of evidence of existing systematic reviews on acupuncture and moxibustion for PSD. In addition, this study also analyzed the limitations of previous studies and suggested directions for future research.

Methods: Systematic reviews concerning acupuncture and moxibustion for PSD published before August 10, 2024, were identified from 8 databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang, VIP Database, and Chinese Biomedical Literature Database. Eligible studies included systematic reviews and meta-analyses of randomized controlled trials comparing moxibustion and acupuncture for the treatment of PSD. The methodological quality, reporting quality, and evidence quality were evaluated using AMSTAR 2 (Assessment of Multiple Systematic Reviews-2), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020, and GRADE (Grading of Recommendations Assessment, Development and Evaluation), respectively. The corrected covered area was calculated to assess overlap among the included primary studies.

Results: A total of 24 studies were included. According to the Assessment of Multiple Systematic Reviews-2 assessment, all studies were rated as having "low" or "critically low" methodological quality. Based on PRISMA, 1 study demonstrated seriously inadequate reporting quality, while 21 studies had partially inadequate reporting quality. The quality of evidence in the included reviews ranged from very low to moderate. Most of the primary outcomes exhibited mild to moderate overlap among studies.

Conclusions: Most of the included systematic reviews indicated that acupuncture may be beneficial for PSD. Nevertheless, the methodology, reporting, and evidence quality of these reviews require improvement. Stronger evidence will depend on the conduct of larger, multicenter, rigorously designed randomized controlled trials, as well as high-quality systematic reviews.