Brain Behav. 2026 Nov;16(11):e71887. doi: 10.1002/brb3.71887.
ABSTRACT
BACKGROUND: To characterize the methodological quality, certainty of evidence, primary-study overlap, outcome coverage, and recurrent acupuncture prescription patterns in the existing secondary evidence on acupuncture for poststroke dysphagia (PSD).
METHOD: Systematic reviews and meta-analyses (SRs/MAs) evaluating acupuncture for PSD were identified. Methodological quality was assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, and primary-study overlap using the corrected covered area (CCA). Evidence mapping summarized outcome coverage and certainty, and prescription pattern mining explored frequently used acupoints and combinations.
RESULT: Forty-five SRs/MAs were included. Under the original AMSTAR 2 critical-domain configuration, one review was rated moderate, eight low, and 36 critically low. GRADE indicated that most outcome evidence was of low or very low certainty. The CCA was 0.34%, indicating slight overlap of primary studies across reviews. Evidence was concentrated on total effective rate and swallowing-function outcomes, whereas patient-important outcomes, including aspiration/pneumonia, nutritional status, safety, and quality of life, were underrepresented. Frequently used acupoints included Fengchi (GB20), Lianquan (RN23), Jinjin (EX-HN12), and Yuye (EX-HN13), with recurrent combinations reflecting local stimulation and swallowing-related functional regulation.
CONCLUSION: Current secondary evidence suggests that acupuncture, primarily as an adjunctive intervention, may improve swallowing-related outcomes in PSD, but confidence remains limited by methodological weaknesses and low certainty of evidence. Future studies should improve methodological rigor, standardize clinically important outcomes, and prospectively validate recurrent prescription patterns.
PMID:42967503 | DOI:10.1002/brb3.71887