Multicentre randomized controlled trial of acupuncture for vascular cognitive impairment: cognitive benefits and inflammatory biomarker modulation

Vascular Cognitive Impairment (VCI) results from reduced cerebral blood flow, leading to cognitive dysfunction. This multicentre randomized controlled trial evaluated the clinical efficacy of acupuncture in improving cognitive function, daily living abilities, and quality of life in patients with Vascular Cognitive Impairment (VCI). In addition to standardized functional assessments, the authors also measured serum levels of BDNF, IL-6, and TNF-α as exploratory biomarkers of neuroplasticity and inflammation. This investigation was designed as a randomized controlled trial, encompassing patients who had been clinically diagnosed with VCI between July 2022 and March 2024. Participants were divided into three distinct groups based on the type of treatment they received. One group was treated with oral donepezil, representing the medicine intervention group. A second group underwent sham acupuncture, serving as the sham acupuncture comparison group. The third group received actual acupuncture treatment, denoting the acupuncture intervention group. The cognitive and functional capabilities of the participants across all three groups were systematically evaluated using comprehensive assessment tools. Of the 270 recruited patients, 262 completed treatment and follow-up. Participants received oral donepezil (medicine group), sham acupuncture, or acupuncture. After 4 weeks, all groups showed significant MoCA, MMSE, and ADL score improvements (p < 0.001), with the acupuncture group demonstrating the greatest gains (MoCA: 20.39 ± 3.15 to 25.47 ± 3.14; MMSE: 23.05 ± 2.71 to 27.42 ± 2.57, p < 0.05). These benefits persisted through 12 weeks, while the sham group showed moderate improvements, outperforming the medicine group. SF-36 results indicated significant enhancements in physical, psychological, and social function across all groups (p < 0.001), with the acupuncture group consistently scoring highest (p < 0.05). While improvements in the acupuncture group remained stable, the other groups experienced partial regression. All treatments were well tolerated, with no severe adverse effects. These findings highlight acupuncture's superior and lasting benefits for cognitive function, daily living, and quality of life in VCI patients. Acupuncture also modulated serum (BDNF ↑) and inflammatory markers (IL-6/TNF-α ↓), suggesting neuroprotective and anti-inflammatory mechanisms. Evidence indicates that acupuncture can notably improve cognitive abilities and daily living skills, while presenting few side effects. This research backs the clinical use and endorsement of acupuncture in treating VCI. These findings support the use of acupuncture as an effective and safe intervention for VCI, with sustained functional gains and favorable modulation of peripheral inflammatory and neurotrophic biomarkers.