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• Review •
Research progress of structural and functional MRI on acupuncture treatment for post-stroke cognitive impairment after ischemic stroke
PENG Cailiang  WANG Yang  WANG Peng  LI Xiaoling 

Cite this article as: PENG C L, WANG Y, WANG P, et al. Research progress of structural and functional MRI on acupuncture treatment for post-stroke cognitive impairment after ischemic stroke[J]. Chin J Magn Reson Imaging, 2026, 17(9): 183-189. DOI:10.12015/issn.1674-8034.2026.09.024.


[Abstract] Post-stroke cognitive impairment (PSCI) is a common cognitive dysfunction syndrome following stroke, with typical clinical manifestations including inattention, memory decline, slowed thinking, language disorders, and decreased orientation, which severely affect patients' quality of life. Acupuncture, as a non-pharmacological therapy, has demonstrated definite efficacy in improving ischemic PSCI, and its mechanisms involve inhibiting neuronal apoptosis, enhancing synaptic plasticity, anti-neuroinflammation, and regulating cerebral energy metabolism. MRI studies on acupuncture treatment for ischemic PSCI primarily utilize multiple imaging modalities such as diffusion tensor imaging, quantitative susceptibility mapping, resting-state functional MRI, and magnetic resonance spectroscopy. These modalities respectively reveal that acupuncture can repair white matter microstructural damage, reduce excessive cerebral iron deposition, modulate cognitive-related brain network functional connectivity, and optimize cerebral metabolite levels. This review aims to systematically summarize relevant literature, integrate data from the aforementioned multiple MRI sequences, elucidate the central effects of acupuncture in treating ischemic PSCI, point out limitations of existing studies, and propose directions for future research, thereby providing imaging evidence for individualized clinical diagnosis and treatment evaluation.
[Keywords] acupuncture；acupoint；ischemic post-stroke cognitive impairment；magnetic resonance imaging；structural imaging；functional imaging；central mechanism

PENG Cailiang1, 2   WANG Yang3   WANG Peng4*   LI Xiaoling3*  

1 Third Department of Cardiovascular Disease, the First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150040, China

2 Graduate School, Heilongjiang University of Chinese Medicine, Harbin 150040, China

3 Department of CT and MRI, the First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150040, China

4 Department of Oncology, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150040, China

Corresponding author: WANG P, E-mail: pengpeng7231@163.com LI X L, E-mail: lixiaoling1525@163.com

Conflicts of interest   None.

Received  2026-06-18
Accepted  2026-09-10
DOI: 10.12015/issn.1674-8034.2026.09.024
Cite this article as: PENG C L, WANG Y, WANG P, et al. Research progress of structural and functional MRI on acupuncture treatment for post-stroke cognitive impairment after ischemic stroke[J]. Chin J Magn Reson Imaging, 2026, 17(9): 183-189. DOI:10.12015/issn.1674-8034.2026.09.024.

[1]
GUO T, ZHANG W. To explore the cognitive impairment after stroke based on "collateral disease theory"[J]. Asia-Pac Trad Med, 2025, 21(2): 83-86. DOI: 10.11954/ytctyy.202502019.
[2]
LEVINE D A, GALECKI A T, MORGENSTERN L B, et al. Preexisting Mild Cognitive Impairment, Dementia, and Receipt of Treatments for Acute Ischemic Stroke[J]. Stroke, 2021, 52(6): 2134-2142. DOI: 10.1161/strokeaha.120.032258.
[3]
BRANCH C S A V C I. Chinese Guidelines for the Diagnosis and Treatment of Vascular Cognitive Impairment (2024 Edition)[J]. Natl Med J China, 2024, 104(31): 2881-2894. DOI: 10.3760/cma.j.cn112137-20240501-01024.
[4]
ROST N S, BRODTMANN A, PASE M P, et al. Post-Stroke Cognitive Impairment and Dementia[J]. Circ Res, 2022, 130(8): 1252-1271. DOI: 10.1161/circresaha.122.319951.
[5]
WANG M, SHAO Y, ZHAO X T, et al. To evaluate the effect of eye acupuncture combined with acupuncture rehabilitation on the rehabilitation of cognitive function and motor function in patients with stroke by single group target value method[J]. Chinese Acupuncture & Moxibustion, 2026, 46(2): 161-167. DOI: 10.13703/j.0255-2930.20241128-k0003.
[6]
CHEN X, ZHANG L, MAO W H, et al. Comparing the Effect of Acupuncture, Sham Acupuncture, and Waiting-List Control on Patients with Post-stroke Cognitive Impairment: A Randomized Clinical Trial[J/OL]. QJM, 2025 [2026-06-18]. https://dx.doi.org/10.1093/qjmed/hcaf181. DOI: 10.1093/qjmed/hcaf181.
[7]
WU B, ZHOU D, MEI Z. Targeting the neurovascular unit: Therapeutic potential of traditional Chinese medicine for the treatment of stroke[J/OL]. Heliyon, 2024, 10(19): e38200 [2026-06-18]. https://dx.doi.org/10.1016/j.heliyon.2024.e38200. DOI: 10.1016/j.heliyon.2024.e38200.
[8]
BAO Q, LIU Y, ZHANG X, et al. Clinical observation and mechanism of acupuncture on amnestic mild cognitive impairment based on the gut-brain axis: study protocol for a randomized controlled trial[J/OL]. Front Med (Lausanne), 2023, 10: 1198579 [2026-06-18]. https://dx.doi.org/10.3389/fmed.2023.1198579. DOI: 10.3389/fmed.2023.1198579.
[9]
GUO J, WANG G, LIU T, et al. Acupuncture Improves Chronic Cerebral Ischemia by Inhibiting the CKLF1/HIF-1α/VEGF/Notch1 Signaling Pathway[J/OL]. CNS Neurosci Ther, 2025, 31(3): e70246 [2026-06-18]. https://dx.doi.org/10.1111/cns.70246. DOI: 10.1111/cns.70246.
[10]
MIAO C, YAO F, FANG J, et al. Exploring the role of multimodal [(18)F]F-PSMA-1007 PET/CT and multiparametric MRI data in predicting ISUP grading of primary prostate cancer[J]. Eur J Nucl Med Mol Imaging, 2025, 52(6): 2087-2095. DOI: 10.1007/s00259-025-07099-0.
[11]
JIANG L, ZHOU L, YONG W, et al. A deep learning-based model for prediction of hemorrhagic transformation after stroke[J/OL]. Brain Pathol, 2023, 33(2): e13023 [2026-06-18]. https://dx.doi.org/10.1111/bpa.13023. DOI: 10.1111/bpa.13023.
[12]
MENG L, WU B, OUYANG L, et al. Electroacupuncture regulates histone acetylation of Bcl-2 and Caspase-3 genes to improve ischemic stroke injury[J/OL]. Heliyon, 2024, 10(6): e27045 [2026-06-18]. https://dx.doi.org/10.1016/j.heliyon.2024.e27045. DOI: 10.1016/j.heliyon.2024.e27045.
[13]
PANG R K, FENG Z, HE L T, et al. Research progress of nerve cell apoptosis and acupuncture intervention mechanism after cerebral ischemia reperfusion[J]. World Chinese Medicine, 2023, 18(4): 576-582. DOI: 10.3969/j.issn.1673-7202.2023.04.024.
[14]
LI N, WANG H, LIU H, et al. The effects and mechanisms of acupuncture for post-stroke cognitive impairment: progress and prospects[J/OL]. Front Neurosci, 2023, 17: 1211044 [2026-06-18]. https://dx.doi.org/10.3389/fnins.2023.1211044. DOI: 10.3389/fnins.2023.1211044.
[15]
FAN Z, DOU B, WANG J, et al. Effects and mechanisms of acupuncture analgesia mediated by afferent nerves in acupoint microenvironments[J/OL]. Front Neurosci, 2023, 17: 1239839 [2026-06-18]. https://dx.doi.org/10.3389/fnins.2023.1239839. DOI: 10.3389/fnins.2023.1239839.
[16]
XU N, XU S, WANG L. Bridging tradition and innovation: Acupuncture for depression through clinical efficacy and neurobiological insights[J/OL]. Complement Ther Med, 2026, 96: 103307 [2026-06-18]. https://dx.doi.org/10.1016/j.ctim.2025.103307. DOI: 10.1016/j.ctim.2025.103307.
[17]
WANG L, YANG J W, WANG Q Y, et al. Peripheral Electrical Nerve Stimulation Rescues Spatial Memory Deficits in Vascular Cognitive Impairment Rats by Engaging a Central Cholinergic Circuit[J/OL]. Stroke, 2026 [2026-06-18]. https://dx.doi.org/10.1161/strokeaha.125.053383. DOI: 10.1161/strokeaha.125.053383.
[18]
ZHOU Z Q, YANG Y J, MA X D, et al. Study on the mechanism of electroacupuncture penetration needling method in improving synovial inflammatory response of knee osteoarthritis through TLR4 / MyD88 / NF-κB signaling pathway[J]. Acupuncture Research, 2023, 48(4): 353-358, 365. DOI: 10.13702/j.1000-0607.20220418.
[19]
ZOU L, RUAN J R, CHEN J Y, et al,. Moxibustion inhibits inflammatory response by regulating the expression of miR-345-3p / miR-216a-5p in colon tissue of rats with diarrhea-predominant irritable bowel syndrome[J]. Acupuncture Research, 2023, 48(3): 226-232. DOI: 10.13702/j.1000-0607.20220005.
[20]
JIN B, GAO Y, FU Y, et al. Electroacupuncture improves cognitive function in a rat model of mild traumatic brain injury by regulating the SIRT-1/PGC-1α/mitochondrial pathway[J]. Chin Med J (Engl), 2024, 137(6): 711-719. DOI: 10.1097/cm9.0000000000003032.
[21]
WANG L, SU X T, YANG N N, et al. Electroacupuncture improves cerebral blood flow in pMCAO rats during acute phase via promoting leptomeningeal collaterals[J]. J Cereb Blood Flow Metab, 2025, 45(8): 1507-1518. DOI: 10.1177/0271678x241270240.
[22]
NING W H, LIU Y Y, LI Y Y. Study on the relationship between mitochondria and ischemic stroke and acupuncture intervention[J]. Acta Chinese Medicine, 2023, 38(11): 2282-2286. DOI: 10.16368/j.issn.1674-8999.2023.11.366.
[23]
LI J, ZHANG B, JIA W, et al. Activation of Adenosine Monophosphate-Activated Protein Kinase Drives the Aerobic Glycolysis in Hippocampus for Delaying Cognitive Decline Following Electroacupuncture Treatment in APP/PS1 Mice[J/OL]. Front Cell Neurosci, 2021, 15: 774569 [2026-06-18]. https://dx.doi.org/10.3389/fncel.2021.774569. DOI: 10.3389/fncel.2021.774569.
[24]
QIU Z, MA J, ZHANG X, et al. Electroacupuncture combined with trigonelline inhibits pyroptosis in cerebral ischemia-reperfusion by suppressing autophagy via the PI3K/AKT/mTOR signaling pathway[J/OL]. Brain Res Bull, 2025, 221: 111200 [2026-06-18]. https://dx.doi.org/10.1016/j.brainresbull.2025.111200. DOI: 10.1016/j.brainresbull.2025.111200.
[25]
XUE Y H, AN J M, ZHAO J, et al. Application progress of diffusion tensor imaging in acupuncture research[J]. World Chinese Medicine, 2023, 18(11): 1640-1644. DOI: 10.3969/j.issn.1673-7202.2023.11.026.
[26]
SCHILLIGER Z, PAVAN T, ALEMÁN-GÓMEZ Y, et al. Sex-differences in brain multimodal estimates of white matter microstructure during early adolescence: Sex-specific associations with biological factors[J]. Brain Behav Immun, 2025, 126: 98-110. DOI: 10.1016/j.bbi.2025.01.026.
[27]
MOHAMMADI M, ROOHOLLAHI F, MAHMOUDI M M, et al. Correlation Between Pre-Operative Diffusion Tensor Imaging Indices and Post-Operative Outcome in Degenerative Cervical Myelopathy: A Systematic Review and Meta-Analysis[J]. Global Spine J, 2024, 14(6): 1800-1817. DOI: 10.1177/21925682231225634.
[28]
ZHOU H, SI Y, SUN J, et al. Effectiveness of functional magnetic resonance imaging for early identification of chronic kidney disease: A systematic review and network meta-analysis[J/OL]. Eur J Radiol, 2023, 160: 110694 [2026-06-18]. https://dx.doi.org/10.1016/j.ejrad.2023.110694. DOI: 10.1016/j.ejrad.2023.110694.
[29]
CORROENNE R, PAPASTEFANOU I, MAHALLATI H, et al. Evolution of magnetic resonance diffusion tensor imaging metrics in the normal fetal brain[J]. Ultrasound Obstet Gynecol, 2025, 66(2): 226-232. DOI: 10.1002/uog.29275.
[30]
WANG H F. Study on multimodal neuroimaging and serum biological mechanism of "Yisui Xingshen" acupuncture in the treatment of post-stroke cognitive impairment[D]. Beijing: Beijing University of Chinese Medicine, 2024.
[31]
ZHONG H, LI G, WANG Y, et al. Green's Function Total Field Inversion for Quantitative Susceptibility Mapping[J]. IEEE Trans Med Imaging, 2026, 45(5): 1858-1871. DOI: 10.1109/tmi.2025.3639776.
[32]
FUSHIMI Y, NAKAJIMA S, SAKATA A, et al. Value of Quantitative Susceptibility Mapping in Clinical Neuroradiology[J]. J Magn Reson Imaging, 2024, 59(6): 1914-1929. DOI: 10.1002/jmri.29010.
[33]
SUN N, XIE F, WANG Z T, et al. Electroacupuncture to improve post-stroke cognitive function and modulate cerebral iron deposition: a randomized controlled trial protocol using MRI[J/OL]. Front Neurol, 2025, 16: 1708739 [2026-06-18]. https://dx.doi.org/10.3389/fneur.2025.1708739. DOI: 10.3389/fneur.2025.1708739.
[34]
LIU Q, XIAO K, WAN P, et al. Resting-State fMRI Reveals the Neural Correlates of Acupuncture in the Treatment of Vascular Cognitive Impairment[J]. Clin Interv Aging, 2025, 20: 1191-1204. DOI: 10.2147/cia.S529416.
[35]
MA Y, WANG Q, CAO L, et al. Multi-Scale Dynamic Graph Learning for Brain Disorder Detection With Functional MRI[J]. IEEE Trans Neural Syst Rehabil Eng, 2023, 31: 3501-3512. DOI: 10.1109/tnsre.2023.3309847.
[36]
YUE J, WANG P, GUO X F, et al. Perspectives on resting-state functional magnetic resonance imaging research in vascular dementia[J/OL]. Front Aging Neurosci, 2025, 17: 1547965 [2026-06-18]. https://dx.doi.org/10.3389/fnagi.2025.1547965. DOI: 10.3389/fnagi.2025.1547965.
[37]
LU Y, LIN Z, WANG H, et al. Buyang Huanwu Decoction enhances hippocampal-cortical connectivity remodeling via sonic hedgehog signaling to ameliorate memory dysfunction in cerebral ischemic rats[J/OL]. Chin Med, 2025, 20(1): 144 [2026-06-18]. https://dx.doi.org/10.1186/s13020-025-01122-0. DOI: 10.1186/s13020-025-01122-0.
[38]
MOON H S, VO T T, HO IM G, et al. Interhemispheric resting-state functional connectivity correlates with spontaneous neural interactions[J/OL]. Proc Natl Acad Sci U S A, 2025, 122(34): e2505294122 [2026-06-18]. https://dx.doi.org/10.1073/pnas.2505294122. DOI: 10.1073/pnas.2505294122.
[39]
LIU Z Q, LUPPI A I, HANSEN J Y, et al. Benchmarking methods for mapping functional connectivity in the brain[J]. Nat Methods, 2025, 22(7): 1593-1602. DOI: 10.1038/s41592-025-02704-4.
[40]
LIU R, HU Y, WU J, et al. Dynamic Graph Representation Learning for Spatio-Temporal Neuroimaging Analysis[J]. IEEE Trans Cybern, 2025, 55(3): 1121-1134. DOI: 10.1109/tcyb.2025.3531657.
[41]
BOYANG Z, YANG Z, LIYUAN F, et al. A neural regulation mechanism of head electroacupuncture on brain network of patients with stroke related sleep disorders[J]. J Tradit Chin Med, 2024, 44(6): 1268-1276. DOI: 10.19852/j.cnki.jtcm.2024.06.011.
[42]
WANG F, GAO S, YANG L. Efficacy Observation of Acupuncture Combined with Cognitive Training for Cognitive Impairment After Ischemic Stroke[J]. Shanghai Journal of Acupuncture and Moxibustion, 2021, 40(7): 795-800. DOI: 10.13460/j.issn.1005-0957.2021.07.0795.
[43]
CHEN X L. Influence of Acupuncture at Baihui Acupoint on Functional Brain Connectivity Network of Hippocampus in Patients with Post-Stroke Cognitive Impairment Based on rs-fMRI[D]. Tianjin: Tianjin University of Traditional Chinese Medicine, 2024.
[44]
LIU Z, WU H, XU Y, et al. Age-related regional homogeneity changes in first-episode major depressive disorder: a REST-meta-MDD project study[J/OL]. BMC Psychiatry, 2025, 25(1): 1049 [2026-06-18]. https://dx.doi.org/10.1186/s12888-025-07406-x. DOI: 10.1186/s12888-025-07406-x.
[45]
CHEN Y, LI R, WEI W, et al. Effect of uterine artery embolization therapy on ReHo values in brain regions related to pain perception and emotion regulation in adenomyosis patients accompanied by dysmenorrhea[J/OL]. J Pain, 2025, 33: 105445 [2026-06-18]. https://dx.doi.org/10.1016/j.jpain.2025.105445. DOI: 10.1016/j.jpain.2025.105445.
[46]
FU K L, ZHAO H L, ZHAO M L, et al. To explore the effect of acupuncture on brain function in patients with cognitive impairment after stroke based on resting state functional magnetic resonance imaging[J]. Guangming Journal of Chinese Medicine, 2025, 40(4): 650-654. DOI: 10.3969/j.issn.1003.8914.2025.04.008.
[47]
FAN K, ZHANG T, HE W. Multilevel Clustering-Evolutionary Random Support Vector Machine Cluster Algorithm-Based Functional Magnetic Resonance Imaging in Diagnosing Cerebral Ischemic Stroke[J/OL]. Sci Program, 2021 [2026-06-18]. https://dx.doi.org/10.1155/2021/3729379. DOI: 10.1155/2021/3729379.
[48]
WANG L, LIU Q, ZHENG Z, et al. Common neural dysfunction in psychiatric disorders: Insights from a meta-analysis of resting-state fMRI studies[J/OL]. Transl Psychiatry, 2025, 16(1): 29 [2026-06-18]. https://dx.doi.org/10.1038/s41398-025-03760-2. DOI: 10.1038/s41398-025-03760-2.
[49]
HU J, HUA Y, LI C, et al. Resting-State Functional Magnetic Resonance Imaging Reveals the Effects of rTMS on Neural Activity and Brain Connectivity After Experimental Stroke[J/OL]. CNS Neurosci Ther, 2024, 30(11): e70104 [2026-06-18]. https://dx.doi.org/10.1111/cns.70104. DOI: 10.1111/cns.70104.
[50]
WU Z, YU X, ZHANG Y, et al. Altered Brain Function and Network Topology in Patients With Acromegaly: Resting-State fMRI Study of Networks Related to Cognitive and Emotional Processing[J/OL]. CNS Neurosci Ther, 2026, 32(1): e70755 [2026-06-18]. https://dx.doi.org/10.1002/cns.70755. DOI: 10.1002/cns.70755.
[51]
MAO W H. Study on the central mechanism of ' Tiaoshen Yizhi ' acupuncture in the treatment of post-stroke cognitive impairment[D]. Tianjin: Tianjin University of Traditional Chinese Medicine, 2025.
[52]
WEN T, ZHANG X, LIANG S, et al. Electroacupuncture Ameliorates Cognitive Impairment and Spontaneous Low-Frequency Brain Activity in Rats with Ischemic Stroke[J]. J Stroke Cerebrovasc Dis, 2018, 27(10): 2596-2605. DOI: 10.1016/j.jstrokecerebrovasdis.2018.05.021.
[53]
MCGLADE E C, HAN D H, KIM S M, et al. Proton magnetic resonance spectroscopy (MRS) in individuals with internet gaming[J/OL]. Front Psychiatry, 2022, 13: 1031947 [2026-06-18]. https://dx.doi.org/10.3389/fpsyt.2022.1031947. DOI: 10.3389/fpsyt.2022.1031947.
[54]
XU M, LIU J, LIU Q, et al. Preliminary study on early diagnosis of Alzheimer's disease in APP/PS1 transgenic mice using multimodal magnetic resonance imaging[J/OL]. Front Aging Neurosci, 2024, 16: 1326394 [2026-06-18]. https://dx.doi.org/10.3389/fnagi.2024.1326394. DOI: 10.3389/fnagi.2024.1326394.
[55]
QIN C, LI B, ZHUO B, et al. Neuroimaging evidence of acupuncture in cognitive impairment following ischemic stroke: a systematic review[J/OL]. Front Neurosci, 2025, 19: 1629305 [2026-06-18]. https://dx.doi.org/10.3389/fnins.2025.1629305. DOI: 10.3389/fnins.2025.1629305.
[56]
WANG F, LIANG H, CHEN S, et al. Magnetic resonance spectroscopy study of acupuncture regulating brain tissue metabolism in the treatment of mild cognitive impairment after stroke[J]. Journal of Emergency in Traditional Chinese Medicine, 2014, 23(10): 1928-1930. DOI: 10.3969/j.issn.1004-745X.2014.10.072.
[57]
ZHANG J B, WEI R P, YANG H, et al. Scalp acupuncture combined with computer-aided training in the treatment of cognitive impairment after cerebral infarction in the elderly magnetic resonance spectroscopy imaging[J]. Chinese Journal of Gerontology, 2020, 40(19): 4067-4070. DOI: 10.3969/j.issn.1005-9202.2020.19.011.

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