Efficacy of scalp acupuncture for post stroke dysphagia: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND: Stroke persists as a paramount global health priority, maintaining persistently elevated incidence and mortality metrics across epidemiological registries. Post-stroke dysphagia, serving as a critical determinant of functional prognosis, imposes multidimensional burdens spanning aspiration pneumonia risk, nutritional compromise, and psychosocial well-being. This neurogenic deglutition disorder has consequently catalyzed clinical innovation in rehabilitation modalities, with scalp acupuncture emerging as a promising neuromodulatory intervention. METHODS: We conducted a systematic search of 8 databases for randomized controlled trials (RCTs) assessing scalp acupuncture treatment for post-stroke dysphagia. The primary outcomes included clinical efficacy, while the secondary outcomes comprised the Kubota Water Swallowing Test (WST), standardized swallowing assessment (SSA), videofluoroscopic dysphagia scale (VDS), and adverse events. Rigorous evaluation of potential biases within the selected studies was performed by the Cochrane Handbook (version 5.1.0) for systematic reviews of interventions. Heterogeneity among studies was addressed through sensitivity analysis. RESULTS: Based on data derived from 20 RCTs involving 1278 participants, the meta-analysis revealed significant clinical effective rate in the application of scalp acupuncture for post-stroke dysphagia [odds ratio = 4.45, 95% confidence interval (CI) (3.04, 6.51), P < .01], improvement in the Kubota WST [mean differences (MD) = -0.82, 95% CI (-1.04, -0.59), P < .00001], SSA [MD = -4.01, 95% CI (-4.59, -3.42), P < .00001], VDS [MD = -5.75, 95% CI (-8.33, -3.17), P < .0001], in comparison with the conventional rehabilitation protocols. Only one study reported adverse events. CONCLUSION: Current evidence suggests that scalp acupuncture therapy may be an effective measure for post-stroke dysphagia.