Scalp Acupuncture Combined with Mouse Nerve Growth Factor Acupoint Injection for Post-stroke Cognitive Impairment

Clinical Snapshot

Key Findings

• P Value: Group C vs. Group A: P < 0.001; Group C vs. Group B: P = 0.003; ADL between groups: F = 28.963, P < 0.001; FMA between groups: F = 29.745, P < 0.001; MBI between groups: F = 35.872, P < 0.001

• Effect Size: Mean difference Group C vs. Group A: +5.2 MoCA points (exceeds commonly cited MCID of ~2 points); Mean difference Group C vs. Group B: +2.9 MoCA points

• Primary Outcome: MoCA score at 4 weeks post-intervention: Group C (triple therapy) 26.7 ± 2.9 vs. Group B (dual therapy) 23.8 ± 3.2 vs. Group A (conventional training alone) 21.5 ± 3.5

• Nnt Or Sensitivity: NNT cannot be calculated — no dichotomous responder threshold defined. No hazard ratios or relative risk data provided. Between-group F-statistics suggest large effect sizes across all secondary outcomes.

• Confidence Interval: Group A MoCA: 95% CI 20.22–22.78; Group B MoCA: 95% CI 22.48–25.12; Group C MoCA: 95% CI 25.53–27.87 (non-overlapping between A and C, and between B and C)

Clinical Application

Scalp acupuncture is feasible in settings with trained practitioners and is increasingly available in integrative rehabilitation units. However, mNGF acupoint injection requires a mouse-derived biological product that is not standard of care in Western rehabilitation medicine, requires specific preparation and administration expertise, and carries immunogenic risk. Replication outside specialised Chinese rehabilitation centres would require significant infrastructure and regulatory approval. Mouse nerve growth factor (mNGF) is not approved by the Therapeutic Goods Administration (TGA) for use in Australia and is not listed on the Pharmaceutical Benefits Scheme (PBS). Its use in Australian clinical practice would require TGA Special Access Scheme (SAS) approval or clinical trial authorisation. Scalp acupuncture is practised by registered acupuncturists in Australia under AHPRA (Chinese Medicine Board of Australia) registration, but is not a standard component of RACGP or AuSPEN stroke rehabilitation guidelines. The RACGP and Stroke Foundation Australia guidelines emphasise evidence-based cognitive rehabilitation and pharmacological management of vascular risk factors; neither scalp acupuncture nor mNGF injection is currently recommended. Australian clinicians should note that this evidence, from a single Chinese centre with significant methodological limitations, is insufficient to support practice change. Adults with confirmed post-stroke cognitive impairment undergoing inpatient or outpatient rehabilitation, particularly those with mild-to-moderate cognitive deficits amenable to structured cognitive training programmes

Abstract

Post-stroke cognitive impairment (PSCI) markedly impairs rehabilitation efficacy and quality of life. Safe and effective interventions are urgently needed. Eighty-four patients with PSCI were randomly allocated into three groups (n = 28 per group). Group A received conventional cognitive training. Group B received conventional training plus scalp acupuncture. Group C received the treatment of Group B combined with mouse nerve growth factor (mNGF) acupoint injection. All interventions lasted 4 weeks. All groups exhibited significant within-group improvements in MoCA, ADL, MBI, and FMA scores after intervention. Group C achieved the optimal cognitive efficacy:​ the post-treatment MoCA score was 26.7 ± 2.9 (95% CI, 25.53-27.87), significantly higher than that in Group A (21.5 ± 3.5 (95% CI, 20.22-22.78), P < 0.001) and Group B (23.8 ± 3.2)(95% CI, 22.48-25.12), P = 0.003). The ADL score in Group C was the lowest among the three groups (F = 28.963, P < 0.001), suggesting better independence. Moreover, motor function (FMA) and basic self-care ability (MBI) were also significantly improved in all groups after intervention. There were significant inter-group differences in post-treatment FMA and MBI scores (F-FMA = 29.745, P < 0.001; F-MBI = 35.872, P < 0.001). The scores increased gradually from Group A to Group C, with Group C achieving the best improvement. Conventional cognitive training improves cognitive function and daily living ability in patients with PSCI. Scalp acupuncture combined with conventional training is more effective than training alone. The triple therapy of conventional training, scalp acupuncture, and mNGF acupoint injection further enhances rehabilitation outcomes, with prominent clinical application value.

References

1. 1.Zhou, H., Li, M., Liu, Y., Cheng, X., & Ma, T. (2026). Scalp acupuncture combined with mouse nerve growth factor acupoint injection for post-stroke cognitive impairment. Journal of Molecular Neuroscience, advance online publication. https://doi.org/10.1007/s12035-025-03992-1