{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T04:26:12Z","timestamp":1787199972124,"version":"build-2736575974"},"reference-count":88,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Stroke is highly prevalent among older adults, and age-related reductions in neuroplastic reserve may limit motor recovery. This systematic review and network meta-analysis aimed to compare and rank the effects of noninvasive brain stimulation combined with acupuncture on post-stroke motor recovery, spasticity, balance, and activities of daily living (ADL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, the Cochrane Library, Web of Science, Scopus, CNKI, SinoMed, Wanfang, and CQVIP were searched from inception to July 1, 2026. Randomized controlled trials evaluating noninvasive brain stimulation, including TMS-based NIBS or transcranial direct current stimulation, combined with acupuncture or electroacupuncture were included. Pairwise and frequentist random-effects network meta-analyses were performed. Risk of bias was assessed using the Cochrane tool, and confidence in network estimates was evaluated using CINeMA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty-six randomized controlled trials involving 4,080 participants were included. Combined interventions generally showed greater effects than single-modality therapies or conventional rehabilitation, although heterogeneity was substantial. In the network meta-analysis, both TMS-based NIBS plus acupuncture and tDCS plus acupuncture showed favorable ranking probabilities across several outcomes. tDCS plus acupuncture ranked highly for FMA total, FMA-UE, and ADL, whereas TMS-based NIBS plus acupuncture ranked favorably for FMA-LE, spasticity, and balance. Differences between the two combined regimens were generally not statistically significant. CINeMA indicated moderate, low, or very low confidence across network estimates, with no high-confidence evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Combined noninvasive brain stimulation and acupuncture may provide additional benefits for post-stroke motor and functional recovery. However, current findings should be interpreted cautiously because of substantial heterogeneity, sparse evidence for some intervention nodes, risk-of-bias concerns, and limited confidence in several network estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251051398<\/jats:ext-link>\n                      , Identifier: CRD420251051398.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1901205","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T04:16:23Z","timestamp":1787199383000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Combined noninvasive brain stimulation and acupuncture for post-stroke motor recovery: a systematic review and network meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Qingping","family":"Su","sequence":"first","affiliation":[{"name":"College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, Fujian, China"]},{"name":"Rehabilitation Medicine Center, Fuzhou University Affiliated Provincial Hospital","place":["Fuzhou, Fujian, China"]},{"name":"National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changmei","family":"Lu","sequence":"additional","affiliation":[{"name":"College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, Fujian, China"]},{"name":"National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuping","family":"Yang","sequence":"additional","affiliation":[{"name":"College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, Fujian, China"]},{"name":"National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bao","family":"Wu","sequence":"additional","affiliation":[{"name":"College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, Fujian, China"]},{"name":"National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingfang","family":"Zhu","sequence":"additional","affiliation":[{"name":"College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, Fujian, China"]},{"name":"National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minguang","family":"Yang","sequence":"additional","affiliation":[{"name":"College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, Fujian, China"]},{"name":"National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Xu","sequence":"additional","affiliation":[{"name":"College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, Fujian, China"]},{"name":"National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhizhen","family":"Liu","sequence":"additional","affiliation":[{"name":"National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Tao","sequence":"additional","affiliation":[{"name":"National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, Fujian, China"]},{"name":"Traditional Chinese Medicine Rehabilitation Research Center of State Administration of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, Fujian, China"]},{"name":"Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fujian University of Traditional Chinese Medicine), Ministry of Education","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"880","DOI":"10.1177\/23969873231191304","article-title":"Motor rehabilitation after stroke: European stroke organisation (ESO) consensus-based definition and guiding framework","volume":"8","author":"Kwakkel","year":"2023","journal-title":"Eur Stroke 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