Electroacupuncture in Post-Stroke Cognitive Impairment: A Review From the Perspective of Programmed Cell Death

Stroke remains a leading cause of mortality and long-term disability worldwide, and post-stroke cognitive impairment (PSCI) is among its most prevalent and debilitating sequelae. Accumulating evidence suggests that electroacupuncture (EA) modulates dysregulated programmed cell death (PCD) after stroke, including apoptosis, autophagy, ferroptosis, and pyroptosis, which play central roles in neuronal loss, synaptic disruption, and cognitive decline. Specifically, EA may suppress excessive neuronal apoptosis and ferroptosis, modulate autophagic activity, and attenuate pyroptosis-associated neuroinflammation. However, the mechanisms underlying the effects of EA in PSCI remain fragmented, and the lack of standardized treatment protocols limits its clinical translation. In this review we integrate clinical findings with molecular and cellular evidence to propose a unified mechanistic framework in which EA may improve cognitive function and may act through modulation of multiple PCD pathways. We further highlight EA as a potential multi-target and network-oriented intervention with therapeutic potential in stroke rehabilitation, providing a mechanistic basis for future studies and standardized clinical application.