Speech and language therapy plus electroacupuncture or non-invasive brain stimulation for post-stroke aphasia: a systematic review and network meta-analysis

Background The combination of speech and language therapy (SLT) with acupuncture, electroacupuncture, and non-invasive brain stimulation is commonly used in clinical practice and scientific research for post-stroke aphasia (PSA). Objective This study assesses the therapeutic effectiveness of SLT-based combination therapies in improving language function in patients with PSA. Methods PubMed, CBM, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang Data and Chinese Scientific Journals Database (VIP) were searched through 2 December, 2024. This study included randomized controlled trials (RCTs) that compared the influence of SLT-based combination treatments and controls on language function in patients with PSA. The meta-analysis was conducted using random effects NMA. Results A total of 66 studies were included. The NMA assessing the effectiveness of various interventions for improving speech, repetition, and listening comprehension skills following SLT revealed that combined therapies generally outperformed SLT alone. For speaking skills, SLT + Electroacupuncture demonstrated the highest likelihood of improvement (SUCRA = 84.6). For repetition scores, SLT + Electroacupuncture was effective (SUCRA = 92.0). In listening comprehension, SLT + tDCS showed the greatest potential for improvement (SUCRA = 89.8). Conclusions The results revealed that any type of SLT-based combination intervention was more effective than SLT alone. PROSPERO registration number: CRD42022343595.