Efficacy of acupuncture for tension-type headache prophylaxis: systematic review and meta-analysis with trial sequential analysis

Background Acupuncture has been shown to reduce tension-type headache (TTH) frequency in previous studies. Nevertheless, repeated significance testing might inflate type I error. We aimed to verify the effectiveness and safety of acupuncture in reducing TTH frequency by meta-analysis and trial seque...

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Bibliographic Details
Published in:Journal of neurology 2023-07, Vol.270 (7), p.3402-3412
Main Authors: Tao, Qing-Feng, Wang, Xiao-Ying, Feng, Si-Jia, Xiao, Xin-Yu, Shi, Yun-Zhou, Xie, Chao-Rong, Zheng, Hui
Format: Article
Language:English
Subjects:
Acupuncture
Headache
Medicine
Medicine & Public Health
Meta-analysis
Neurology
Neuroradiology
Neurosciences
Prophylaxis
Review
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Summary:Background Acupuncture has been shown to reduce tension-type headache (TTH) frequency in previous studies. Nevertheless, repeated significance testing might inflate type I error. We aimed to verify the effectiveness and safety of acupuncture in reducing TTH frequency by meta-analysis and trial sequential analysis (TSA). Methods Ovid Medline, Embase, and Cochrane Library were searched until September 29, 2022. Randomized controlled trials comparing acupuncture with sham acupuncture, no acupuncture, or other active therapies in adults with TTH were included. The primary outcome was TTH frequency. The secondary outcomes were responder rate and adverse event. Results Fourteen studies involving 2795 participants were included. Acupuncture had more reduction than sham acupuncture in TTH frequency, both after treatment (standardized mean difference [SMD] − 0.80, 95% CI − 1.36 to − 0.24, P  = 0.005) and at the follow-up period (SMD − 1.33, 95% CI − 2.18 to − 0.49, P  = 0.002), while TSA showed the included sample size did not exceed required information size (RIS). Acupuncture was superior over no acupuncture after treatment (SMD − 0.52, 95% CI − 0.63 to − 0.41, P  
ISSN:0340-5354
1432-1459
DOI:10.1007/s00415-023-11695-1