Acupuncture in neural stem cell-based therapy for cognitive impairment

Table 1 Comparison of neuromodulation modalities relevant to brain-function regulation

Modality	Core physical carrier	Typical biological “entry points”	Strengths for dementia-relevant brain regulation	Key constraints/risks
Photonic, e.g., photobiomodulation	Light (red/NIR)	Mitochondrial cytochrome c oxidase, redox signaling, cerebral blood flow	Non-invasive; potential metabolic and vascular effects; clinically scalable	Uncertain dose window; limited tissue penetration; heterogeneous protocols[18-20]
Electrical, e.g., tDCS/tACS	Electric fields/currents	Membrane polarization, oscillatory entrainment	Low cost; portable; growing evidence base from RCTs and meta-analyses in cognitive impairment/dementia	Variable field delivery; modest effect sizes; placebo sensitivity; montage heterogeneity[21-23]
Magnetic, e.g., rTMS	Magnetic pulses inducing electric fields	Cortical excitability, circuit plasticity	Can target circuits; clinical infrastructure exists	Protocol variability; challenging sham-controlled designs; mixed durability of effects[24-26]
Acoustic, e.g., transcranial ultrasound stimulation	Focused ultrasound pressure waves	Mechanosensitive channels	Deep targeting capability; emerging precision and focality	Safety standards still evolving; parameter sensitivity; limited clinical data[27-29]
Acupuncture	Mechanical stimulation at acupoints; afferent nerve activation	Afferent nerve activation; peripheral-central neuroimmune and autonomic pathways; local niche modulation (e.g., miR-124/Notch-Wnt signaling)	Engages whole-body systems; modulates inflammation and metabolism; suitable for repeated dosing; potential to prime stem-cell niche	Protocol heterogeneity; blinding difficulties; need for rigorous mechanism-based controls[30-33]

NIR: Near-infrared; tDCS: Transcranial direct current stimulation; tACS: Transcranial alternating current stimulation; RCT: Randomized controlled trial; rTMS: Repetitive transcranial magnetic stimulation.