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Experimental evidence for electroacupuncture in managing pain from chemotherapy-induced peripheral neuropathy: a systematic review and meta-analysis

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: This study systematically evaluated the evidence from animal experiments on electroacupuncture (EA) for chemotherapy-induced peripheral neuropathy (CIPN) pain models. A systematic review and meta-analysis was conducted using the PICOS framework to assess the behavioral and molecular effects of EA and clarify its underlying mechanisms and translational potential. Thirteen eligible studies involving 235 animals were included. Methodological quality scores ranged from 5 to 8, with a mean of 6.5. Meta-analysis showed that EA significantly increased the paw withdrawal threshold (PWT), thermal pain withdrawal latency (PWL), and nerve conduction velocity (NCV), while reducing cold allodynia. At the molecular level, EA significantly decreased the expression of pro-inflammatory and sensitization markers, including TNF-α, IL-1β, GFAP, TLR4, TRPA1, and TRPV1, and increased the oxidative stress regulator Nrf2. Sensitivity analysis, publication bias assessment, subgroup analysis, and meta-regression were performed for the highly heterogeneous PWT outcome. Significant publication bias was identified and may account for much of the observed heterogeneity. Sensitivity analysis for TRPV1 suggested that this result may be disproportionately influenced by individual studies and should therefore be interpreted cautiously. Heterogeneity in the remaining outcomes likely reflects differences in animal models, acupoint selection, treatment duration, and intervention protocols. Overall, EA demonstrated analgesic and neuroprotective effects in CIPN models, primarily through modulation of neuroinflammation, attenuation of oxidative stress, and reduction of neuronal sensitization. These findings provide systematic preclinical evidence supporting EA as a promising adjuvant therapy for CIPN pain and highlight the need for high-quality clinical trials to optimize treatment protocols and facilitate clinical translation.

Source: Brazilian Journal of Medical and Biological Research

DOI: 10.1590/1414-431x2026e15562