From empirical efficacy to neurovascular and cerebrovascular systems perspective: a bibliometric and visualized analysis of traditional Chinese medicine for vascular dementia.

OBJECTIVE

Vascular dementia (VaD) is a major form of cognitive impairment associated with cerebrovascular injury, neuroinflammation, oxidative stress, impaired neurovascular coupling, and progressive disruption of brain homeostasis. Traditional Chinese medicine (TCM)-related interventions for VaD encompass heterogeneous categories, including herbal formulas, single herbs, natural products, plant-derived bioactive compounds, acupuncture, electroacupuncture, and moxibustion. Within this broad landscape, the herbal and natural-product branch provides an important interface linking TCM research with food-medicine homology, neurological nutrition, and neurovascular protection. This bibliometric study aimed to map the research landscape, knowledge structure, hotspots, and emerging trends of TCM-related interventions for VaD, with particular attention to herbal, natural-product, and neurovascular research.

METHODS

English-language articles and reviews related to TCM treatment of VaD published from 1997 to 2025 were retrieved from the Web of Science Core Collection. VOSviewer, CiteSpace, and GraphPad Prism were used to analyze annual publication trends, countries/regions, institutions, authors, journals, co-cited references, and keywords. To address intervention heterogeneity, the findings were interpreted across herbal/natural-product, acupuncture/electroacupuncture, moxibustion, and mixed TCM-related categories.

RESULTS

A total of 357 publications were included, comprising 256 original articles and 101 reviews. China ranked first with 281 publications and occupied a central position in the collaboration network. High-frequency keywords included "vascular dementia," "acupuncture," "cognitive impairment," "oxidative stress," "apoptosis," "hippocampus," and "chronic cerebral hypoperfusion." Two major research branches were identified. Herbal formulas, single herbs, natural products, and active compounds were mainly associated with oxidative stress, neuroinflammation, apoptosis, autophagy, chronic cerebral hypoperfusion, component characterization, and multi-target regulation. In contrast, acupuncture, electroacupuncture, and moxibustion were more closely related to neuromodulation, hippocampal plasticity, cerebral perfusion, and functional recovery. Emerging topics included network pharmacology, expression profiling, inflammasomes, component characterization, and mixed vascular-neurodegenerative mechanisms.

CONCLUSION

The TCM-VaD literature represents a heterogeneous research landscape involving both herbal/natural-product and non-pharmacological intervention branches. Herbal medicines, natural products, and plant-derived bioactive compounds constitute the branch most directly connected with food-medicine homology, neurological nutrition, antioxidant and anti-inflammatory regulation, and neurovascular protection. However, bibliometric attention should not be interpreted as evidence of validated efficacy, and conclusions concerning phytoactive compounds should not be generalized to acupuncture- or moxibustion-related research. Future studies should strengthen intervention stratification, component standardization, mechanistic validation, and clinical translation.