Assessor‐ and participant‐blinded, randomized controlled trial of dense cranial electroacupuncture stimulation plus body acupuncture for neuropsychiatric sequelae of stroke

Abstract

Aim Acupuncture has benefits in the rehabilitation of neuropsychiatric sequelae of stroke. This study was aimed to evaluate the effectiveness of dense cranial electroacupuncture stimulation plus body acupuncture (DCEAS+BA) in treating poststroke depression (PSD), functional disability, and cognitive deterioration. Methods In this assessor‐ and participant‐blinded, randomized controlled trial, 91 stroke patients who initially had PSD were randomly assigned to either DCEAS+BA (n = 45) or minimum acupuncture stimulation as controls (n = 46) for three sessions per week over 8 consecutive weeks. The primary outcome was baseline‐to‐end‐point change in score of the 17‐item Hamilton Depression Rating Scale. Secondary outcomes included the Montgomery–Åsberg Depression Rating Scale for depressive symptoms, the Barthel Index for functional disability, and the Montreal Cognitive Assessment for cognitive function. Results DCEAS+BA‐treated patients showed strikingly greater end‐point reduction than MAS‐treated patients in scores of the three symptom domains. The clinical response rate, defined as an at least 50% baseline‐to‐end‐point reduction in 17‐item Hamilton Depression Rating Scale score, was markedly higher in the DCEAS+BA‐treated group than that of controls (40.0% vs 17.4%, P = 0.031). Incidence of adverse events was not different in the two groups. Subgroup analysis revealed that DCEAS+BA with electrical stimulation on forehead acupoints was more apparent in reducing Barthel‐Index‐measured disability than that without electrical stimulation. Conclusion DCEAS+BA, particularly with electrical stimulation on forehead acupoints, reduces PSD, functional disability, and cognitive deterioration of stroke patients. It can serve as an effective rehabilitation therapy for neuropsychiatric sequelae of stroke.

Electroacupuncture on Trigeminal Nerve-Innervated Acupoints Ameliorates Poststroke Cognitive Impairment in Rats with Middle Cerebral Artery Occlusion: Involvement of Neuroprotection and Synaptic Plasticity

“…This result could be mainly attributed to the multiple effects of acupuncture. In fact, similar multiple effects were observed in our clinical study [ 20 ]. EA could reduce not only cognitive deterioration of stroke patients but also some other sequelae of stroke, such as poststroke depression and functional disability [ 20 ].…”

“…These results indicate that the MCAO group rats had not only impaired spatial learning and memory but also recognition decline, while the EA/TNS treatment could ameliorate these dysfunctions in both cognitive tests. This could provide additional animal behavior evidence to support the findings in our clinical study [ 20 ].…”

“…Systematic reviews have proposed that acupuncture may be effective on cognitive function after stroke [ 34 , 35 ]. This novel EA/TNS has applied into different kinds of cognitive impairment in clinical studies [ 20 , 36 ].…”

“…We have explored a novel acupuncture regimen named electroacupuncture trigeminal nerve stimulation (EA/TNS) [ 19 ]. Recently, we have published one directly related clinical trials of EA/TNS on PSCI patients, suggesting that EA on forehead acupoints could reduce cognitive deterioration of stroke patients [ 20 ]. We want to explore the mechanism of it through this study.…”

The effect of acupuncture on depression and its correlation with metabolic alterations

“…Disorders of short-chain fatty acid metabolism are also playing an increasingly important role in depression. [ 43 ] EA could modulate the intestinal flora of depressive rats in our other unpublished experiments. We are boldly suggesting whether acupoints such as Zusanli (ST36), may change the lipid metabolism by adjusting the intestinal flora, thereby improving the symptoms of depression and the cognitive ability of patients.…”