Abstract
BackgroundOur previous studies have demonstrated the treatment benefits of dense cranial electroacupuncture stimulation (DCEAS), a novel brain stimulation therapy in patients with major depression, postpartum depression and obsessive-compulsive disorder. The purpose of the present study was to further evaluate the effectiveness of DCEAS combined with body acupuncture and selective serotonin reuptake inhibitors (SSRIs) in patients with post-stroke depression (PSD).MethodsIn a single-blind, randomized controlled trial, 43 patients with PSD were randomly assigned to 12 sessions of DCEAS plus SSRI plus body electroacupuncture (n = 23), or sham (non-invasive cranial electroacupuncture, n-CEA) plus SSRI plus body electroacupuncture (n = 20) for 3 sessions per week over 4 weeks. Treatment outcomes were measured using the 17-item Hamilton Depression Rating Scale (HAMD-17), the Clinical Global Impression - Severity scale (CGI-S) and Barthel Index (BI), a measure used to evaluate movement ability associated with daily self-caring activity.ResultsDCEAS produced a significantly greater reduction of both HAMD-17 and CGI-S as early as week 1 and CGI-S at endpoint compared to n-CEA, but subjects of n-CEA group exhibited a significantly greater improvement on BI at week 4 than DCEAS. Incidence of adverse events was not different in the two groups.ConclusionsThese results indicate that DCEAS could be effective in reducing stroke patients’ depressive symptoms. Superficial electrical stimulation in n-CEA group may be beneficial in improving movement disability of stroke patients. A combination of DCEAS and body acupuncture can be considered a treatment option for neuropsychiatric sequelae of stroke.Trial registrationhttp://www.clinicaltrials.gov, NCT01174394.
Highlights
Our previous studies have demonstrated the treatment benefits of dense cranial electroacupuncture stimulation (DCEAS), a novel brain stimulation therapy in patients with major depression, postpartum depression and obsessive-compulsive disorder
We have developed a novel brain stimulation called dense cranial electroacupuncture stimulation (DCEAS), in which electrical stimulation is directly delivered on a group of acupoints on the forehead, which are innervated by the trigeminal sensory pathway [10]
A majority of subjects (86%) were having selective serotonin reuptake inhibitors (SSRIs) treatment at study entry and 78% of them were treated with FLX
Summary
Our previous studies have demonstrated the treatment benefits of dense cranial electroacupuncture stimulation (DCEAS), a novel brain stimulation therapy in patients with major depression, postpartum depression and obsessive-compulsive disorder. The purpose of the present study was to further evaluate the effectiveness of DCEAS combined with body acupuncture and selective serotonin reuptake inhibitors (SSRIs) in patients with post-stroke depression (PSD). Apart from the general understanding that acupuncture is effective in chronic pain treatment [7], its efficacy for post-stroke conditions have been investigated. A meta-analysis reported the therapeutic benefits of acupuncture on stroke related disability [8]. Another study reported acupuncture as safe and effective in treating PSD [9]. In a recent systematic review and meta-analysis it has been suggested that acupuncture might be superior to antidepressants and waitlist controls in improving clinical response and reducing depressive symptoms of PSD patients [9]. As a number of these trials lacked methodological vigour, further appropriately design clinical studies are recommended to verify the conclusions
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