A pilot controlled trial of a combination of dense cranial electroacupuncture stimulation and body acupuncture for post-stroke depression

Sui-Cheung Man, Ben H B Hung, Roger M K Ng, Xiao-Chun Yu, Hobby Cheung, Mandy P M Fung, Leonard S W Li, Kwok-Pui Leung, Kei-Pui Leung, Kevin W Y Tsang, Eric Ziea, Vivian T Wong, Zhang-Jin Zhang, Sui-Cheung Man, Ben H B Hung, Roger M K Ng, Xiao-Chun Yu, Hobby Cheung, Mandy P M Fung, Leonard S W Li, Kwok-Pui Leung, Kei-Pui Leung, Kevin W Y Tsang, Eric Ziea, Vivian T Wong, Zhang-Jin Zhang

Abstract

Background: 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).

Methods: In 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.

Results: DCEAS 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.

Conclusions: These 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 registration: http://www.clinicaltrials.gov, NCT01174394.

Figures

Figure 1
Figure 1
Enrollment flow. Of 345 patients screened, 43 eligible subjects were randomly assigned to n-CEA (sham) (n = 20) and DCEAS (n = 23) group. For n-CEA (sham), 14 subjects completed; while for DCEAS, 19 completed.
Figure 2
Figure 2
Changes in score from baseline on HAMD-17, CGI-S, and BI over time.

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