Antidepressant Monotherapy and Combination Therapy with Acupuncture in Depressed Patients: A Resting-State Functional Near-Infrared Spectroscopy (fNIRS) Study

Abstract

Depression is a common psychiatric illness affecting over 300 million people globally. Acupuncture has been reported to be a safe complementary treatment for depression. This study is aimed to investigate the efficacy and mechanism of combining acupuncture with antidepressants in treating depression compared to the sole use of antidepressants. Seventy depression patients were randomly assigned to the treatment group (n = 50) and control group (n = 20). The treatment group received acupuncture combined antidepressants treatment for 3 weeks, while the control group took antidepressants monotherapy for 3 weeks. Among the 70 patients, 40 participants (20 control; 20 treatment) were randomized for studying functional connectivity (FC) of the dorsolateral prefrontal cortex (DLPFC) measured by the functional near-infrared spectroscopy. The primary outcome was HAMD-17 and secondary outcomes were PHQ-9, and the relationships of resting-state FC (rsFC) with the depression severity. PHQ-9 and HAMD-17 scores in the treatment group were significantly lower than those in the control group at Week 3 (p = 0.01) with effect sizes of -0.4 and -0.61 respectively. The rsFC in F1, F3, AF3, AF7, FC3, FC5 (left DLPFC, 10-20 system), AF8, and F6 (right DLPFC) in the treatment group had significant temporal correlation (p < 0.05, FDR corrected) in DLPFC compared to the channels in the control group. No significant correlation was found between the changes of rsFC and depression severity. In conclusion, depressed patients receiving acupuncture combined with antidepressants have improvement of depressive symptoms and the stronger rsFC in the DLPFC compared to those using antidepressants alone.

Keywords: Acupuncture; Antidepressant; Clinical trial; Depression; Functional near-infrared spectroscopy.

Conflict of interest statement

The authors declare that they have no competing interests or personal relationships that could have appeared to influence the work reported in this paper.

© 2021. The American Society for Experimental NeuroTherapeutics, Inc.

Figures

Fig. 1

fNIRS device recording of DLPFC hemodynamic changes. A An illustration of fNIRS device. B Locations of sources, detectors, and channels. C Graphic representation of resting-state hemodynamic concentration changes in the DLPFC. DLPFC: dorsolateral prefrontal cortex; fNIRS: Functional near-infrared spectroscopy

Fig. 2

Flow chart

Fig. 3

The resting-state functional connectivity in oxyhemoglobin. A Grand average value of functional connectivity in oxyhemoglobin. B Significant channel pairs for oxyhemoglobin

Fig. 4

The resting-state functional connectivity in deoxyhemoglobin. A Grand average value of functional connectivity in deoxyhemoglobin. B Significant channel pair for deoxyhemoglobin

Fig. 5

The resting-state functional connectivity for total hemoglobin. A Grand average value of functional connectivity in total hemoglobin. B Significant channel pairs for total hemoglobin