Dense Cranial Electroacupuncture Stimulation for Major Depressive Disorder—A Single-Blind, Randomized, Controlled Study

BACKGROUND: Previous studies suggest that electroacupuncture possesses therapeutic benefits for depressive disorders. The purpose of this study was to determine whether dense cranial electroacupuncture stimulation (DCEAS) could enhance the antidepressant efficacy in the early phase of selective serotonin reuptake inhibitor (SSRI) treatment of major depressive disorder (MDD). METHODS: In this single-blind, randomized, controlled study, patients with MDD were randomly assigned to 9-session DCEAS or noninvasive electroacupuncture (n-EA) control procedure in combination with fluoxetine (FLX) for 3 weeks. Clinical outcomes were measured using the 17-item Hamilton Depression Rating Scale (HAMD-17), Clinical Global Impression-severity (CGI-S), and Self-rating Depression Scale (SDS) as well as the response and remission rates. RESULTS: Seventy-three patients were randomly assigned to n-EA (n = 35) and DCEAS (n = 38), of whom 34 in n-EA and 36 in DCEAS group were analyzed. DCEAS-treated patients displayed a significantly greater reduction from baseline in HAMD-17 scores at Day 3 through Day 21 and in SDS scores at Day 3 and Day 21 compared to patients receiving n-EA. DCEAS intervention also produced a higher rate of clinically significant response compared to n-EA procedure (19.4% (7/36) vs. 8.8% (3/34)). The incidence of adverse events was similar in the two groups. CONCLUSIONS: DCEAS is a safe and effective intervention that augments the antidepressant efficacy. It can be considered as an additional therapy in the early phase of SSRI treatment of depressed patients. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN88008690

Epidemiological and electrophysiological studies for TCM-based diagnostic classification of insomnia

TCM-based diagnostic classification is the essence of Chinese medicine theories and remains as the foundation for individualized remedies. The philosophy of TCM syndrome stratification of Excess and Deficiency is an empirical concept yet to need scientific recognition. This thesis reported two studies which were conducted by employing the concept of Excess and Deficiency classifications as the major axis, with a view to identify prominent epidemiological and electrophysiological changes in insomnia among different internal equilibrium conditions. The paper started with a comprehensive literature review outlining the updated prevalence, diagnosis and conventional treatment of insomnia. An introduction of Chinese medicine perspectives of the disease was also discussed, serving grounds for the conduction of the two studies covered in this thesis. The first study was an epidemiological survey examining the differences in Chinese medicine syndromes concerning subjects’ demographic, sleep pattern, medical-seeking behavior, clinical outcome and emotion scores. Significant associations were found between Chinese medicine syndromes and gender, work hour, duration of insomnia and several related sleep parameters, as well as clinical outcome for herbal prescriptions and proprietary medicines. Inertia to proper medical care was observed and emotion scores from validated scales showed psychiatric attention should be required in large proportion of the sample. Awareness of insomnia should be raised in prevention for adverse consequences of unattended symptoms. The second study was an electrophysiological research summarizing the electrical conductivity of selected acupuncture points commonly used for treating insomnia. Subsequent analysis was also conducted from the TCM-based diagnostic perspectives to compare such measurements among healthy volunteers and insomniacs of Excess and Deficiency syndromes. Conspicuous differences were discovered in the entire set of auricular acupuncture points being tested, as well as some of the body acupuncture points. The study warranted quantifiable changes in electric current of acupuncture points upon stratification of Chinese medicine syndromes. The breakthrough guaranteed the significance of syndrome classification in the course of diagnosis and treatment procedures for insomnia. In conclusion, our work consolidated evidence for the importance in TCM-based diagnostic classification in insomnia. This might provide insight for future advancement of related Chinese medicine research in the field of sleep medicine.published_or_final_versionChinese MedicineDoctoralDoctor of Philosoph

Dense Cranial Electroacupuncture Stimulation for Major Depressive Disorder-A Single-Blind, Randomized, Controlled Study

Abstract Background: Previous studies suggest that electroacupuncture possesses therapeutic benefits for depressive disorders. The purpose of this study was to determine whether dense cranial electroacupuncture stimulation (DCEAS) could enhance the antidepressant efficacy in the early phase of selective serotonin reuptake inhibitor (SSRI) treatment of major depressive disorder (MDD)

Mean changes from baseline in score on the 17-item Hamilton Rating Scale for Depression (HAMD-17), Clinical Global Impression-Severity (CGI-S) and Self-rating Depression Scale (SDS).

<p>Data are expressed as mean with 95% confidence interval (95% CI). * <i>P</i>≤0.037: between-group comparison using Student <i>t</i>-test.</p

Changes in score on depression scales from baseline in MDD patients.

a<p>Overall and between-group <i>P</i> values were obtained from linear mixed-effects model analysis and student <i>t</i>-test, respectively.</p><p>MDD, major depressive disorder; n-EA, noninvasive electroacupuncture; DCEAS, dense cranial electroacupuncture stimulation; 95% CI, 95% confidence interval; HAMD-17, 17-item Hamilton Rating Scale for Depression; CGI-S, Clinical Global Impression-Severity; SDS, Self-rating Depression Scale.</p

Acupoints used in dense cranial electroacupuncture stimulation (DCEAS).

<p>Acupoints used in dense cranial electroacupuncture stimulation (DCEAS).</p

Adverse events occurred in at least 5% of patients in either group.

a<p><i>P</i> values were calculated from Fisher Exact test.</p><p>n-EA, noninvasive electroacupuncture; DCEAS, dense cranial electroacupuncture stimulation.</p

Erratum to: Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition) (Autophagy, 12, 1, 1-222, 10.1080/15548627.2015.1100356

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