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Sun HL, Bai W, Chen P, Zhang L, Smith RD, Su Z, Cheung T, Ungvari GS, Ng CH, Zhang Q, Xiang YT. Pain trajectories and their associations with cognition among older adults: a 10-year cohort study from network perspective. Age Ageing 2024; 53:afae054. [PMID: 38521972 PMCID: PMC10960922 DOI: 10.1093/ageing/afae054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Few studies have examined the associations between pain trajectories and cognitive function in older adults. This study explored the associations between pain trajectories and different cognitive domains in older adults from a network perspective. METHODS Data on pain trajectories were derived from the Health and Retirement Study between 2010 and 2020 using latent class growth analyses. Measurements of key cognition domains, including memory, attention, calculation, orientation and language, were included. Linear regression and network analysis were performed to evaluate the associations between different pain trajectories and cognition. RESULTS A total of 9,551 older adults were included in this study and three trajectories of pain were identified. After controlling for the covariates, persistent severe pain trajectory was associated with poorer overall cognition, memory and calculation ability when compared to mild or non-persistent pain trajectory. In the pain and cognition network model, memory (expected influence (EI) = 0.62), language (EI = 0.58) and calculation (EI = 0.41) were the most central domains. CONCLUSIONS Pain trajectories appeared stable over time among older adults in this study. Severity of persistent pain was an important risk factor for poor cognition, especially in relation to memory and calculation domains. Interventions targeting memory, language and calculation domains might be useful in addressing cognitive decline in older adults with persistent pain.
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Affiliation(s)
- He-Li Sun
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Wei Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Pan Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Ling Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, Beijing Anding Hospital; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Robert D Smith
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Gabor S Ungvari
- Section of Psychiatry, University of Notre Dame Australia, Fremantle, Australia
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent’s Hospital, University of Melbourne, Richmond, Victoria, Australia
| | - Qinge Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, Beijing Anding Hospital; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
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Lyu YR, Lee HY, Park HJ, Kwon OJ, Kim AR, Jung IC, Park YC, Cho JH, Kim JE, Kim M, Lee JH, Kim JH. Electroacupuncture for Cancer-Related Cognitive Impairment: A Clinical Feasibility Study. Integr Cancer Ther 2022; 21:15347354221098983. [PMID: 35608027 PMCID: PMC9134458 DOI: 10.1177/15347354221098983] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/20/2022] [Accepted: 04/20/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Cancer-related cognitive impairment (CRCI) is a significant problem for cancer patients, as the number of cancer survivors experiencing cognitive impairments is increasing in the absence of standard treatment. There have been attempts to improve the cognitive function of patients with cancer using acupuncture; however, no studies have been conducted using electroacupuncture. Thus, we designed a preliminary study to investigate the feasibility of a clinical trial using electroacupuncture in CRCI patients. METHODS We conducted a single-arm, pilot, clinical trial to investigate the feasibility of a study protocol for further large-scale clinical trials of electroacupuncture in CRCI patients. All participants were treated with electroacupuncture twice a week for 30 minutes at a time, for 8 weeks on acupoints GV20, GV24, EX-HN1, and GB20, HT7, PC6, and KI3. Both subjective and objective outcomes of cognitive function, quality of life (QoL), and psychological factors were measured in all participants at baseline, week 4, 8, and 12. For safety assessment, vital signs, laboratory examinations, and adverse events (AEs) were observed throughout the trial. RESULTS A total of 12 participants were enrolled at Daejeon and Dunsan Korean Medicine Hospital of Daejeon University from 21 April 2017 to 31 January 2018. After 8 weeks of treatment, electroacupuncture significantly improved both subjective and objective cognitive outcomes, including the perceived cognitive impairments scale of the Functional Assessment of Cancer Therapy-Cognitive Function, QoL scale of the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire-C30, Korean version of Montreal Cognitive Assessment, Boston Naming Test, Seoul Verbal Learning Test, and Rey Complex Figure Test. During the entire trial period, 19 AEs were observed, with no serious AEs. Additionally, it was found that all feasibility outcomes, including recruitment, completion, and adherence rates, achieved successful results as the ratio exceeded 0.8. CONCLUSION Our study results revealed that electroacupuncture improved cognitive complaints in cancer patients, and we expect electroacupuncture to be a safe and effective management therapy for CRCI patients. These feasibility trial results will be used as preliminary data for future randomized controlled clinical trials. TRIAL REGISTRATION NUMBER Korean Clinical Trial Registry (KCT0002168).
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Affiliation(s)
- Yee Ran Lyu
- Korea Institute of Oriental Medicine,
Daejeon, Republic of Korea
| | - Hye-Yoon Lee
- Pusan National University, Yangsan,
Republic of Korea
| | - Hyo-Ju Park
- Korea Institute of Oriental Medicine,
Daejeon, Republic of Korea
| | - O-jin Kwon
- Korea Institute of Oriental Medicine,
Daejeon, Republic of Korea
| | - Ae-Ran Kim
- Korea Institute of Oriental Medicine,
Daejeon, Republic of Korea
| | | | | | | | - Jung-Eun Kim
- Pusan National University Hospital,
Busan, Republic of Korea
| | - Mikyung Kim
- Sangji University, Wonju, Gangwon-do,
Republic of Korea
| | - Jun-Hwan Lee
- Korea Institute of Oriental Medicine,
Daejeon, Republic of Korea
- University of Science & Technology
(UST) Daejeon, Republic of Korea
| | - Joo-Hee Kim
- Sangji University, Wonju, Gangwon-do,
Republic of Korea
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Yan B, Wang FC, Ma TS, Liu YZ, Liu W, Cheng L, Wang ZY, Wang ZK, Liu CY. Efficacy and safety of electroacupuncture treatment in the prevention of negative moods in healthy young men after 30 h of total sleep deprivation: study protocol for a single-center, single-blind, parallel-arm, randomized clinical trial. Trials 2021; 22:761. [PMID: 34724966 PMCID: PMC8559366 DOI: 10.1186/s13063-021-05659-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 09/27/2021] [Indexed: 11/22/2022] Open
Abstract
Background Sleep deprivation (SD) among young adults is a major public health concern. In humans, it has adverse effects on mood and results in serious health problems. Faced with SD, persons may take precautionary measures to try and reduce their risk. The aim of this study is to evaluate the efficacy and safety of electroacupuncture (EA) for the prevention of negative moods after SD. In addition, we will do a comparison of the effects of EA on mood after SD at different time points. Methods This randomized controlled trial (RCT) will be performed at the First Affiliated Hospital of Changchun University of Chinese Medicine in China. The Standards for Reporting Interventions in Clinical Trials of Acupuncture 2010 will be strictly adhered to. Forty-two healthy male volunteers will be distributed into acupoints electroacupuncture (AE) group, non-acupoints electroacupuncture (NAE) control group, or blank control group. This trial will comprise 1-week baseline (baseline sleep), 1-week preventative treatment, 30-h total sleep deprivation (TSD), and 24-h after waking follow-up period. Participants in the AE group and the NAE control group during the preventative treatment period will be administered with EA treatment once daily for 1 week. Participants in the blank control group will not be administered with any treatment. The primary outcome will be the Profile of Mood States (POMS) Scale. Secondary outcome measures will include changes in the Noldus FaceReader (a tool for automatic analysis of facial expressions) and Positive and Negative Affect Schedule (PANAS) Scale. Total sleep deprivation will be 30 h. During the 30-h TSD period, participants will be subjected to 11 sessions of assessment. Adverse events will be recorded. Discussion This study is designed to evaluate the efficacy and safety of EA for the prevention of negative moods after SD. The results of this trial will allow us to compare the effects of EA on mood after SD at different time points. Moreover, the findings from this trial will be published in peer-reviewed journals. Trial registration Chinese Clinical Trial Registry Chi2000039713. Registered on 06 November 2020
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Affiliation(s)
- Bing Yan
- School of Acupuncture-Moxibustion and Tuina, Changchun University of Chinese Medicine, Changchun, China
| | - Fu-Chun Wang
- Department of Acupuncture, The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Tian-Shu Ma
- Innovative Practice Center, Changchun University of Chinese Medicine, Changchun, China
| | - Yan-Ze Liu
- School of Acupuncture-Moxibustion and Tuina, Changchun University of Chinese Medicine, Changchun, China
| | - Wu Liu
- School of Acupuncture-Moxibustion and Tuina, Changchun University of Chinese Medicine, Changchun, China
| | - Lei Cheng
- School of Acupuncture-Moxibustion and Tuina, Changchun University of Chinese Medicine, Changchun, China
| | - Zi-Yuan Wang
- School of Acupuncture-Moxibustion and Tuina, Changchun University of Chinese Medicine, Changchun, China
| | - Zhong-Ke Wang
- School of Acupuncture-Moxibustion and Tuina, Changchun University of Chinese Medicine, Changchun, China
| | - Cheng-Yu Liu
- School of Rehabilitation Medicine, Changchun University of Chinese Medicine, Changchun, China.
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Efectividad de la acupuntura y la auriculoterapia para reducir el nivel de depresión, ansiedad y estrés en personal sanitario de urgencias durante la pandemia de COVID-19. REVISTA INTERNACIONAL DE ACUPUNTURA 2021. [PMCID: PMC8157320 DOI: 10.1016/j.acu.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objetivo Analizar la efectividad de una intervención mediante acupuntura y auriculoterapia para la reducción clínica de síntomas de estrés y ansiedad en personal sanitario durante la pandemia de COVID-19. Diseño Estudio prospectivo de comparación de 2 cohortes. Emplazamiento Urgencias del Hospital de Palamós, Girona. Participantes Sanitarios del servicio de urgencias. Participaron 22 profesionales, 11 en cada grupo. Intervenciones Se aplicó la versión abreviada de las Escalas de Depresión, Ansiedad y Estrés (DASS-21) a todos los participantes, los del grupo de intervención (GI) recibieron además 6 sesiones de acupuntura y auriculoterapia. Posteriormente se repitió la escala DASS-21. Mediciones Las variables fueron grupo, sexo, edad, categoría profesional, años de experiencia en urgencias, escala DASS-21 con sus subescalas para estrés, ansiedad y depresión. Resultados El 45,4% de los profesionales sufrían estrés, el 40,9% ansiedad y el 27,2% depresión. Hay una reducción del estrés en un 90,9% del GI frente al 18,2% del grupo control (GC) y esta es estadísticamente significativa. Hay una reducción de la ansiedad en un 81,8% del GI frente al 63,6% del GC: p = 0,065; odds ratio: 2,57 (intervalo de confianza del 95%, 0,36-18,33). La media de la ansiedad del GI es estadísticamente inferior en el valor postintervención que en el valor preintervención (1,36 frente a 3,90; p = 0,003), mientras que en el GC (3,09 frente a 2,45; p = 0,208). Hay una reducción del nivel de depresión en un 81,8% del GI frente al 45,5% del GC (p = 0,183). Conclusiones La acupuntura es un tratamiento que mejora los niveles de estrés y ansiedad de los profesionales sanitarios frente a la COVID-19.
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Shetty GB, Jacob J, Shetty P, Mooventhan A, Aryal P, Asha BK. Effect of acupuncture on cognitive task performance of college students: a pilot study. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2020; 18:633-636. [PMID: 34592075 DOI: 10.1515/jcim-2020-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 07/08/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Reduction in cognitive function of college students affects their academic recitation. Acupuncture is widely practiced for health promotion. Objective of this study was to evaluate the effect of acupuncture on cognitive task performance in college students. METHODS Sixty students aged 18-25 years were randomly allocated into acupuncture group (AG) (n=30) and control group (CG) (n=30). The AG underwent 20 min of acupuncture/day, while the CG underwent their normal routine for 10 days. Assessments were performed before and after the intervention. RESULTS Between-group analysis showed a significant increase in the six-letter cancellation test (SLCT) score in AG compared with CG. Within-group analysis showed a significant increase in the scores of all tests (i.e. SLCT, forward and backward Digit span test [DST]) in AG, while a significant increase in backward DST was observed in CG. CONCLUSION Acupuncture has a beneficial effect on improving the cognitive function of college students.
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Affiliation(s)
- Geetha B Shetty
- Department of Nutrition and Physical Therapies, SDM College of Naturopathy and Yogic Sciences, Ujire, Karnataka, India
| | - Jithin Jacob
- SDM College of Naturopathy and Yogic Sciences, Ujire, Karnataka, India
| | - Prashanth Shetty
- Department of Naturopathy, SDM College of Naturopathy and Yogic Sciences, Ujire, Karnataka, India
| | - A Mooventhan
- Department of Research and Development, Government Yoga and Naturopathy Medical College, Chennai, Tamilnadu, India
| | - Pratikshya Aryal
- SDM College of Naturopathy and Yogic Sciences, Ujire, Karnataka, India
| | - B K Asha
- SDM College of Naturopathy and Yogic Sciences, Ujire, Karnataka, India
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McCarberg B, Peppin J. Pain Pathways and Nervous System Plasticity: Learning and Memory in Pain. PAIN MEDICINE 2020; 20:2421-2437. [PMID: 30865778 DOI: 10.1093/pm/pnz017] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objective This article reviews the structural and functional changes in pain chronification and explores the association between memory and the development of chronic pain. Methods PubMed was searched using the terms "chronic pain," "central sensitization," "learning," "memory," "long-term potentiation," "long-term depression," and "pain memory." Relevant findings were synthesized into a narrative of the processes affecting pain chronification. Results Pain pathways represent a complex sensory system with cognitive, emotional, and behavioral influences. Anatomically, the hippocampus, amygdala, and anterior cortex-central to the encoding and consolidation of memory-are also implicated in experiential aspects of pain. Common neurotransmitters and similar mechanisms of neural plasticity (eg, central sensitization, long-term potentiation) suggest a mechanistic overlap between chronic pain and memory. These anatomic and mechanistic correlates indicate that chronic pain and memory intimately interact on several levels. Longitudinal imaging studies suggest that spatiotemporal reorganization of brain activity accompanies the transition to chronic pain, during which the representation of pain gradually shifts from sensory to emotional and limbic structures. Conclusions The chronification of pain can be conceptualized as activity-induced plasticity of the limbic-cortical circuitry resulting in reorganization of the neocortex. The state of the limbic-cortical network determines whether nociceptive signals are transient or chronic by extinguishing pathways or amplifying signals that intensify the emotional component of nociceptive inputs. Thus, chronic pain can be seen as the persistence of the memory of pain and/or the inability to extinguish painful memories. Ideally, pharmacologic, physical, and/or psychological approaches should reverse the reorganization accompanying chronic pain.
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Affiliation(s)
- Bill McCarberg
- Chronic Pain Management Program, Kaiser Permanente, San Diego, California; †University of California, San Diego, California; ‡Neighborhood Health, San Diego, California; §College of Osteopathic Medicine, Marian University, Indianapolis, Indiana; ¶John F. Peppin, DO, LLC, Hamden, Connecticut
| | - John Peppin
- Chronic Pain Management Program, Kaiser Permanente, San Diego, California; †University of California, San Diego, California; ‡Neighborhood Health, San Diego, California; §College of Osteopathic Medicine, Marian University, Indianapolis, Indiana; ¶John F. Peppin, DO, LLC, Hamden, Connecticut
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Zhang ZJ, Man SC, Yam LL, Yiu CY, Leung RCY, Qin ZS, Chan KWS, Lee VHF, Kwong A, Yeung WF, So WKW, Ho LM, Dong YY. Electroacupuncture trigeminal nerve stimulation plus body acupuncture for chemotherapy-induced cognitive impairment in breast cancer patients: An assessor-participant blinded, randomized controlled trial. Brain Behav Immun 2020; 88:88-96. [PMID: 32305573 DOI: 10.1016/j.bbi.2020.04.035] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/08/2020] [Accepted: 04/13/2020] [Indexed: 02/07/2023] Open
Abstract
Chemotherapy causes various side effects, including cognitive impairment, known as 'chemobrain'. In this study, we determined whether a novel acupuncture mode called electroacupuncture trigeminal nerve stimulation plus body acupuncture (EA/TNS + BA) could produce better outcomes than minimum acupuncture stimulation (MAS) as controls in treating chemobrain and other symptoms in breast cancer patients. In this assessor- and participant-blinded, randomized controlled trial, 93 breast cancer patients under or post chemotherapy were randomly assigned to EA/TNS + BA (n = 46) and MAS (n = 47) for 2 sessions per week over 8 weeks. The Montreal Cognitive Assessment (MoCA) served as the primary outcome. Digit span test was the secondary outcomes for attentional function and working memory. The quality of life and multiple functional assessments were also evaluated. EA/TNS + BA treated group had much better performance than MAS-treated group on reverse digit span test at Week 2 and Week 8, with medium effect sizes of 0.53 and 0.48, respectively, although no significant differences were observed in MoCA score and prevalence of chemobrain between the two groups. EA/TNS + BA also markedly reduced incidences of diarrhoea, poor appetite, headache, anxiety, and irritation, and improved social/family and emotional wellbeing compared to MAS. These results suggest that EA/TNS + BA may have particular benefits in reducing chemotherapy-induced working memory impairment and the incidence of certain digestive, neurological, and distress-related symptoms. It could serve as an effective intervention for breast cancer patients under and post chemotherapy (trial registration: https://www.clinicaltrials.gov: NCT02457039).
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Affiliation(s)
- Zhang-Jin Zhang
- Department of Chinese Medicine, The University of Hong Kong Shenzhen Hospital (HKU-SZH), Shenzhen, Guangdong 518053, China; School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | - Sui-Cheung Man
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Lo-Lo Yam
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Chui Ying Yiu
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Roland Ching-Yu Leung
- Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Zong-Shi Qin
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Kit-Wa Sherry Chan
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Victor Ho Fun Lee
- Department of Clinical Oncology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Ava Kwong
- Department of Surgery, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Wing-Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Winnie K W So
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territory, Hong Kong
| | - Lai Ming Ho
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Ying-Ying Dong
- Department of Psychosomatic Disorders, The Seventh People Hospital of Shaoxing, Shaoxing, Zhejiang 312000, China.
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Effects of a chattering teeth training oral appliance for working memory improvement in healthy volunteers: a cross-over randomized trial. Integr Med Res 2019; 8:247-251. [PMID: 31768310 PMCID: PMC6872829 DOI: 10.1016/j.imr.2019.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/23/2019] [Accepted: 09/24/2019] [Indexed: 11/22/2022] Open
Abstract
Background Memory is an important part of the mental activity. Chattering teeth training practiced in Korean Medicine (known as gochi in Korean), which is a practice of making a sound by touching the upper and the lower teeth, has been accepted as a modality for the dental health. The purpose of this study is to confirm the effect of a specially designed intraoral appliance, the No-Sick Exerciser, on working memory improvement in healthy participants. Methods Thirty healthy participants aged between 16 and 30 years will be recruited and randomized into sequence A and B of 15 each, as in a cross-over design (sequence A: chattering teeth training oral appliance)-chewing the gum; sequence B: chewing the gum-chattering teeth training oral appliance with a washout period of one week. The primary outcome will be assessed by the digit span test and secondary outcomes by the symbol digit modality test and the word list recall, which will be conducted before and after each intervention, four times on each participant. Discussion This protocol proposes the rationale and method for the use of an intraoral appliance for working memory improvement. If the oral appliance demonstrates better feasibility for working memory improvement compared with chewing gum, a large scale study will be needed to investigate the effectiveness of the device on populations who require memory improvement.
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Suh HW, Kim J, Kwon O, Cho SH, Kim JW, Kwak HY, Kim Y, Lee KM, Chung SY, Lee JH. Neurocircuitry of acupuncture effect on cognitive improvement in patients with mild cognitive impairment using magnetic resonance imaging: a study protocol for a randomized controlled trial. Trials 2019; 20:310. [PMID: 31146774 PMCID: PMC6543690 DOI: 10.1186/s13063-019-3446-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 05/13/2019] [Indexed: 02/06/2023] Open
Abstract
Background Mild cognitive impairment (MCI) is defined as a decline in cognitive state with preservation of activities of daily living. Medications such as donepezil and rivastigmine have been commonly prescribed for MCI, but their use is controversial. Acupuncture has been widely used in Korea and has been shown to improve cognitive function. The aim of this study is to evaluate the efficacy of acupuncture for MCI and investigate the effect of acupuncture on structural and functional brain changes in patients with MCI. Methods This study is a randomized, assessor-blinded, sham-controlled trial. Fifty participants with MCI will be randomly assigned to the acupuncture group (n = 25) or sham acupuncture group (n = 25). The acupuncture group will receive acupuncture treatment at nine acupuncture points (GV20, EX-HN1, bilateral LI4, and ST36) twice a week for 12 weeks. The sham acupuncture group will receive sham acupuncture treatment at the same points with non-penetrating sham needles. Both groups will be restricted from all other treatments for the improvement of cognitive function. The primary outcome measure is the Digit Span Test (DST). The secondary outcome measures are the Digit Symbol Substitution Test (DSST), Korean version of Montreal Cognitive Assessment (MoCA-K), Seoul Neuropsychological Screening Battery-II (SNSB-II), Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory (STAI), working memory (WM) task performance score, and structural/functional brain changes. Outcomes will be assessed at screening, baseline, 4 and 8 weeks, and after the end of treatment. We will also observe adverse events. In the statistical analysis, a full analysis set and per-protocol analysis will be performed. Discussion This randomized clinical trial aims to examine the efficacy of acupuncture treatment for MCI. Neuropsychological tests, psychological inventories for measuring depression and anxiety, and magnetic resonance imaging will be performed to investigate the underlying neurological mechanisms and the association between cognition, emotion, and brain networks following acupuncture treatment. The results of the trial will provide evidence supporting the efficacy of acupuncture and also add to the neurobiological understanding of acupuncture treatment for MCI. Trial registration Clinical Research Information Service, KCT0002896. Registered on 25 May 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3446-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hyo-Weon Suh
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Jieun Kim
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, 34054, Republic of Korea
| | - Ojin Kwon
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, 34054, Republic of Korea
| | - Seung-Hun Cho
- Department of Neuropsychiatry, Kyung Hee University Medical Center Korean Medicine Hospital, Seoul, 02447, Republic of Korea
| | - Jong Woo Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea.,Department of Neuropsychiatry, Kyung Hee University Korean Medicine Hospital at Gangdong, Seoul, 05278, Republic of Korea
| | - Hui-Yong Kwak
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Yunna Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea.,Department of Neuropsychiatry, Kyung Hee University Medical Center Korean Medicine Hospital, Seoul, 02447, Republic of Korea
| | - Kyung Mi Lee
- Department of Radiology, Kyung Hee University Hospital, Seoul, 02447, Republic of Korea.,Department of Radiology, Kyung Hee University College of Medicine, Seoul, 02447, Republic of Korea
| | - Sun-Yong Chung
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea. .,Department of Neuropsychiatry, Kyung Hee University Korean Medicine Hospital at Gangdong, Seoul, 05278, Republic of Korea.
| | - Jun-Hwan Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, 34054, Republic of Korea. .,Korean Medicine Life Science, University of Science & Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon, 34054, Republic of Korea.
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Zhang W, Lang S, Zheng Y, Qin X, Chen H, You Y, Ou H. The Effects of Transcranial Direct Current Stimulation Versus Electroacupuncture on Working Memory in Healthy Subjects. J Altern Complement Med 2019; 25:637-642. [PMID: 31033335 DOI: 10.1089/acm.2018.0532] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: Working memory (WM) can influence human thought processes through interactions with perception, long-term memory, and behavior. In recent years, transcranial direct current stimulation (tDCS) and electric acupuncture have been used to improve the performance of WM. Therefore, due to the n-back task as a continuous performance task that is commonly used to measure WM, the aim of this study is to investigate the differences in short-term efficacy between tDCS and electroacupuncture on WM under n-back task paradigm in healthy subjects. Methods: Forty-four college students (age: 23.70 ± 1.52 years; education: 16.93 ± 2.24 years) were recruited as experimental subjects and randomly divided into two groups by a random double-blind two-stage crossover experiment design. Group A received a tDCS intervention followed by at least 1 week of washout period and then the electroacupuncture intervention. Group B had the opposite sequence of interventions. The WM test under the n-back task paradigm was conducted before and after each intervention, and the changes in the accuracy (number of correct responses) and correct response time (RT) before and after the interventions were detected. The data were statistically analyzed using SPSS 24.0 to compare the short-term efficacy of tDCS and electroacupuncture on WM under different tasks. Results: In the 0-back task and 1-back tasks, there was no significant difference in the accuracy or RT before and after the interventions between tDCS and electroacupuncture stimulation. In the 2-back task, there was no significant difference in the accuracy before and after interventions between tDCS and electroacupuncture stimulation. However, there was a significant difference in RT (p < 0.05), which was lower after tDCS than after electroacupuncture in the 2-back task. Conclusion: The results show that tDCS with anodal stimulation on the left dorsolateral prefrontal cortex could increase the RT of the 2-back task performance in comparison with electroacupuncture stimulation of the Baihui (GV20) and Shenting (DU24) acupoints. The present results indicate that tDCS may have greater impact on WM in healthy subjects than electroacupuncture stimulation.
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Affiliation(s)
- Wenjing Zhang
- 1 Department of Rehabilitation, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shijuan Lang
- 1 Department of Rehabilitation, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuxin Zheng
- 1 Department of Rehabilitation, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xi Qin
- 1 Department of Rehabilitation, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hongxin Chen
- 1 Department of Rehabilitation, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yaoyao You
- 1 Department of Rehabilitation, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Haining Ou
- 1 Department of Rehabilitation, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,2 Experiment Education Model Center of Rehabilitation Medicine, Guangzhou Medical University, Guangzhou, China.,3 Department of Rehabilitation, Guangdong Province Hospital of Chinese Medicine, Guangzhou, China
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11
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Razavy S, Gadau M, Zhang SP, Wang FC, Bangrazi S, Berle C, Li T, Li WH, Zaslawski C. Anxiety related to De Qi psychophysical responses as measured by MASS: A sub-study embedded in a multisite randomised clinical trial. Complement Ther Med 2018; 39:24-35. [PMID: 30012389 DOI: 10.1016/j.ctim.2018.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 05/09/2018] [Accepted: 05/16/2018] [Indexed: 12/17/2022] Open
Abstract
Acupuncture has been broadly applied in the management of many diseases and conditions; however, its mechanism of action has been partially elucidated. Additionally, assessment of psychophysical responses in the acupuncture therapy is not common regarding anxiety disorder studies. Taken together, the therapeutic effect of acupuncture appears when De Qi psychophysical response is experienced following stimulation of the afferent sensory nerves. The present study investigates the level of anxiety perceived at different occasions in acupuncture and mock laser group. Furthermore, it examines the relationship between perceived De Qi psychophysical response and the level of anxiety experienced during administration of each intervention. The study was embedded in a two-arm parallel design multi-center, randomized clinical trial, the Tennis Elbow Acupuncture-International Study-China, Hong Kong, Australia, Italy. Participants' level of anxiety was measured using a validated instrument, the Massachusetts General Hospital Acupuncture Sensation Mood Scale. Ninety-six participants with Lateral Elbow Pain were randomly allocated into two groups; the acupuncture treatment group (n = 47) and the inactive mock laser control group (n = 49). Data were collected immediately following the interventions at the first and the ninth session within the clinical trial. Acupuncture with De Qi did not induce higher level of anxiety compared to prior administration of acupuncture. In fact, participants were more relaxed after receiving acupuncture than those who received mock laser. There was also a weak association between participants' perception of anxiety during acupuncture and the MASS De Qi Index in session nine only (p < 0.01). Further investigation of the result revealed weak positive correlation between anxiety perceived during administration of acupuncture and the following De Qi characteristics; 'soreness' (p < 0.01), 'Deep pressure' (p < 0.05), 'Heaviness' (p < 0.05), and 'Fullness/distension' (p < 0.05). Acupuncture can be regarded as a potential therapy for preoperative anxiety through its possible regulatory function of emotion. While culture may not alter the expectation of the individual regarding anxiety, symptomology associated with anxiety should be understood within the context of the cultural background.
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Affiliation(s)
- Shohreh Razavy
- School of Life Sciences, University of Technology Sydney, Sydney 2007, New South Wales, Australia
| | - Marcus Gadau
- School of Chinese Medicine, Hong Kong Baptist University, China
| | - Shi Ping Zhang
- School of Chinese Medicine, Hong Kong Baptist University, China
| | - Fu Chun Wang
- Changchun University of Traditional Chinese Medicine, Changchun 130117, Jilin, China
| | | | - Christine Berle
- School of Life Sciences, University of Technology Sydney, Sydney 2007, New South Wales, Australia
| | - Tie Li
- Changchun University of Traditional Chinese Medicine, Changchun 130117, Jilin, China
| | - Wei Hong Li
- School of Life Sciences, University of Technology Sydney, Sydney 2007, New South Wales, Australia
| | - Christopher Zaslawski
- School of Life Sciences, University of Technology Sydney, Sydney 2007, New South Wales, Australia.
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12
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Amorim D, Amado J, Brito I, Fiuza SM, Amorim N, Costeira C, Machado J. Acupuncture and electroacupuncture for anxiety disorders: A systematic review of the clinical research. Complement Ther Clin Pract 2018; 31:31-37. [PMID: 29705474 DOI: 10.1016/j.ctcp.2018.01.008] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 01/29/2018] [Indexed: 11/17/2022]
Abstract
Anxiety disorders are one of the most common mental health concerns with a major contribution to the global burden of disease. When not treated, anxiety can be aggravated to more serious and complicated health problems. Pharmacology and psychotherapy stand for the conventional treatment for anxiety disorders but these present limited efficacy, especially in the case of chronic anxiety, with high relapse rates and often causing adverse side effects. Clinical research studies render acupuncture as a valid treatment therapy for anxiety disorders without significant adverse effects. The objective of this paper is to review the literature on the effectiveness of acupuncture and electroacupuncture for the treatment of patients with anxiety disorders in order to find strong scientific evidence for its regular practice in Western culture. The systematic review of the clinical research was focused on published clinical trials (controlled, randomized and non-randomized) regarding the treatment of anxiety with acupuncture. Only clinical trials where anxiety was treated as the therapeutic target, and not as a secondary measurement or being associated with other health condition or disease, were considered. Two authors extracted the data independently and exclusion and inclusion criteria were set. The search rendered 1135 papers addressing anxiety as a primary therapeutic target. After review, 13 papers were identified to match exclusion and inclusion criteria and were selected for this analysis. Methodology, design, and quality of the research were highly variable and are discussed and compared. Overall, there is good scientific evidence encouraging acupuncture therapy to treat anxiety disorders as it yields effective outcomes, with fewer side effects than conventional treatment. More research in this area is however needed.
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Affiliation(s)
- Diogo Amorim
- Instituto de Medicina Integrativa, Rua Afonso Duarte nº10 A, 3030-402 Coimbra, Portugal.
| | - José Amado
- Escola Superior de Enfermagem de Coimbra, Avenida Bissaya Barreto (Polo A), Apartado 7001, 3046-851 Coimbra, Portugal
| | - Irma Brito
- Escola Superior de Enfermagem de Coimbra, Avenida Bissaya Barreto (Polo A), Apartado 7001, 3046-851 Coimbra, Portugal
| | - Sónia M Fiuza
- Instituto de Medicina Integrativa, Rua Afonso Duarte nº10 A, 3030-402 Coimbra, Portugal
| | - Nicole Amorim
- Instituto de Medicina Integrativa, Rua Afonso Duarte nº10 A, 3030-402 Coimbra, Portugal
| | - Cristina Costeira
- Instituto Português de Oncologia de Coimbra, Av. Bissaya Barreto 98, 3000-075 Coimbra, Portugal
| | - Jorge Machado
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua de Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal
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13
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Goyatá SLT, Avelino CCV, Santos SVMD, Souza Junior DID, Gurgel MDSL, Terra FDS. Effects from acupuncture in treating anxiety: integrative review. Rev Bras Enferm 2017; 69:602-9. [PMID: 27355312 DOI: 10.1590/0034-7167.2016690325i] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 11/01/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to evaluate the scientific evidence that is available in the literature on the effects of acupuncture for treating anxiety and on the quality of such studies. METHOD the study is an integrative review of CINAHL, LILACS, PUBMED-PICO, SciELO, and The Cochrane Library between 2001 and 2014. Keywords anxiety, acupuncture therapy, acupuncture, and anxiety disorders were combined among themselves to ensure a wide search of primary studies. RESULTS among 514 articles, 67 were selected to be fully read and 19 were included. Among these, 11 were found to have strong evidence levels. Among the six articles about randomized clinical studies, five were found to be of reasonable quality. Two studies used acupuncturist nurses to perform their interventions. Its results showed positive and statistically significant effects from using acupuncture for treating subjects with anxiety. CONCLUSION acupuncture seems to be a promising treatment for anxiety; however, there is a need for improving the methodological quality of the research on this field.
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Affiliation(s)
| | | | - Sérgio Valverde Marques Dos Santos
- Programa de Pós-Graduação Enfermagem Fundamental, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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14
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Gaesser AH, Karan OC. A Randomized Controlled Comparison of Emotional Freedom Technique and Cognitive-Behavioral Therapy to Reduce Adolescent Anxiety: A Pilot Study. J Altern Complement Med 2016; 23:102-108. [PMID: 27642676 DOI: 10.1089/acm.2015.0316] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The objective of this pilot study was to compare the efficacy of Emotional Freedom Techniques (EFT) with that of Cognitive-Behavioral Therapy (CBT) in reducing adolescent anxiety. DESIGN Randomized controlled study. SETTINGS This study took place in 10 schools (8 public/2 private; 4 high schools/6 middle schools) in 2 northeastern states in the United States. PARTICIPANTS Sixty-three high-ability students in grades 6-12, ages 10-18 years, who scored in the moderate to high ranges for anxiety on the Revised Children's Manifest Anxiety Scale-2 (RCMAS-2) were randomly assigned to CBT (n = 21), EFT (n = 21), or waitlist control (n = 21) intervention groups. INTERVENTIONS CBT is the gold standard of anxiety treatment for adolescent anxiety. EFT is an evidence-based treatment for anxiety that incorporates acupoint stimulation. Students assigned to the CBT or EFT treatment groups received three individual sessions of the identified protocols from trained graduate counseling, psychology, or social work students enrolled at a large northeastern research university. OUTCOME MEASURES The RCMAS-2 was used to assess preintervention and postintervention anxiety levels in participants. RESULTS EFT participants (n = 20; M = 52.16, SD = 9.23) showed significant reduction in anxiety levels compared with the waitlist control group (n = 21; M = 57.93, SD = 6.02) (p = 0.005, d = 0.74, 95% CI [-9.76, -1.77]) with a moderate to large effect size. CBT participants (n = 21; M = 54.82, SD = 5.81) showed reduction in anxiety but did not differ significantly from the EFT (p = 0.18, d = 0.34; 95% CI [-6.61, 1.30]) or control (p = 0.12, d = 0.53, 95% CI [-7.06, .84]). CONCLUSIONS EFT is an efficacious intervention to significantly reduce anxiety for high-ability adolescents.
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Affiliation(s)
- Amy H Gaesser
- 1 Department of Educational Studies, Counseling and Development Program, Purdue University , West Lafayette, IN
| | - Orv C Karan
- 2 Department of Educational Psychology, Counseling Program, University of Connecticut , Storrs, CT
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Hazards of insomnia and the effects of acupuncture treatment on insomnia. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2016; 14:174-86. [DOI: 10.1016/s2095-4964(16)60248-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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16
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The effect of acupuncture on mood and working memory in patients with depression and schizophrenia. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2015; 13:380-90. [DOI: 10.1016/s2095-4964(15)60204-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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17
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Beikmoradi A, Najafi F, Roshanaei G, Pour Esmaeil Z, Khatibian M, Ahmadi A. Acupressure and anxiety in cancer patients. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e25919. [PMID: 26019908 PMCID: PMC4441788 DOI: 10.5812/ircmj.25919] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 01/04/2015] [Accepted: 02/23/2015] [Indexed: 11/16/2022]
Abstract
Background: Anxiety has negative effects on mental and physical performance, quality of life, duration of hospitalization, and even on the treatment of patients with cancer. Objectives: Today acupressure is widely used to treat anxiety. Thus, the present study aimed to investigate the effects of acupressure on anxiety in patients with cancer. Patients and Methods: A double-blind randomized clinical trial was conducted on 85 patients hospitalized with 3 groups including acupressure group (n = 27), sham group (n = 28), and control group (n = 30) in the hematologic ward of Shahid Beheshti Hospital of Hamadan, Iran, in 2013. The sampling permuted-block randomization with triple block was used. The anxiety of the patients in the experimental, sham, and control groups were measured with Spielberger’s State-Trait Anxiety Inventory (STAI). Then, real acupressure was performed in the experimental group and fake acupressure in the sham group, and only routine care was provided for the control group. Anxiety of the patients was also assessed at 5 and 10 days after the intervention. Statistical analysis of the data was performed by SPSS software using repeated measures analysis of variance (ANOVA) and post hoc least significant difference (LSD) test. Results: According to the findings, the mean level of anxiety before the intervention between groups were matched (P > 0.05). Acupressure had a significant influence on the anxiety in the experimental group at 5 (45.30 ± 7.14) and 10 days (43.48 ± 6.82) after the intervention (P < 0.05). However, it did not have a significant impact on their covert anxiety (45.48 ± 7.92 at 5th day vs 45.63 ± 8.08 at 10th day, P > 0.05). No significant differences were observed in the fake points regarding overt and covert anxiety of patients in the sham group (overt anxiety; 47.57 ± 7.85 at 5th day vs. 46.71 ± 7.32 at 10th day, P > 0.05) (covert anxiety; 47.96 ± 6.33 at 5th day vs. 46.89 ± 6.94 at 10th day, P > 0.05). Moreover, the routine care provided for the control group did not have any effect on the overt and covert anxiety of the patients (P > 0.05). Conclusions: Acupressure is recommended as a complementary therapy to reduce anxiety in patients with cancer because of its low cost, safety, and simplicity.
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Affiliation(s)
- Ali Beikmoradi
- Chronic Disease Home Care Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Fatemeh Najafi
- Department of Nursing, Faculty of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, IR Iran
- Corresponding Author: Fatemeh Najafi, Department of Nursing, Faculty of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, IR Iran. Tel: +98-9127123830, E-mail:
| | - Ghodratallah Roshanaei
- Research Center for Modeling of Non-Communicable Diseases, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Zahra Pour Esmaeil
- Department of Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Mahnaz Khatibian
- Research Center for Maternal and Child Care, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Alireza Ahmadi
- Department of Oncology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran
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