The efficacy and cerebral mechanism of intradermal acupuncture for major depressive disorder: a multicenter randomized controlled trial.

Dec 09, 2024

Experts: Xiaoting Wu,Mingqi Tu,Zelin Yu,Zhijian Cao,Siying Qu,Nisang Chen,Junyan Jin,Sangsang Xiong,Jiajia Yang,Shuangyi Pei,Maosheng Xu,Jia Wang,Yan Shi,Lishu Gao,Jian Xie,Xinwei Li,Jianqiao Fang,Xiaomei Shao

New combinations or alternative therapies for major depressive disorder (MDD) are necessary. Intradermal acupuncture (IA) shows promise but requires further investigation regarding its efficacy, safety, and mechanisms. Conducted across 3 centers from November 2022 to January 2024, our randomized controlled trial included 120 participants with moderate to severe MDD, divided into the selective serotonin reuptake inhibitors (SSRIs), SSRIs plus sham IA (SSRIs + SIA), and SSRIs plus active IA (SSRIs + AIA) groups. Acupuncture groups received 10 sessions over 6 weeks at Shenmen (HT7), Neiguan (PC6), Sanyinjiao (SP6) and Taichong (LR3) bilaterally, followed by a 4-week follow-up. The primary outcome was changes in Hamilton Depression Rating Scale-17 (HAMD-17) scores at week 6. Furthermore, healthy controls (HCs) and MDD patients underwent magnetic resonance imaging (MRI) scans for functional connectivity (FC) analysis. After 6 weeks of treatment, the SSRIs + AIA group showed a greater reduction in HAMD-17 score than the SSRIs + SIA group (MD, -4.9 [CI, -7.6 to -2.2], P < 0.001) and SSRIs group (MD, -5.1 [CI, -7.8 to -2.3], P < 0.001). No serious adverse events occurred. SSRIs + AIA resulted in lower incidences of palpitations (vs.SSRIs + SIA: OR, 0.1% [CI, 0.0-1.0%]; vs. SSRIs: OR, 0.1% [CI, 0.0-0.7%]; P < 0.05), somnolence (vs.SSRIs + SIA: OR, 0.1% [CI, 0.0-0.9%]; vs.SSRIs: OR, 0.1% [CI, 0.0-0.7%]; P < 0.05), and nausea (vs.SSRIs + SIA: OR, 0.1% [CI, 0.0-1.0%]; vs. SSRIs: OR, 0.1% [CI, 0.0-0.9%]; P < 0.05). MDD patients showed abnormal FCs, and IA enhanced FCs between striatum and frontal_inf_tri, and striatum and cerebellum in the MRI study. Overall, IA as adjunctive therapy provides clinical efficacy and safety for MDD, and it may exert antidepressant effects by modulating striatal FCs.
© 2024. The Author(s).

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ABOUT THE EXPERTS

Xiaoting Wu,Mingqi Tu,Zelin Yu,Zhijian Cao,Siying Qu,Nisang Chen,Junyan Jin,Sangsang Xiong,Jiajia Yang,Shuangyi Pei,Maosheng Xu,Jia Wang,Yan Shi,Lishu Gao,Jian Xie,Xinwei Li,Jianqiao Fang,Xiaomei Shao

Xiaoting Wu

Department of Acupuncture, The Third Clinical Medical College, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

Department of Rehabilitation Medicine, The Second Affiliated Hospital of Zhejiang University, Hangzhou, China.

Mingqi Tu

Department of Acupuncture, The Third Clinical Medical College, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

Department of Acupuncture, The Affiliated Hangzhou First People’s Hospital, Hangzhou, China.

Zelin Yu

Department of Acupuncture, The Third Clinical Medical College, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

Zhijian Cao

Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

Siying Qu

Department of Acupuncture, The Third Clinical Medical College, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

Nisang Chen

Department of Acupuncture, The Third Clinical Medical College, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

Junyan Jin

Department of Acupuncture, The Third Clinical Medical College, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

Sangsang Xiong

Department of Acupuncture, The Third Clinical Medical College, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

Jiajia Yang

Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

Shuangyi Pei

Department of Psychiatry, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

Maosheng Xu

Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

Jia Wang

Department of Psychiatry, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

Yan Shi

Department of Acupuncture, The Affiliated Hangzhou First People’s Hospital, Hangzhou, China.

Lishu Gao

Department of Psychiatry, The Affiliated Hangzhou First People’s Hospital, Hangzhou, China.

Jian Xie

Department of Psychiatry, The Affiliated Hangzhou First People’s Hospital, Hangzhou, China.

Xinwei Li

Department of Acupuncture, Tongde Hospital of Zhejiang Province, Hangzhou, China.

Jianqiao Fang

Department of Acupuncture, The Third Clinical Medical College, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China. fangjianqiao7532@163.com.

Xiaomei Shao

Department of Acupuncture, The Third Clinical Medical College, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China. shaoxiaomei@zcmu.edu.cn.