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The Efficacy and Cerebral Mechanism of Intradermal Acupuncture for Major Depressive Disorder

Not Applicable
Completed
Conditions
Major Depressive Disorder
Interventions
Drug: SSRI
Device: SIA
Device: AIA
Registration Number
NCT05720637
Lead Sponsor
Xiaomei Shao
Brief Summary

Major depressive disorder (MDD) is highly prevalent, affecting nearly 4% of the global population. Pharmacotherapy is the frontline treatment recommended by the guideline, but it also has some limitations such as delayed onset, inadequate response, and drug resistance. Intradermal acupuncture (IA) is a method of using short indwelling needles retained under the skin to produce continuous stimulation for long-term efficacy. It has been reported that IA combination medication appears to be more valuable than medication alone in the treatment of MDD, however, there is a lack of high-quality clinical evidence.While several studies have proposed that manual or electroacupuncture can improve MDD symptoms by modulating brain networks, the cerebral mechanism of IA as superficial acupuncture for MDD has not been reported. Hence, investigators designed a multicentre randomized controlled trial to assess the clinical efficacy and safety of IA for MDD and preliminarily explore the potential therapeutic mechanisms for IA by functional magnetic resonance imaging (fMRI) .

Detailed Description

A total of 120 patients with MDD who meet the inclusion criteria will be included in the study. Participants will be randomly assigned 1:1:1 to the waiting list group (patients in this group will be treated with selective 5-hydroxytryptamine reuptake inhibitors (SSRIs) only), sham intradermal acupuncture combined with SSRIs (SIA) group and active intradermal acupuncture combined with SSRIs (AIA) group. The study will assess the efficacy and safety of intradermal acupuncture for MDD. In addition, investigator will explore the possible cerebral mechanisms by which IA exerts its antidepressant effects.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
120
Inclusion Criteria
  1. Patients diagnosed with MDD according to the International Classification of Disease-10 (ICD-10);
  2. Aged between 18 and 60 years (no limitation on gender);
  3. Administration of SSRIs;
  4. Patients undergoing MRI and MRS should be right-handed and free of traumatic brain injury, claustrophobia or metal implants;
  5. Written informed consent is obtained by the person or guardian.
Exclusion Criteria
  1. ICD-10 diagnoses: schizophrenia, bipolar disorder, manic episode or other psychotic disorders; alcohol and drug addiction;
  2. Significant skin lesions, severe allergic diseases, tumors, and severe or unstable internal diseases involving the cardiovascular, digestive, endocrine, or hematological system;
  3. Acute suicidal tendency;
  4. Allergy to adhesive tape and fear of intradermal acupuncture;
  5. Pregnancy and lactation;
  6. Mental retardation and difficulty cooperating with doctors.
  7. Participating in other clinical trials.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Waiting list groupSSRIThis group will include 40 patients with MDD who will be treated with oral SSRIs only, the dosage of which will be determined by the psychiatrist. At the end of this trial, patients could choose 6 weeks' intradermal acupuncture treatments free of charge.
SIA groupSIAThis group will include 40 patients with MDD who will be treated with sham intradermal acupuncture (SIA) combined with SSRIs. Acupoints related to MDD will be stimulated by acupuncturists and the dosage of oral SSRIs will be determined by the psychiatrist.
SIA groupSSRIThis group will include 40 patients with MDD who will be treated with sham intradermal acupuncture (SIA) combined with SSRIs. Acupoints related to MDD will be stimulated by acupuncturists and the dosage of oral SSRIs will be determined by the psychiatrist.
AIA groupSSRIThis group will include 40 patients with MDD who will be treated with active intradermal acupuncture (AIA) combined with SSRIs. Acupoints related to MDD will be stimulated by acupuncturists and the dosage of oral SSRIs will be determined by the psychiatrist.
AIA groupAIAThis group will include 40 patients with MDD who will be treated with active intradermal acupuncture (AIA) combined with SSRIs. Acupoints related to MDD will be stimulated by acupuncturists and the dosage of oral SSRIs will be determined by the psychiatrist.
Primary Outcome Measures
NameTimeMethod
Changes in the Hamilton Depression Scale-17 (HAMD-17) ScoresBaseline, 3 weeks after treatment, 6 weeks after treatment, at 4-week follow-up.

The HAMD scale is the most commonly used in the clinical assessment of depression, including 17 items. The higher the score, the more severe the depression. 0-7 means no depressive symptoms, 8-17 means mild depression, 18-24 was divided into moderate depression, and 25-52 was divided into severe depression.

Secondary Outcome Measures
NameTimeMethod
Changes in the Pittsburgh Sleep Quality Index (PSQI) ScoresBaseline, 3 weeks after treatment, 6 weeks after treatment, at 4-week follow-up

The PSQI is used to assess the sleep quality of the participant in the last 1 month and consisted of 19 self-rated and 5 other rated items. The higher the score, the worse the sleep quality. Sleep quality is divided into 4 levels according to the total score.

Changes in the Self-Rating Depression Scale (SDS) ScoresBaseline, 3 weeks after treatment, 6 weeks after treatment, at 4-week follow-up.

The standard score is the total of all scores multiplied by 1.25 to the nearest whole number on this scale, which has 20 questions. A standard score below 50 is normal; 50-60 is mild depression; 61-70 is moderate depression; 70 or more is severe depression.

Trial Locations

Locations (1)

the Third affiliated hospital of Zhejiang Chinese Medical university [Recruiting]

🇨🇳

Hangzhou, Zhejiang, China

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