Effects of Electroacupuncture on Cognitive Symptoms in Major Depressive Disorder

Not Applicable

Completed

Interventions: Procedure: Electroacupuncture group
Procedure: Sham acupuncture

Brief Summary: The goal of this pilot Study and Randomized Controlled Trial is to investigate the impact of electroacupuncture on cognitive function, quality of life (QoL), and depression severity in patients with major depressive disorder (MDD).

The main question\[s\] it aims to answer are:

* Primary : electroacupuncture has the potential to treat subjective cognitive complaints and cognitive impairment in MDD outpatients

* Secondary : electroacupuncture has the potential to treat depressive in MDD outpatients The 60 participants will randomly be assigned to either the treatment group or the control group in a 1:1 ratio. The treatment group will undergo electroacupuncture (EA), while the control group will receive sham acupuncture within 10 weeks period.

Both groups will receive antidepressants with adjunctive medication (i.e., benzodiazepines, tricyclics, or antipsychotics) as the standard treatment. All participants will be assessed for executive functions and memory using specific cognitive tests, including the Trail Making Test B (TMT-B), Stroop Color and Word Test (SCWT), category delayed recall in the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), and subjective reports of concern regarding concentration, memory, problem-solving, learning, communication, and quality of life (QoL) concerns using the WHO Disability Assessment Schedule (WHODAS 2.0; sections D1.1-1.6 and H1-3), and depressive symptoms were assessed using the Thai-PHQ-9.

Recruitment & Eligibility

Inclusion Criteria

aged between 18 and 55 years
MDD diagnosed according to the DSM-5 or DSM-IV-TR criteria,
low suicidal risk
receiving treatment with antidepressants for at least 3 months from psychiatrists and psychiatric residents.
Subjective cognitive symptoms from the screening using the Thai version of the Patient Health Questionnaire (Thai-PHQ-9).

Exclusion Criteria

severe cognitive deficits from traumatic brain injury, delirium, neurodevelopmental disorders, or intellectual disability;
neurological disorders such as stroke, Parkinson's disease, epilepsy, or other brain lesions;
severe medical conditions preventing lying down for 20 minutes;
recent electroconvulsive therapy (ECT) within the last 6 months;
Individuals with a pacemaker;
visual or hearing impairment that could not be corrected with eyeglasses or hearing aids;
severe MDD or scoring 20 points or more on the Thai-PHQ-9.

Arm && Interventions

Group	Intervention	Description
Electroacupuncture group	Electroacupuncture group	In the electroacupuncture group (EG), participants received acupuncture at 10 scalp points (Baihui \[GV20\], Ex-hn 1, 3 points of intelligence \[Shenting \[GV24\], Benshen \[GB13\] on both sides, Touwei \[ST8\] on both sides). Electroacupuncture was applied for 20 minutes at Benshen \[GB13\] and Touwei \[ST8\] on both sides. They also received acupuncture at Tai chong \[LV3\], Tai Yuan \[LU9\], and Tai Xi \[KI3\] on both sides, as shown in picture 1. Acupuncture sessions were weekly for 10 weeks.
Sham acupuncture	Sham acupuncture	In the sham acupuncture control group (CG), participants received acupress or a brief needle insertion at He gu on both hands during the first and 10th weeks, marking the endpoint of the study

Primary Outcome Measures

Name	Time	Method
Trail making test B (TMT-B)	Pre-intervention at the beginning point (T0) and the endpoint will be the 10th week (T10)	The TMT- B is scored based on the time (in seconds) it takes to complete the test, including corrections for errors prompted by the examiner. A shorter time implies better performance.
The Stroop Color and Word Test (SCWT)	Pre-intervention at the beginning point (T0) and the endpoint will be the 10th week (T10)	SCWT used to assess the ability to inhibit cognitive interference that occurs when the processing of a specific stimulus feature impedes the simultaneous processing of a second stimulus attribute."Score" refers to the number of words achieved, and a higher number of words indicates a better score.
ADAS-cog category delayed recall	Pre-intervention at the beginning point (T0) and the endpoint will be the 10th week (T10)	ADAS-cog category delayed recall is used to assess memory. The score reflects the number of words that can be remembered. The more words remembered, the better the score.
Subjective cognitive complaint	Pre-intervention at the beginning point (T0) and the endpoint will be the 10th week (T10)	WHODAS 2.0; sections D1.1-1.6 and H1-3, which is a questionnaire asking about the number of days in the past 30 days when participants experienced difficulties with attention, understanding, and initiating conversation. "Score" is the rating of the number of days with issues, and a decrease in score indicates improvement or a better outcome.

Secondary Outcome Measures

Name	Time	Method
Thai Patient Health Questionnaire (PHQ-9)	Pre-intervention at the beginning point (T0) and the endpoint will be the 10th week (T10)	The Thai PHQ-9 (Patient Health Questionnaire-9) objectifies and assesses degree of depression severity via questionnaire. A lower score means better."

Locations (1): Faculty of Medicine, Thammasat University
🇹🇭
Khlong Luang, Pathum Thani, Thailand