Acupuncture Continuing Education

Acupuncture Found Effective For ADHD

acupuncture adhd

Acupuncture increases the total effective rate of psychological intervention for the relief of attention-deficit/hyperactivity disorder (ADHD). Weifang Municipal Yidu Central Hospital researchers combined acupuncture with standard psychological treatment. Treatment with both acupuncture and psychological intervention produced an 83.3% total effective rate. Patients using only psychological intervention had a 63.3% total effective rate. [1] The results were measured with the Cambridge Neuropsychological Test Automated Battery (CANTAB) test and the Digi-Lite Digital Transcranial Doppler (TCD).

Researchers (Zhang et al.) used the following study design. A total of 100 patients were treated and evaluated in this study. Patients received treatment for ADHD between January 2019 and September 2019. They were randomly divided into an acupuncture treatment group and a control group, with 50 patients in each group. Control group patients received psychological intervention monotherapy. The treatment group received acupuncture in addition to the identical psychological treatment administered to the drug control group.

Inclusion criteria were as follows. All participants were diagnosed with ADHD according to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). In addition, patients participating in the study met the following inclusion criteria:

  • 6–14 years of age
  • Did not receive any treatment prior to the research
  • The parent/guardian signed a consent form prior to the research 

Patients having the following conditions did not participate in the study:

  • Comorbid cerebrovascular diseases
  • Comorbid tic disorders, neurodevelopmental delay, affective disorders, epilepsy and other neurological diseases
  • Comorbid systemic chronic diseases

For both groups, patients received psychological intervention. First, the living and study environments of patients were evaluated to eliminate any risk factors that may exacerbate the condition. Second, patients received concentration training (i.e., role-playing), twice per day, with each session lasting 30 minutes. Third, the performance during training was recorded to monitor the treatment progress. The psychological intervention lasted for three months. The acupuncture group received body acupuncture at the following acupoints:

  • LV3 (Taichong)
  • PC6 (Neiguan)
  • HT7 (Shenmen)
  • SP6 (Sanyinjiao)
  • GV20 (Baihui)
  • EX-HN1 (Sishencong)
  • Dingshen I (0.5 cun superior to EX-HN3/Yintang)

Treatment commenced with patients in a supine position. After disinfection of the acupoint sites, a 0.25 mm × 25 mm or 0.25 mm × 40 mm disposable filiform needle was inserted into each acupoint with a high needle entry speed. For Taichong and Shenmen, the needle was inserted perpendicularly to a depth of 7–12 mm and was applied with the tonifying (Bu) technique.

For Neiguan, the needle was inserted perpendicularly to a depth of 7–20 mm. For Sanyinjiao, the needle was inserted perpendicularly to a depth of 20–37 mm. Both Neiguan and Sanyinjiao were applied with the tonifying technique. For Baihui, the needle was inserted obliquely and posteriorly, reaching a depth of 7–15 mm. For Sishencong, the needle was inserted obliquely towards Baihui, reaching a depth of 7–15 mm. For Dingshen I, the needle was inserted obliquely, reaching a depth of 7–15 mm. Baihui, Sishencong, and Dingshen I were applied with the mild tonifying and attenuating (ping bu ping xie) technique. One acupuncture session was applied every day, five sessions per week. The treatment was applied for a total of three months.

All patients underwent the Cambridge Neuropsychological Test Automated Battery (CANTAB) and Digi-Lite Digital Transcranial Doppler (TCD) assessments before and after treatments. CANTAB is a measurement instrument for evaluating patients’ attention and response inhibition. It consists of two aspects: rapid visual information processing (RVP) and stop signal task (SST). RVP tests sustained attention and SST measures the ability to patients’ response to distractions.

TCD was used to measure cerebral arterial blood flow velocity in multiple areas, including the basilar artery (BA), vertebral artery (VA), middle cerebral artery (MCA), anterior cerebral artery (ACA), and posterior cerebral artery (PCA). After completion of treatment, the efficacy rates for each patient were categorized into 1 of 4 tiers based on DSM-5 and the Swanson, Nolan, and Pelham Teacher and Parent Rating Scale (SNAP):

  • Recovery: complete absence of ADHD symptoms.
  • Significantly effective: at least five ADHD symptoms were relieved.
  • Effective: at least two ADHD symptoms were relieved.
  • Not effective: no improvement in ADHD severity.

The acupuncture plus psychological intervention group outperformed the psychological intervention group for improvement of all RVP and SST parameters. TCD revealed that both groups had improved mean blood velocity in the left MCA, left ACA, and right ACA, and the acupuncture treatment group outperformed the control group in the mean blood velocity of the left PCA, left MCA, left ACA, and right ACA. In addition, acupuncture plus psychological intervention achieved an 83.3% total effective rate. Using only psychological intervention produced a 63.3% total effective rate. The researchers concluded that acupuncture improves cerebral artery blood flow in children with ADHD, increases their sustained attention and ability to inhibit distraction (inhibition response), and increases overall treatment efficacy for ADHD patients.

 

Reference:
[1] Zhang HJ, Dong XL, Zhang YF, Fang YF, Zhang HY. Effect of combination of acupuncture and psychological intervention on attention, response inhibition and cerebral blood flow in children with attention deficit hyperactivity disorder [J]. Chinese Acupuncture and Moxibustion, 2021,04:400-404.

 

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