Acupuncture alleviates post-stroke depression (PSD). This is a common and debilitating complication following a stroke, affecting up to 33% of survivors. Symptoms such as low mood, impaired attention, and sleep disturbances hinder recovery and significantly impact quality of life. A recent bibliometric analysis consolidates evidence on acupuncture as a promising treatment modality for PSD, highlighting its therapeutic benefits and mechanisms.
The analysis reviewed 11,540 studies spanning from 2014 to 2023. Acupuncture emerged as a robust intervention, effectively reducing depressive symptoms, improving neurological function, and promoting motor recovery. Electroacupuncture (EA) and scalp acupuncture were identified as particularly effective techniques. These approaches were shown to regulate neurotransmitter activity, reduce neuroinflammation, and improve gut microbiota profiles. [1]
Patients treated with acupuncture experienced significant improvements in standardized depression scores and reduced reliance on pharmacological treatments. Moreover, acupuncture was associated with an enhanced quality of life for PSD patients.
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Acupuncture Techniques
The review emphasized detailed protocols crucial for achieving clinical efficacy:
1. Electroacupuncture (EA):
- Target Points: GV20 (Baihui) and ST36 (Zusanli) were frequently selected for PSD.
- Procedure: Needles were inserted at a depth to achieve the deqi sensation. Electrodes connected to a low-frequency electrical stimulator (2 Hz) provided consistent stimulation for 30 minutes per session.
- Frequency: Treatments were typically administered 3–5 times per week over 4–8 weeks.
2. Scalp Acupuncture:
- Target Regions: The motor and sensory areas of the scalp.
- Technique: Fine needles (0.22 mm gauge) were inserted tangentially to a depth of approximately 10–20 mm. Continuous manual manipulation was used to maintain stimulation.
3. Press Needles:
- Points Used: PC6 (Neiguan), HT7 (Shenmen), and SP6 (Sanyinjiao).
- Application: Press needles were left in place for up to 48 hours, with patient education on avoiding vigorous activity.
Apple iTunes Podcast:
https://podcasts.apple.com/us/podcast/acupuncture-and-herbs/id442141931
Spotify Podcast:
https://open.spotify.com/show/685ilKlbo1HyYd8PWgvVgA?si=772776c7aeaf42bb
Mechanisms of Action
Acupuncture’s efficacy in PSD is supported by its multi-faceted mechanisms:
- Neurotransmitter Modulation: Acupuncture enhances serotonin (5-HT) and norepinephrine (NE) activity, alleviating depressive symptoms.
- Neuroinflammation Reduction: EA significantly reduces pro-inflammatory cytokines, such as IL-1β and TNF-α, which are implicated in PSD pathology.
- Gut-Brain Axis Regulation: Changes in gut microbiota, such as increased Lactobacillaceae and decreased Peptostreptococcaceae, were observed following acupuncture, correlating with improved PSD outcomes.
Practical Considerations
To maximize therapeutic outcomes, acupuncturists followed the following guidelines:
- Stimulation Techniques: Emphasize achieving and maintaining the deqi sensation, which correlates with effective qi flow regulation.
- Session Frequency: Acute PSD cases may benefit from daily sessions, while chronic cases often require 2–3 sessions per week.
Research and Future Directions
While China leads in PSD acupuncture research, collaboration with international institutions such as Harvard University and South Korea’s Gyeong Hee University is growing. Future studies aim to refine treatment protocols and further explore biomarkers, such as brain-derived neurotrophic factor (BDNF), to establish acupuncture as a first-line treatment for PSD .
Conclusion
Acupuncture offers a non-invasive, effective, and safe approach to managing PSD. By integrating it into multidisciplinary care, clinicians can provide comprehensive support to stroke survivors, addressing both emotional and physical rehabilitation needs.
Source:
1. Dong Li, Larissa Tao, Jia Yang, Wa Cai, Weidong Shen. Global Research Trends in Acupuncture Treatment for Post-Stroke Depression: A Bibliometric Analysis. Complementary Therapies in Medicine. 2024; 84:103070.
