The relevance between symptoms and magnetic resonance imaging analysis of the hippocampus of depressed patients given electro-acupuncture combined with Fluoxetine intervention - A randomized, controlled trial / 中国结合医学杂志

<p><b>OBJECTIVE</b>To probe the relevance between depressive symptoms and hippocampal volume and its metabolites detected by magnetic resonance imaging (MRI) in depressed patients who were given electro-acupuncture (EA) combined with Fluoxetine before and after treatment.</p><p><b>METHODS</b>A randomized, controlled trial was conducted. A total of 75 cases of mild or moderate depression were randomly assigned to two groups: the EA group which received EA combined with Fluoxetine; the Fluoxetine group which received Fluoxetine only as the control. The 17-item Hamilton Scale for Depression (HAMD) was used to assess the depression level. The relevance between the changes of the hippocampal volume and its metabolites, including N-acetyl aspartate (NAA)/creatine (Cr) and choline containing compounds (Cho)/Cr, and the reduction rate of the HAMD score before and after treatment of the two groups were analyzed.</p><p><b>RESULTS</b>At the end of the treatment, the therapeutic response rates were not statistically different between the two groups (73.53% for the Fluoxetine group and 83.33% for the EA group, respectively). Compared to that of the Fluoxetine group, a significant difference was shown in the EA group in the reduction rate of the HAMD scores (P<0.05). There was a negative correlation between the therapeutic effect and the HAMD scores before treatment in both groups of patients. There was no significant difference in the hippocampal volume before and after treatment. The NAA/Cr ratio of both groups increased after treatment, with the EA group increasing more. There was a negative correlation between the rate of change of the NAA/Cr after treatment and the HAMD scores before treatment in the two groups. In the Fluoxetine group, the Cho/Cr ratio showed no significant difference before and after treatment, which had no relevance with the HAMD scores before treatment either. Meanwhile, in the EA group, the Cho/Cr ratio showed a significant difference before and after treatment, which also had a positive relevance with the HAMD scores before treatment.</p><p><b>CONCLUSIONS</b>There was a significant improvement in the hippocampal metabolites in depressed patients who treated by EA combined with Fluoxetine. Those differences showed relevance with the HAMD scores before treatment.</p>

Effect of Shuyusan on neuropeptide Y and serotonin expression in the hippocampal neurons of rats with chronic mild unpredictable stress-induced depression / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of Shuyusan decoction on neuropeptide Y (NPY) and serotonin (5-HT) expression in the hippocampus and plasma of rats with chronic mild unpredictable stressors depression.</p><p><b>METHODS</b>Fifty Wistar rats were randomly divided into 5 groups, namely the normal control group, model group, fluoxetine group, and high- and low-dose Shuyusan groups. Except for those in the normal control group, all the rats were subjected to chronic mild unpredicted stress for 21 consecutive days with corresponding treatments. Open-field test was used to assess the behavioral changes of the rats. The content of NPY in the hippocampus and plasma was detected by competitive enzyme-linked immunosorbent assay, and immunocytochemistry was used to determine the expression of 5-HT in the hippocampus.</p><p><b>RESULTS</b>NPY levels in the hippocampus and plasma was significantly decreased in the model group as compared with that in the normal control group (P<0.05). Treatments with fluoxetine and high-dose Shuyusan both significantly increased NPY levels in the hippocampus and plasma in the depressive rats (P<0.05), resulting also in significantly increased 5-HT-immunoreactive neurons in the cerebral cortex and hippocampus and the average optical density (P<0.05).</p><p><b>CONCLUSION</b>Shuyusan decoction can effectively increase plasma and hippocampus NPY levels and the number of 5-HT-positive neurons in the cerebral cortex and happocampus of rats with chronic mild unpredictable stress-induced depression.</p>

Study on electroacupuncture treatment of depression by magnetic resonance imaging / 中国针灸

<p><b>OBJECTIVE</b>To explore the changes of metabolites in brain after treatment by analysis on 1H-MRS examination of the hippocampus and prefrontal lobe in the healthy volunteers and the depression patients.</p><p><b>METHODS</b>Seventy-five cases of mild and moderate depression were randomly divided into groups A, B and C, 25 cases in each group. The group A was treated with oral administration of Prozac capsule, 20 mg/d; the group B by electroacupuncture for 30-40 min and the needle was retained for 1 h, once each day, with main points Baihui (GV 20), Yin-tang (GV 29) and adjuvant acupoints selected; the group C by combination of the treatment methods in the groups A and B. They were treated for 6 weeks. Use PROBE-J sequence at the MRI system on Single Voxel of ROI of each lateral of hippocampus and frontal lobe in the depression patients of the 3 groups. Compare the differences of N-acetylasp artate/creatine (NAA/Cr) and choline/creatine (Cho/Cr) between the healthy volunteers and the patients before and after treatment.</p><p><b>RESULTS</b>Before treatment, NAA/Cr in the bilateral hippocampus decreased in the 3 groups as compared with the control group, and after treatment, NAA/Cr in the bilateral hippocampus of the group B and in the right hippocampus of the group C increased compared with that before treatment (P < 0.05), and NAA/Cr in the left hippocampus of the group C significantly increased as compared with that before treatment (P < 0.01). Before treatment, Cho/Cr in the bilateral prefrontal lobe in the 3 groups increased as compared with that in the control group (P < 0.05), after treatment, Cho/Cr in the bilateral prefrontal lobes of the groups A, B and C significantly decreased as compared with that before treatment (P < 0.05, P < 0.01).</p><p><b>CONCLUSION</b>There are differences in contents of metabolites in corresponding parts in bilateral frontal lobes and hippocampus between the depression patient and healthy person.</p>

Effects of electroacupuncture at different acupoint groups on behavior activity and p-CREB expression in hippocampus in the rat of depression / 中国针灸

<p><b>OBJECTIVE</b>To observe therapeutic effects and mechanisms at different acupoint groups for treatment of the depression rat.</p><p><b>METHODS</b>Fifty Wistar rats were randomly divided into a normal group, a model group, a body acupoint group, a scalp acupoint group and a Fluoxetine hydrochloride group, 10 cases in each group. Depression rat model was established by using chronic unpredictable mild stress stimulation combined with lonely breeding for 21 days. EA (2 Hz, 1 mA, 20 min) was given at "Taichong" (LR 3), "Neiguan" (PC 6) and "Zusanli" (ST 36) in the body point group and "Baihui" (GV 20), "Yintang" (EX-HN 3), "Sishencong" (EX-HN 1) in the head point group, once daily, and Fluoxetine hydrochloride was given to the Fluoxetine hydrochloride group by intragastric administration, 2 mg/kg, once daily, for 21 days. Body weight of the rat was recorded, and the sucrose-intake test and forced swimming test were conducted one day before the experiment and on the 7th, 14th and 21st day of the experiment, and the open field test was conducted one day before the experiment and on the 21st day. p-CREB expression in the hippocampus of the rats were observed on the 22nd day.</p><p><b>RESULTS</b>As compared with the model group, in the head point group and the Fluoxetine group, the crossing and rearing movement times, the relative volume of sucrose-intake and p-CREB expression in the hippocampus increased significantly, and the duration of immovability in forced swimming test shortened significantly (P<0.05). The relative volume of sucrose-intake increased and the duration of immovability in forced swimming test in the body point group significantly shortened (P<0.05), but the crossing and rearing movement times and p-CREB expression in the hippocampus did not insignificantly increase (P>0.05), with no significant differences among the treatment groups (P>0.05).</p><p><b>CONCLUSION</b>EA at the head acupoints can improve behavioral activities and increase positive neuron number of p-CREB in the hippocampus of the depression rat, and selection of acupoints is of important role in treatment of depression.</p>

Assessment of effectiveness of electroacupuncture and fluoxetine for treatment of depression with physical symptoms / 中国针灸

<p><b>OBJECTIVE</b>To study on clinical therapeutic effect and safety of electroacupuncture and Fluoxetine for treatment of mild or moderate depression with physical symptoms.</p><p><b>METHODS</b>Seventy-five cases were randomly divided into a western medicine group (group A), an electroacupunctue group(group B) and an electroacupuncture plus medicine group (group C), 25 cases in each group. The group A were treated by oral Fluoxetine, 20 mg each day; the group B by electroacupuncture with Baihui (GV 20) and Yintang (EX-HN 3) selected as main points; the group C by oral administration of Fluoxetine plus electroacupunctue. HAMD depression scale was used for assessment of clinical therapeutic effect and TESS adverse reaction scale was used for adverse reactions.</p><p><b>RESULTS</b>The clinical effective rate was 78.3% in the group A, 82.6% in the group B and 91.7% in the group C, with significant differences between group C and A, group C and B (P < 0.05). Groups B and C had significant therapeutic effects in improvement of physical symptoms, and the adverse reaction of Fluoxetine in the group C was less than that in the group A.</p><p><b>CONCLUSION</b>Electroacupuncture can significantly improve physical symptoms and relieve adverse reactions of Fluoxetine. Electroacupuncture combined with Fluoxetine has a better therapeutic effect on depression with mild or moderate physical symptoms, with less adverse reactions.</p>