Effect of Music Therapy Based on Scalp Acupuncture on Post-stroke Depression: Study with Resting-state Functional Magnetic Resonance Imaging / 中国康复理论与实践

ABSTRACT

Objective:To observe the effects of music therapy combined with scalp acupuncture on post-stroke depression (PSD) using resting-state functional magnetic resonance imaging (rs-fMRI). Methods:From December, 2018 to November, 2019, 40 patients with PSD from Rehabilitation Department of the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine were randomly divided into control group (n = 20) and observation group (n = 20). Both groups received routine rehabilitation and scalp acupuncture, while the observation group received music therapy as acupuncture, for four weeks. They were assessed with Hamilton Depression Scale (HAMD-17), Pittsburgh Sleep Quality Index (PSQI) and modified Barthel Index (MBI) before and after treatment, and scanned with rs-fMRI to obtain amplitude of low-frequency fluctuation (ALFF). The patients with definite improvement were followed up with HAMD-17 through telephone four weeks after treatment. Results:There were three cases dropped down in each group. The scores of HAMD-17, PSQI and MBI improved in both groups (|t| > 11.446,P < 0.001), and improved more in the observation group than in the control group (|t| > 2.314, P < 0.05). ALFF of bilateral wedge lobe, bilateral lingual gyrus, right orbitofrontal cortex, right anterior cingulate gyrus and right middle temporal gyrus increased in the observation group, and it increased in the right lingual gyrus, right angular gyrus and lateral groove of right occipital lobe in the control group. A total of 29 patients were followed up successfully, and the HAMD-17 scores were still less than that before treatment (t > 13.558, P < 0.001). Conclusion:Music therapy can further alleviate depression under scalp acupuncture in patients with PSD for a long time after treatment, and improve sleep and activities of daily living, which may relate with the activation of the emotional circuit, such as orbitofrontal cortex and the middle temporal gyrus, and the primary visual cortex.