Electro-Scalp Acupuncture With Different Frequencies And Transcranial Direct Current Stimulation For Post-Stroke Depression:A Clinical Trial

Objective: This randomized controlled trial was aimed at investigating and comparing the synergistic effects of electro-scalp acupuncture with different frequencies and transcranial direct current stimulation for post-stroke depression patients.The safety of electro-scalp acupuncture and transcranial direct current stimulation were also measured to provide a clinical evidence for better electro-scalp acupuncture parameters in the treatment of post-stroke depression.Methods: 39 patients qualified for the inclusion criteria were randomly assigned to 2 groups(20 cases in 2Hz scalp acupuncture combined with transcranial direct current stimulation treatment group,19 cases in 50 Hz scalp acupuncture combined with transcranial direct current stimulation treatment group).The scalp acupunture lines including middle line of vertex,middle line of forehead and bilateral oblique lines of vertex-temporal were chosen to perform acupuncture operation(30 minutes once,once daily a week except Sunday,consecutive for 4 straight weeks).Transcranial direct current stimulation were performed with a standard t DCS device.We used a‘bifrontal' montage,where the anode and cathode were placed over the areas corresponding to,respectively,the left and right DLPFC(F3 and F4 areas,according to the international 10–20 electroencephalography system).Rubber electrodes were inserted into 25cm2 saline-soaked sponges and fixed with a headband.The current intensity was 2 m A(20 minutes once,once daily a week except Sunday,consecutive for 4 straight weeks).The primary outcomes were the changes in the Hamilton Depression Rating Scale(24-items),Activities of Daily Living Score and plasma homocysteine levels.Statistical analysis were conducted to compare the curative effects.Results: 1.Compared with the pre-treatment scores,the Hamilton depression rating scales of patients after the treatment in two groups were both significantly decreased.Between-group comparisons exhibited that 2Hz-treated subjects had a significantly greater reduction in HAMD-24 scores than that of 50Hz-treated subjects(p<0.05).2.Compared with the baseline,the Barthel Index scores of patients after the treatment in two groups were both significantly alleviated.And the 2Hz-treated subjects showed a better improvement than that of 50Hz-treated subjects(p<0.05).3.A significant decrease in plasma homocysteine levels were observed in both groups after the treatment.And 2Hz-treated subjects had a significantly greater reduction in homocysteine levels than that of 50Hz-treated subjects(p<0.05).4.A significant difference was observed with obvious effective rate between the two groups(p<0.05).While,no significant difference referred to the total efficacy rate between the two groups was observed(p>0.05).Conclusion: Our study showed that a combination of electro-scalp acupuncture and transcranial direct current stimulation can ameliorate the HAMD-24 scores and Activities of Daily Living Score as well as decrease the plasma homocysteine levels of post-stroke depression patients.What's more,2-Hz electro-scalp acupuncture showed a better curative effect in alleviating the depression symptoms than 50-Hz electro-scalp acupuncture.