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Title: [Brian effects of electroacupuncture on sleep quality and cognitive function in patients with insomnia related to cerebral infarction].
Author: Jiao M, Wang D, He L, Feng L, Wang R, Sui X.
Journal: Zhongguo Zhen Jiu; 2024 Oct 12; 44(10):1107-13. PubMed ID: 39401806.
Abstract:
OBJECTIVE: To observe the effects of electroacupuncture (EA) on sleep quality, sleep structure, and cognitive function in patients with insomnia related to cerebral infarction, and to explore the brain effect mechanism of EA on insomnia related to cerebral infarction. METHODS: Thirty-six patients with insomnia related to cerebral infarction were randomly divided into an EA group (18 cases, 1 case was eliminated and 1 case dropped out) and a sham acupuncture group (18 cases, 1 case was eliminated and 2 cases dropped out). Both groups received conventional treatment for cerebral infarction. The EA group received EA at Sishencong (EX-HN 1) with continuous waves at a frequency of 2 Hz, at an intensity tolerable to the patient. The sham acupuncture group received sham acupuncture at non-acupoints with the same EA parameters but electrical stimulation was interrupted after 30 s. Both groups were treated for 20 min each session, once daily, 5 days per week, for a total of 4 weeks. Pittsburgh sleep quality index (PSQI), Montreal cognitive assessment-basic (MoCA-B) scores, and short-term memory (STM) encoding test accuracy and average reaction time were observed before and after treatment in the two groups. Polysomnography (PSG) was used to evaluate sleep structure, and electroencephalogram (EEG) data were collected to observe the standardized power value of the Theta frequency band before and after treatment. RESULTS: Compared with before treatment, PSQI score was decreased and MoCA-B score was increased in the EA group after treatment (P<0.001); the EA group had lower PSQI score and higher MoCA-B score than those in the sham acupuncture group (P<0.001, P<0.01). Compared with before treatment, STM encoding test accuracy was increased and average reaction time was shortened in the EA group after treatment (P<0.01, P<0.001); sleep efficiency (SE) was increased (P<0.01), total sleep time (TST), REM, and N3 stages were prolonged (P<0.01, P<0.05), and sleep latency (SL) was shortened (P<0.01). The standardized power value of the Theta frequency band in EEG channels F3, C3, C4, O1 and O2 was decreased (P<0.05). After treatment, the EA group had higher STM encoding test accuracy, shorter average reaction time (P<0.05), higher SE (P<0.01), longer TST, REM and N3 stages (P<0.01), and shorter SL (P<0.01) than those in the sham acupuncture group. There was no statistically significant difference in the standardized power value of the Theta frequency band between the two groups (P>0.05). CONCLUSION: EA could regulate sleep quality and structure in patients with insomnia related to cerebral infarction, and improve cognitive function, possibly related to the reduction of slow-wave activity in EEG. 目的：观察电针对脑梗死相关失眠患者睡眠质量、睡眠结构及认知功能的影响，探究电针干预脑梗死相关失眠的脑效应机制。方法：将36例脑梗死相关失眠患者随机分为电针组（18例，剔除1例、脱落1例）和假针刺组（18例，剔除1例、脱落2例）。两组均接受脑梗死常规治疗。电针组于四神聪穴行电针干预，连续波，频率2 Hz，强度以患者耐受为宜；假针刺组于远端非穴行假针刺，电针参数同电针组，予电刺激30 s后中断。两组每次均治疗20 min，每天1次，每周5 d，共治疗4周。分别于治疗前后观察两组患者匹兹堡睡眠质量指数（PSQI）、蒙特利尔认知评估基础量表（MoCA-B）评分及短时记忆（STM）编码试验正确率、平均反应时间；采用整夜多导睡眠监测（PSG）评价患者睡眠结构，同时采集脑电（EEG）数据，观察Theta频段标准化功率值。结果：治疗后，电针组患者PSQI评分较治疗前降低、MoCA-B评分较治疗前升高（P<0.001）；电针组患者PSQI评分低于假针刺组、MoCA-B评分高于假针刺组（P<0.001，P<0.01）。与治疗前比较，治疗后电针组患者STM编码试验正确率升高、平均反应时间缩短（P<0.01，P<0.001）；睡眠效率（SE）提高（P<0.01），总睡眠时间（TST）、快速眼动睡眠期（REM）、N3延长（P<0.01，P<0.05），入睡潜伏期（SL）缩短（P<0.01）；EEG F3、C3、C4、O1、O2通道Theta频段标准化功率值减小（P<0.05）。治疗后，电针组患者STM编码试验正确率高于假针刺组、平均反应时间短于假针刺组（P<0.05）；SE高于假针刺组（P<0.01），TST、REM、N3长于假针刺组（P<0.01），SL短于假针刺组（P<0.01）；两组患者EEG各通道Theta频段标准化功率值比较，差异无统计学意义（P>0.05）。结论：电针能调节脑梗死相关失眠患者的睡眠质量及结构，改善患者认知功能，可能与脑电慢波活动减弱有关。.

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