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Clinical study of electroacupuncture improving sleep electroencephalogram and event-related potential in patients with somatoform disorders

电针改善躯体形式障碍患者睡眠脑电及事件相关电位的临床研究

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Abstract

Objective

To observe the effects of electroacupuncture (EA) on sleep electroencephalogram (EEG) and event-related potential (ERP) in patients with somatoform disorders (SFD).

Methods

Seventy-five SFD patients were recruited as an EA group to receive EA at Shenting (GV24) and Baihui (GV20) once daily, 30 min each time, with 6 straight days as a treatment course, and 4 courses were conducted at 1-day intervals. Before treatment, patients underwent a survey using a physical symptom checklist on their primary symptoms. Before and after treatment, their sleep EEG was monitored using Quisi, and the ERP mismatch negativity (MMN) and P300 were detected. The Quisi sleep EEG and ERP were also examined among 40 normal volunteers as the normal group data.

Results

During the trial, 13 cases were removed from the EA group due to incomplete data, and 62 cases were finally included for statistical analyses. Of the 62 SFD patients, the main disturbing symptoms were cognitive impairments, sleep disorders, respiratory symptoms, digestive symptoms, five-sense organ problems, and cardiovascular symptoms in order. Before treatment, the EA group had increased MMN and P300 latencies and decreased amplitudes compared with the normal control group (P<0.01 or P<0.05); according to Quisi, the EA group also had reduced total sleep time (TST), shorter rapid eye movement sleep (REM) latency (RL) and REM time (RT), smaller number of REM period (NRP), extended sleep latency (SL), longer awaking time (AT), lower sleep efficiency (SE), larger percent of non-rapid eye movement sleep (NREM) stage 1 (S1) and smaller percent of NREM stage 2 (S2), and the percent of slow wave sleep (SWS), i.e. NREM stage 3 (S3) plus stage 4 (S4), also went down, all presenting significant differences between groups (P<0.01 or P<0.05). After 4 courses of treatment, the MMN and P300 latencies were reduced, and their amplitudes became larger in the EA group compared with the baseline (P<0.05); they had insignificant differences compared with the normal control group (P>0.05). Quisi showed that the TST and RL increased, and the SL and AT decreased in the EA group, and the predominant change in sleep architecture was reduced S1 percent, increased S2, and improved SE, all showing significant intra-group differences (P<0.01 or P<0.05); however, the intra-group difference in the NRP was statistically insignificant (P>0.05). Except the TST, RT, S1 percent, and SWS, there was no statistical significance in comparing the other Quisi parameters (including RL, NRP, SL, AT, SE, and S2 percent) between the two groups (P>0.05).

Conclusion

SFD patients have a variety of clinical symptoms, and most of them show abnormal sleep EEG and ERP; EA can correct abnormal sleep EEG parameters and the MMN and P300 of ERP in SFD patients.

摘要

目的

观察电针治疗对躯体形式障碍(SFD)患者睡眠脑电及事件相关电位(ERP)的影响。

方法

选择75例SFD患 者为电针组, 予以电针神庭和百会治疗, 每次30 min, 每日1次, 连续治疗6 d为1个疗程, 疗程间休息1 d, 共治疗4个疗 程。治疗前采用躯体症状检查报告单对患者的主要症状进行调查。治疗前和治疗后进行睡眠脑电Quisi监测, 检测 ERP失匹配负波(MMN)和P300。对40名正常人进行相同的睡眠脑电Quisi监测和ERP检测, 作为正常对照组数据。

结果

研究过程中电针组13例患者因资料不全被剔除, 最终有62例纳入统计分析。在62例SFD患者中, 困扰患者的主 要症状依次是认知功能障碍、睡眠障碍、呼吸系统、消化系统、五官及心血管系统症状。与正常对照组比较, 治 疗前电针组患者ERP的MMN及P300潜伏期延长, 波幅下降, 组间差异均有统计学差异(P<0.01或P<0.05); Quisi指标中 睡眠总时间(TST)减少; 快速动眼睡眠(REM)潜伏期(RL)缩短, REM时间(RT)减少, REM周期数(NRP)减少; 睡眠潜伏期(SL) 延长, 醒觉时间(AT)增加, 睡眠效率(SE)下降; 非快速动眼睡眠(NREM)第一阶段(S1)占比增加, 第二阶段(S2)占比降低, 慢 波睡眠(SWS), 即NREM第三阶段和第四阶段(S3+S4)占比降低, 组间差异均有统计学意义(P<0.01或P<0.05)。治疗4个疗 程后, 电针组患者ERP的MMN和P300潜伏期缩短, 波幅增大, 与本组治疗前均有统计学差异(P<0.05), 与正常对照组差 异均无统计学意义(P>0.05); Quisi指标中电针组的TST增加, RL延长, SL缩短, AT减少; 睡眠结构的主要改变是S1占比减 少, S2占比增加, SE提高, 与本组治疗前差异均有统计学意义(P<0.01或P<0.05); NRP的组内差异无统计学意义 (P>0.05)。除TST、RT、S1占比及SWS外, 其他Quisi指标(包括RL、NRP、SL、AT、SE及S2占比)的组间差异均无统计学 意义(P>0.05)。

结论

SFD患者的临床症状表现多样, 多数患者存在睡眠脑电及ERP异常; 电针治疗可纠正SFD患者异 常的睡眠脑电指标及ERP的MMN和P300。

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Acknowledgments

This work was supported by the Project of Shanghai Changning District Science and Technology Commission (上海市长宁区科学技术委员会项目, No. CNKW2020Y34); Sub-professional Project of Shanghai Changning District Medical Master and Doctor Innovative Talent Base (上海市长宁区医学硕博士创新人才基地亚专业课题, No. RCJD2021S05).

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Authors and Affiliations

  1. Shanghai Changning Mental Health Center/Affiliated Mental Health Center, East China Normal University, Shanghai, 200335, China

    Zhanwen Liu  (刘占文), Li Zhang  (张郦), Minmin Zhang  (张敏敏), Xueqian Hu  (胡学谦) & Jie Su  (苏杰)

  2. Shanghai Mental Health Center, Shanghai, 200030, China

    Xingshi Chen  (陈兴时)

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  1. Zhanwen Liu  (刘占文)
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  2. Li Zhang  (张郦)
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  3. Minmin Zhang  (张敏敏)
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  4. Xueqian Hu  (胡学谦)
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  5. Xingshi Chen  (陈兴时)
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  6. Jie Su  (苏杰)
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Correspondence to Xingshi Chen  (陈兴时) or Jie Su  (苏杰).

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The authors declare that there is no potential conflict of interest in this article.

Statement of Informed Consent

This trial was approved by the Medical Ethics Committee of Shanghai Changning Mental Health Center (Approval No. M202024). Informed consent was obtained from all individual participants.

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First Author: LIU Zhanwen, M.D., associate chief physician

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Liu, Z., Zhang, L., Zhang, M. et al. Clinical study of electroacupuncture improving sleep electroencephalogram and event-related potential in patients with somatoform disorders. J. Acupunct. Tuina. Sci. 22, 58–64 (2024). https://doi.org/10.1007/s11726-024-1422-8

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  • DOI: https://doi.org/10.1007/s11726-024-1422-8

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