Acupuncture plus sertraline linked to improved depression scores and M1 plasticity

A two-phase study assessed motor-cortex plasticity in 134 people across depression severity levels and tested adjunctive acupuncture in a randomized trial of 60 patients with moderate depression. Over six weeks, sertraline plus verum acupuncture was associated with greater HAMD-24 score reductions than sertraline with sham acupuncture or sertraline alone.

Higher depression severity was associated with greater M1 plasticity impairment.
Adjunctive acupuncture improved HAMD-24 scores over six weeks.
PAS25 plasticity changes correlated with symptom-score reductions.
Small trial limits conclusions about routine clinical use.

Researchers first conducted a cross-sectional study of 134 participants to assess primary motor cortex (M1) plasticity using paired associative stimulation (PAS). They then randomized 60 patients with moderate depression to six weeks of sertraline plus verum acupuncture, sertraline plus sham acupuncture, or sertraline alone. The clinical outcome was change in HAMD-24 depression scores; PAS-induced motor-evoked potentials were also measured.

In the cross-sectional phase, people with depression had blunted long-term potentiation-like and long-term depression-like plasticity compared with healthy controls (FDR-adjusted P<0.001), with greater impairment at higher symptom severity. In the trial, the verum-acupuncture group had a greater percentage reduction in HAMD-24 scores than either comparison group (both FDR-adjusted P<0.01) and fewer antidepressant-related side effects. Improvement in PAS25-induced plasticity correlated with symptom-score reduction (Spearman r=0.423; FDR-adjusted P=0.006); PAS10 changes did not.

The findings suggest M1 plasticity may track depressive symptom severity and treatment-associated change. The trial was small and lasted six weeks; the reported associations do not establish PAS as a clinical monitoring test or show that acupuncture should routinely be added to treatment.

In practice

For patients with moderate depression in this small, six-week randomized trial, adding verum acupuncture to sertraline was associated with greater HAMD-24 score reduction than sertraline alone or sertraline with sham acupuncture, and fewer antidepressant-related side effects. These findings are preliminary and do not establish that acupuncture should routinely be added to treatment. M1 plasticity changes correlated with symptom improvement for PAS25 but not PAS10; PAS was assessed as a research measure, not established as a clinical monitoring tool.

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Source

BMC Medicine: M1 neuroplasticity as a neurophysiological index of depressive symptom severity and treatment associated neural changes: a two-phase cross-sectional and randomized controlled trial ↗

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