Electroacupuncture improves cognitive function and neuropsychiatric symptoms in breast cancer survivors: a pilot randomized controlled trial.

Abstract

Background: We conducted a randomized, double-blinded pilot trial to compare the impact of 2 electroacupuncture (EA) regimens on co-occurring neuropsychiatric symptoms among breast cancer survivors.

Methods: Breast cancer survivors (BCS) who self-reported cognitive impairment, fatigue, insomnia, or psychological distress were randomized (1:1) to receive 10 weekly EA to target either neuropsychiatric-specific (neuropsychiatric-specific EA, nEA) or nonneuropsychiatric-specific (sham EA, sEA) acupoints. Primary endpoints were the within-group pre-post effect sizes (Glass's Δ) in symptom severities, adjusted for multiple comparisons (Padjusted). Outcomes were assessed using neurocognitive tests (CANTAB), patient-reported outcomes (PROs) (Functional Assessment of Cancer Therapy-Cognitive Function, Multidimensional Fatigue Symptom Inventory-Short Form, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30), plasma biomarkers, and neuroimaging. Responders were defined by reliable change index (for objective cognition) or minimal clinically important differences (for PROs).

Results: Thirty-five participants were recruited, with 30 (86%) completing all sessions. The mean (±SD) age was 58.2 (±12.2) years, and 86% reported co-occurring symptoms. Following treatment, the nEA group demonstrated significant improvements in attention (T3: Δ = 0.562, T4: Δ = 0.708, both Padjusted <.05) and distress (T3: Δ = 0.764, T4: Δ = 0.711, both Padjusted < .05). More responders were observed after nEA treatment for objective cognition (42.9% vs 12.5%) and distress (50% vs 37.5%). Neuropsychiatric-specific EA-treated participants showed increased gray matter volume compared with sEA (P = .033), which positively correlated with better attention function (r = 0.69, P = .020). Neuropsychiatric-specific EA-related improvements in memory and response speed were associated with reduced connectivity in the default mode network (DMN-SFG, r = -0.93, P < .01) and increased connectivity in the dorsal attention network (DAN-SMG, r = 0.86, P < .001), respectively. All adverse events were grade 2 or lower.

Conclusion(s): Electroacupuncture targeting neuropsychiatric-specific acupoints suggests improvements in cognition and distress symptoms in BCS, warranting validation in larger, multicenter trials.

Clinicaltrials.gov: NCT05283577.