Laureano Maura Regina, Onishi Ektor Tsuneo, Bressan Rodrigo Affonseca, Neto Pedro Braga, Castiglioni Mario Luiz Vieira, Batista Ilza Rosa, Reis Marilia Alves, Garcia Michele Vargas, de Andrade Adriana Neves, Sanchez Maura Lígia, Moreira Hugo Cogo, de Almeida Roberta Ribeiro, Garrido Griselda Jara, Jackowski Andrea Parolin
Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brasil.
Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Universidade Federal de São Paulo, Rua Pedro de Toledo, 947, Vila Clementino, São Paulo, 04039-032, Brasil.
Eur Radiol. 2016 Sep;26(9):3234-42. doi: 10.1007/s00330-015-4164-7. Epub 2016 Jan 8.
Investigate the effect of acupuncture on brain perfusion using ethyl cysteinate dimer single-photon emission computed tomography ((99m)Tc-ECD SPECT) in patients with tinnitus.
This randomized, single-blind, sham-control study examined patients (18-60 years old) with normal hearing and chronic, idiopathic, continuous tinnitus. Fifty-seven subjects were randomly assigned to true (n = 30) or sham (n = 27) acupuncture (ACP); (99m)Tc-ECD SPECT examinations were performed before and after 12 twice-weekly ACP sessions. Secondary outcomes included changes in the Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS), Hamilton Anxiety Scale (HAS) and Beck Depression Inventory (BDI). Imaging data were analysed using Statistical Parametric Mapping (SPM8) software. Regression models were used to examine secondary outcomes via two paradigms: intention-to-treat (ITT; where multiple imputations were conducted because of study attrition) and complete cases.
No between-group brain perfusion differences were observed. However, a significant improvement in THI scores was observed at the end of true ACP treatment for all domains (all p values < 0.01) except the catastrophic scale.
ACP might reduce the effects of tinnitus on daily life; however, additional studies should be conducted to verify the effects of ACP on the neural architecture and brain function of tinnitus patients.
• Efficacy of acupuncture on brain perfusion and symptoms of tinnitus patients. • Acupuncture improved the Tinnitus Handicap Inventory scores in tinnitus patients. • No significant changes in brain perfusion were observed after 12 twice-weekly sessions. • Perfusion changes would reflect changes in neuronal function.
采用半胱氨酸乙酯二聚体单光子发射计算机断层扫描((99m)Tc-ECD SPECT)研究针刺对耳鸣患者脑灌注的影响。
本随机、单盲、假对照研究纳入听力正常、患有慢性、特发性、持续性耳鸣的患者(18 - 60岁)。57名受试者被随机分为真针刺组(n = 30)或假针刺组(n = 27);在每周两次、共12次针刺治疗前后进行(99m)Tc-ECD SPECT检查。次要结局包括耳鸣障碍量表(THI)、视觉模拟量表(VAS)、汉密尔顿焦虑量表(HAS)和贝克抑郁量表(BDI)的变化。使用统计参数映射(SPM8)软件分析成像数据。通过两种范式使用回归模型检查次要结局:意向性分析(ITT;由于研究失访进行多次插补)和完全病例分析。
未观察到组间脑灌注差异。然而,在真针刺治疗结束时,除灾难性量表外,所有领域的THI评分均有显著改善(所有p值<0.01)。
针刺可能减轻耳鸣对日常生活的影响;然而,应进行更多研究以验证针刺对耳鸣患者神经结构和脑功能的影响。
•针刺对耳鸣患者脑灌注和症状的疗效。•针刺改善了耳鸣患者的耳鸣障碍量表评分。•每周两次、共12次治疗后未观察到脑灌注的显著变化。•灌注变化将反映神经元功能的变化。