Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA.
Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada.
Acupunct Med. 2021 Dec;39(6):637-645. doi: 10.1177/0964528421999395. Epub 2021 Mar 22.
Decreased brain-derived neurotrophic factor (BDNF) is associated with poor sleep. This study examined the effects of acupuncture versus cognitive behavioral therapy for insomnia (CBT-I) on serum BDNF and sleep outcomes in cancer survivors with insomnia.
This was an exploratory analysis of a randomized clinical trial (n = 160) comparing acupuncture versus CBT-I for cancer survivors with insomnia. Interventions were delivered over 8 weeks. Outcomes were assessed at baseline and week 8. Serum BDNF was evaluated with enzyme-linked immunosorbent assay (ELISA). Sleep was evaluated with the insomnia severity index and consensus sleep diary. Pearson correlations between BDNF and sleep outcomes were calculated. Data analysis was limited to 87 survivors who provided serum samples.
Among 87 survivors, the mean age was 61.9 (SD: 11.4) years, 51.7% were women, and 24.1% were non-White. Mean serum BDNF did not significantly increase in acupuncture (n = 50) or CBT-I (n = 37) groups. When analysis was restricted to patients with low baseline BDNF (i.e. levels below the sample median of 47.1 ng/mL), the acupuncture group (n = 22) demonstrated a significant 7.2 ng/mL increase in mean serum BDNF (P = 0.03), whereas the CBT-I group (n = 21) demonstrated a non-significant 2.9 ng/mL increase (P = 0.28). Serum BDNF was not significantly correlated with sleep outcomes (all P > 0.05).
Among cancer survivors with insomnia and low baseline BDNF, acupuncture significantly increased serum BDNF levels; however, the clinical significance of this finding requires further investigation. NCT02356575 (ClinicalTrials.gov).
脑源性神经营养因子（BDNF）水平降低与睡眠质量差有关。本研究旨在探讨针刺与失眠认知行为疗法（CBT-I）对失眠癌症幸存者血清 BDNF 和睡眠结果的影响。
这是一项针对比较针刺与失眠认知行为疗法（CBT-I）对失眠癌症幸存者影响的随机临床试验（n = 160）的探索性分析。干预措施在 8 周内进行。在基线和第 8 周评估结局。采用酶联免疫吸附试验（ELISA）评估血清 BDNF。采用失眠严重程度指数和共识睡眠日记评估睡眠。计算 BDNF 与睡眠结果之间的 Pearson 相关性。数据分析仅限于提供血清样本的 87 名幸存者。
在 87 名幸存者中，平均年龄为 61.9（SD：11.4）岁，51.7%为女性，24.1%为非白人。针刺组（n = 50）和 CBT-I 组（n = 37）的血清 BDNF 均无显著增加。当分析仅限于基线 BDNF 水平较低的患者（即水平低于样本中位数 47.1ng/mL）时，针刺组（n = 22）的平均血清 BDNF 显著增加 7.2ng/mL（P = 0.03），而 CBT-I 组（n = 21）则增加 2.9ng/mL，无统计学意义（P = 0.28）。血清 BDNF 与睡眠结果无显著相关性（所有 P > 0.05）。
在失眠和低基线 BDNF 的癌症幸存者中，针刺显著增加了血清 BDNF 水平；然而，这一发现的临床意义需要进一步研究。NCT02356575（ClinicalTrials.gov）。
