Electroacupuncture may alleviate some persistent neuropsychiatric symptoms experienced by breast cancer survivors, including psychological distress and cognitive impairment, according to the results of a randomized, double-blinded pilot trial published in the Journal of the National Cancer Institute.
“This study provides evidence that a targeted electroacupuncture approach may help address the cluster of cognitive and related symptoms—such as insomnia, fatigue, and psychological distress—that many breast cancer survivors experience,” said corresponding author Alexandre Chan, PharmD, PhD, MPH, Professor and Founding Chair of the Department of Clinical Pharmacy Practice at the UC Irvine School of Pharmacy & Pharmaceutical Sciences. “Current guidelines support the use of acupuncture to manage distress in people with cancer. However, these recommendations often lack precision. It’s time to step up and further optimize how integrative therapies are delivered to patients.”
Study Methods
Researchers enrolled a group of breast cancer survivors who self-reported symptoms of cognitive impairment, fatigue, insomnia, and/or psychological distress. The participants were randomly assigned 1:1 to receive 10 weekly sessions of electroacupuncture to target neuropsychiatric-specific or -nonspecific acupressure points. The researchers looked at neurocognitive tests, patient-reported outcomes, plasma biomarkers, and neuroimaging to assess outcomes.
The primary endpoints of the study were within-group pre/post effect sizes of symptom severities.
“Patients often report feeling unprepared for the cognitive and emotional challenges that persist after treatment,” Dr. Chan said. “We need robust scientific evidence to show how effective interventions can be integrated into their treatment in order to reduce survivors’ symptoms and improve their healing journeys. Our randomized, controlled trial incorporated multiple aspects, including cognitive testing, brain imaging, and blood-based biomarkers, to understand the mechanisms underlying our intervention.”
Key Findings
Among 35 enrolled participants, only 30 patients (86%) completed all of their 10 electroacupuncture sessions.
The neuropsychiatric-specific acupoints group demonstrated significant improvements at the end of electroacupuncture treatment in attention (Glass's Δ = 0.562; adjusted P < .05) and distress (Δ = 0.764; adjusted P < .05). Four weeks after treatment, differences in attention (Δ = 0.708) and distress (Δ = 0.711) were both still significant (adjusted P < .05 for both).
More responders were found after neuropsychiatric-specific treatment vs -nonspecific treatment in terms of objective cognition (42.9% vs 12.5%) and distress (50% vs 37.5%). Additionally, participants in this group showed greater gray matter volume than patients in the nonspecific acupoints group (P = .033), which had a positive correlation with improved attention function (r = 0.69; P = .020).
In the neuropsychiatric-specific acupoints group, improvements in memory and response speed were linked to reduced connectivity in the Default Mode Network, which is involved in internal, self-focused mental tasks (r = –0.93; P < .01) but greater connectivity in the Dorsal Attention Network, which relates to sustained focus and shifting attention (r = 0.86; P < .001).
Treatment was well tolerated; all reported adverse events were grade 2 or lower.
“These results suggest that where acupuncture is applied matters,” Dr. Chan said. “Targeting acupoints linked to specific brain and neurological functions appears to produce measurable changes not only in symptoms but also in their biomarkers and in the brain.”
The study authors called for larger, multicenter trials to confirm these findings.
DISCLOSURES: The study was supported by the California Breast Cancer Research Program and the Chao Family Comprehensive Cancer Center’s Anti-Cancer Challenge. For full disclosures of the study authors, visit academic.oup.com/jnci/.
