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http://dx.doi.org/10.7231/jon.2016.27.3.169

Analysis of Quantitative Electroencephalography (QEEG) Following Acupuncture Treatment in Patients with Insomnia: Z Scored Absolute Power and sLORETA  

Lee, Go Eun (Department of Oriental Rehabilitative Medicine, Korean National Rehabilitation Center)
Mun, Su Jeong (Mibyeong Research Center, Korea Institute of Oriental Medicine)
Lee, Sung Ik (Department of Neurology, Inam Neuroscience Research Center, Sanbon Medical Center, Wonkwang University School of Medicine)
Lim, Jung Hwa (Department of Neuropsychiatry of Korean Medicine, Pusan National University School of Korean Medicine)
We, Young Man (Hyoo Oriental Medicine Clinic)
Moon, Kwang Su (Department of Psychology, Chung-Ang University)
Lyu, Yeoung Su (Department of Neuropsychiatry, College of Korean Medicine, Wonkwang University)
Kang, Hyung Won (Department of Neuropsychiatry, College of Korean Medicine, Wonkwang University)
Publication Information
Journal of Oriental Neuropsychiatry / v.27, no.3, 2016 , pp. 169-184 More about this Journal
Abstract
Objectives: To investigate the neurophysiological effect of acupuncture treatment on insomnia patients using quantitative electroencephalography (QEEG) and standardized Low Resolution Brain Electromagnetic Tomography method (sLORETA).Background: Insomnia is one of the commonly encountered symptoms in primary medical care. Recent studies of acupuncture for insomnia reported that the acupuncture groups showed significant improvements compared with the control groups. However, the neurophysiological mechanism of acupuncture in the treatment of insomnia has not been revealed and a few studies have measured the effect of acupuncture treatment using QEEG.Methods: Participants who had some problems in initiating or maintaining sleep, or had non-restorative sleep for more than 3 days a week and ISI scores above 8 and below 21 were treated by acupuncture for 2 weeks (3 times a week, total 6 times). We assessed the effectiveness of acupuncture for insomnia by the PSQI (Pittsburgh Sleep Quality Index) at baseline and at 2 weeks after the end of treatment (4th week). Also, we performed EEG and analysed the EEG data at baseline and at the end of treatment (2nd week) on the linked ears montage using the Neuroguide software program and sLORETA.Results: Thirty-two participants were enrolled and 2 participants dropped out because of personal reasons. Among the 30 participants, EEGs of 12 participants were included in the analysis of QEEG and sLORETA. Total score on the ISI and PSQI was significantly decreased after acupuncture treatment. The number of electrodes exceeding the range of 90% (±1.65) or 95% (±1.96) in the z scored absolute power of beta was significantly decreased after acupuncture treatment. There was no significant change in brain activation between pre- and post-acupuncture using sLORETA.Conclusions: The deviation of absolute power compared to the normative database was significantly decreased after acupuncture treatment in the alpha and beta ranges. Therefore, we suggest that acupuncture treatment for insomnia might be effective through the central nervous system especially in the brain. There are many limitations to drawing any conclusion. Further studies are needed in the future to overcome these limitations.
Keywords
Insomnia; Acupuncture; QEEG; sLORETA;
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1 Benjamin J. Sadock. Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry 11th ed. Philadelphia;Lippincott Williams & Wilkins. 2014:533-63.
2 Morin CM, Bélanger L, LeBlanc M, Ivers H, Savard J, Espie CA, Mérette C, Baillargeon L, Grégoire JP. The natural history of insomnia: a population-based 3-year longitudinal study. Archives of internal medicine. 2009;169(5):447-53.   DOI
3 Ancoli-Israel S, Roth T. Characteristics of insomnia in the United States: results of the 1991 National Sleep Foundation Survey. I. Sleep. 1999;22:S347-53.
4 Harvey AG. Insomnia: symptom or diagnosis? Clinical psychology review. 2001;21(7):1037-59.   DOI
5 Ford DE, Kamerow DB. Epidemiologic study of sleep disturbances and psychiatric disorders: an opportunity for prevention? Jama. 1989;262(11):1479-84.   DOI
6 Taylor DJ, Lichstein KL, Durrence HH. Insomnia as a health risk factor. Behavioral sleep medicine. 2003;1(4):227-47.   DOI
7 Suh S, Kim H, Yang HC, Cho ER, Lee SK, Shin C. Longitudinal course of depression scores with and without insomnia in non-depressed individuals: a 6-year follow-up longitudinal study in a Korean cohort. Sleep. 2013;36(3):369-76.   DOI
8 Taylor DJ, Mallory LJ, Lichstein KL, Durrence H, Riedel BW, Bush AJ. Comorbidity of chronic insomnia with medical problems. SLEEP-NEW YORK THEN WESTCHESTER. 2007;30(2):213.
9 Kripke DF, Langer RD, Kline LE. Hypnotics' association with mortality or cancer: a matched cohort study. BMJ open. 2012;2(1):e000850.   DOI
10 NIH State of the Science Conference statement on Manifestations and Management of Chronic Insomnia in Adults statement. Journal of clinical sleep medicine. official publication of the American Academy of Sleep Medicine. 2005;1(4):412-21.
11 Glass J, Lanctôt KL, Herrmann N, Sproule BA, Busto UE. Sedative hypnotics in older people with insomnia: meta-analysis of risks and benefits. Bmj. 2005;331(7526):1169.   DOI
12 Sivertsen B, Omvik S, Pallesen S, Nordhus IH, Bjorvatn B. Sleep and sleep disorders in chronic users of zopiclone and drug-free insomniacs. J Clin Sleep Med 2009;5(4):349-54.
13 Cao H, Pan X, Li H, Liu J. Acupuncture for treatment of insomnia: a systematic review of randomized controlled trials. The journal of alternative and complementary medicine. 2009;15(11):1171-86.   DOI
14 Lee M, Shin BC, Suen L, Park TY, Ernst E. Auricular acupuncture for insomnia: a systematic review. International Journal of Clinical Practice. 2008;62(11):1744-52.   DOI
15 Cheuk DKL, Yeung WF, Chung KF, Wong V. Acupuncture for insomnia. Cochrane Database of Systematic Reviews. 2012;9:CD005472.
16 Cheng CH, Yi PL, Lin JG, Chang FC. Endogenous opiates in the nucleus tractus solitarius mediate electroacupuncture-induced sleep activities in rats. Evidence-Based Complementary and Alternative Medicine. 2011;2011:159209.
17 Cheng CH, Yi PL, Chang HH, Tsai YF, Chang FC. Kappa-opioid receptors in the caudal nucleus tractus solitarius mediate 100 Hz electroacupuncture-induced sleep activities in rats. Evidence-Based Complementary and Alternative Medicine. 2012;2012:715024.
18 Kim MS, Cho YC, Moon JH, Pak SC. A characteristic estimation of bio-signals for electro-acupuncture stimulations in human subjects. The American journal of Chinese medicine. 2009;37(03):505-17.   DOI
19 Yi PL, Lu CY, Jou SB, Chang FC. Low-frequency electroacupuncture suppresses focal epilepsy and improves epilepsy-induced sleep disruptions. Journal of biomedical science. 2015;22(1):1-12.   DOI
20 Streitberger K, Steppan J, Maier C, Hill H, Backs J, Plaschke K. Effects of verum acupuncture compared to placebo acupuncture on quantitative EEG and heart rate variability in healthy volunteers. The Journal of Alternative and Complementary Medicine. 2008;14(5):505-13.   DOI
21 Hsu SF, Chen CY, Ke MD, Huang CH, Sun YT, Lin JG. Variations of brain activities of acupuncture to TE5 of left hand in normal subjects. The American journal of Chinese medicine. 2011;39(04):673-86.   DOI
22 Lee GE, Kim NK, Kim HY, Kang HW. The effects of acupuncture treatment on Hwa-byung patient's insomnia: patient-assessor blind, randomized, placebo-controlled clinical trial. Journal of oriental neuropsychiatry. 2012;23(1):31-48.   DOI
23 Yeung WF, Chung KF, Zhang SP, Yap TG, Law AC. Electroacupuncture for primary insomnia: a randomized controlled trial. Sleep. 2009;32(8):1039-47.   DOI
24 Gao X, Wei Y, Shao S, Li X, Zhang H, Wang J, Ma Q, Zhao X, Sun W, Wang X. Multiple central clinical studies on the needling method for regulating wei and strengthening brain for treatment of insomnia. Chinese acupuncture & moxibustion. 2007;27(8):623-5.
25 Yeung WF, Chung KF, Leung YK, Zhang SP, Law AC. Traditional needle acupuncture treatment for insomnia: a systematic review of randomized controlled trials. Sleep medicine. 2009;10(7):694-704.   DOI
26 Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry research. 1989;28(2):193-213.   DOI
27 Yeung WF, Chung KF, Tso KC, Zhang SP, Zhang ZJ, Ho LM. Electroacupuncture for residual insomnia associated with major depressive disorder: a randomized controlled trial. Sleep. 2011;34(6):807.   DOI
28 Bastien CH, Vallieres A, Morin CM. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep medicine. 2001;2(4):297-307.   DOI
29 Cho YW, Song ML, Morin CM. Validation of a Korean version of the insomnia severity index. Journal of Clinical Neurology. 2014;10(3):210-5.   DOI
30 Sohn SI, Kim DH, Lee MY, Cho YW. The reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index. Sleep and Breathing. 2012;16(3):803-12.   DOI
31 Kaiser DA, Sterman MB. Automatic artifact detection, overlapping windows, and state transitions. Journal of Neurotherapy. 2000;4(3):85-92.   DOI
32 Pascual-Marqui RD. Standardized low-resolution brain electromagnetic tomography (sLORETA): technical details. Methods Find Exp Clin Pharmacol. 2002;24(Suppl D):5-12.
33 Harvey AG. A cognitive model of insomnia. Behaviour research and therapy. 2002;40(8):869-93.   DOI
34 Espie CA. Insomnia: conceptual issues in the development, persistence, and treatment of sleep disorder in adults. Annual review of psychology. 2002; 53(1):215-43.   DOI
35 Perlis M, Giles D, Mendelson W, Bootzin R, Wyatt J. Psychophysiological insomnia: the behavioural model and a neurocognitive perspective. Journal of sleep research. 1997;6(3):179-88.   DOI
36 Wicklow A, Espie C. Intrusive thoughts and their relationship to actigraphic measurement of sleep: towards a cognitive model of insomnia. Behaviour research and therapy. 2000;38(7):679-93.   DOI
37 Morin CM, Stone J, Trinkle D, Mercer J, Remsberg S. Dysfunctional beliefs and attitudes about sleep among older adults with and without insomnia complaints. Psychology and aging. 1993;8(3):463.   DOI
38 Bonnet M, Arand D. 24-Hour metabolic rate in insomniacs and matched normal sleepers. SLEEP-NEW YORK. 1995;18:581.
39 Harvey AG. Pre‐sleep cognitive activity: A comparison of sleep‐onset insomniacs and good sleepers. British Journal of Clinical Psychology. 2000;39(3):275-86.   DOI
40 Perlis M, Pigeon W, Drummond S. The neurobiology of insomnia. Neurobiology of Disease. 2006;735-44.
41 Israel B, Buysse DJ, Krafty RT, Begley A, Miewald J, Hall M. Short-term stability of sleep and heart rate variability in good sleepers and patients with insomnia: for some measures, one night is enough. Sleep. 2012;35(9):1285.   DOI
42 Krystal AD, Edinger JD, Wohlgemuth WK, Marsh GR. NREM sleep EEG frequency spectral correlates of sleep complaints in primary insomnia subtypes. Sleep. 2002;25(6):630-40.
43 Buysse DJ, Germain A, Hall ML, Moul DE, Nofzinger EA, Begley A, Ehlers CL, Thompson W, Kupfer DJ. EEG spectral analysis in primary insomnia: NREM period effects and sex differences. Sleep. 2008;31(12):1673-82.   DOI
44 Marzano C, Ferrara M, Sforza E, De Gennaro L. Quantitative electroencephalogram (EEG) in insomnia: a new window on pathophysiological mechanisms. Current pharmaceutical design. 2008;14(32):3446-55.   DOI
45 Nofzinger EA, Buysse DJ, Germain A, Price JC, Miewald JM, Kupfer DJ. Functional neuroimaging evidence for hyperarousal in insomnia. American Journal of Psychiatry. 2004;161(11):2126-8.   DOI
46 Staner L, Cornette F, Maurice D, Viardot G, Bon OL, Haba J, Staner C, Luthringer R, Muzet A, Macher JP. Sleep microstructure around sleep onset differentiates major depressive insomnia from primary insomnia. Journal of sleep research. 2003;12(4):319-30.   DOI
47 Kim SY, Kim SW, Park HJ. Different Responses to Acupuncture in Electroencephalogram according to Stress Level: A Randomized, Placebo-Controlled, Cross-Over Trial. Korean Journal of Acupuncture. 2014;31(3):136-45.   DOI
48 Kim MS, Kim HD, Seo HD, Sawada K, Ishida M. The effect of acupuncture at PC-6 on the electroencephalogram and electrocardiogram. The American journal of Chinese medicine. 2008;36(03):481-91.   DOI
49 Huang Z, Liang P, Jia X, Zhan S, Li N, Ding Y, Lu J, Wang Y, Li K. Abnormal amygdala connectivity in patients with primary insomnia: evidence from resting state fMRI. European journal of radiology. 2012;81(6):1288-95.   DOI