音乐治疗基础上联合经颅直流电刺激对失眠效果的随机对照试验

doi:10.3969/j.issn.1006-9771.2024.10.010

Abstract

Abstract:

Objective To explore the effect of transcranial direct current stimulation (tDCS) based on music therapy on insomnia.

Methods From July, 2023 to April, 2024, 70 patients with insomnia in the Fourth Affiliated Hospital of Soochow University were randomly divided into control group (n = 35) and observation group (n = 35). Both groups accepted music therapy; moreover, the observation group accepted tDCS, and the control group accepted sham tDCS, for four weeks. They were assessed with Pittsburgh Sleep Quality Index (PSQI) total score and sub-score, Hamilton Depression Scale 17-item (HAMD-17), Hamilton Anxiety Scale (HAMA), Chinese version of Stress Perception Scale (CPSS); and the relative power of resting-state electroencephalography (EEG) and mean blood flow velocity (Vm) of each cerebral artery with transcranial Doppler were measured before and after treatment.

Results Five cases dropped down in the control group, and four in the observation group. PSQI total score and sub-score, HAMD-17 score, HAMA score and CPSS score (|t| > 3.503, P < 0.01) in the observation group decreased after treatment, and were less in the observation group than in the control group (|t| > 2.304, P < 0.05), except sleep duration, sleep efficiency and CPSS scores. The relative power of δ and θ increased in the observation group, and decreased in α, β and γ (|t| > 6.468, P < 0.001), and were better in the observation group than in the control group (|t| > 2.395, P < 0.05). The Vm of each artery increased in the observation group (|t| > 4.624, P < 0.001), and were more in the observation group than in the control group (|t| > 2.147, P < 0.05).

Conclusion tDCS based on music therapy may further improve sleep quality and EEG activity, increase cerebral blood flow velocity, and reduce adverse emotions in insomnia patients.

Key words: insomnia, transcranial direct current stimulation, music therapy, depression, anxiety, lectroencephalography, transcranial Doppler, randomized controlled trial

CLC Number:

R740

CAI Siyan, FAN Yingjie, TIAN Huifang, XIA Chunya, ZHANG Juan, SU Min. Effect of transcranial direct current stimulation based on music therapy on insomnia: a randomized controlled trial[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(10): 1193-1202.

Figures/Tables 7

Table 1

Table 2

Comparison of total and sub-score of PSQI between two groups pre- and post-treatment"

变量	组别	n	测试	$x - ± s$	t值	P值
PSQI总分	对照组	30	前测	12.73±2.94	6.814	< 0.001
			后测	10.37±3.32
	观察组	31	前测	13.10±2.61	9.589	< 0.001
			后测	7.90±2.29
	治疗前两组均值差			0.36±0.71	0.511	0.611
	治疗后两组均值差			-2.46±0.73	-3.388	0.001
睡眠质量	对照组	30	前测	2.70±0.47	8.764	< 0.001
			后测	1.77±0.77
	观察组	31	前测	2.58±0.50	13.616	< 0.001
			后测	1.26±0.51
	治疗前两组均值差			-0.12±0.12	-0.962	0.340
	治疗后两组均值差			-0.51±0.17	-3.013	0.004
入睡时间	对照组	30	前测	2.53±0.68	7.954	< 0.001
			后测	1.73±0.83
	观察组	31	前测	2.45±0.57	11.180	< 0.001
			后测	1.16±0.64
	治疗前两组均值差			-0.08±0.16	-0.509	0.612
	治疗后两组均值差			-0.57±0.19	-3.030	0.004
睡眠时间	对照组	30	前测	1.77±0.90	1.649	0.110
			后测	1.57±0.82
	观察组	31	前测	1.87±0.67	3.503	0.001
			后测	1.48±0.51
	治疗前两组均值差			0.10±0.20	0.513	0.610
	治疗后两组均值差			-0.08±0.18	-0.473	0.638
睡眠效率	对照组	30	前测	1.97±0.85	1.682	0.103
			后测	1.83±0.83
	观察组	31	前测	2.26±0.63	5.068	< 0.001
			后测	1.53±0.63
	治疗前两组均值差			0.29±0.19	1.524	0.133
	治疗后两组均值差			-0.32±0.19	-1.684	0.097
睡眠障碍	对照组	30	前测	1.87±0.90	2.693	0.012
			后测	1.67±0.92
	观察组	31	前测	2.06±0.68	6.750	< 0.001
			后测	1.19±0.65
	治疗前两组均值差			0.20±0.21	0.967	0.338
	治疗后两组均值差			-0.47±0.21	-2.304	0.025
日间功能障碍	对照组	30	前测	1.90±0.89	1.000	0.326
			后测	1.80±0.81
	观察组	31	前测	1.87±0.72	4.811	< 0.001
			后测	1.29±0.64
	治疗前两组均值差			-0.03±0.21	-0.141	0.888
	治疗后两组均值差			-0.51±0.19	-2.737	0.008

Table 2

Table 3

Comparison of score of HAMD-17 between two groups pre- and post-treatment"

组别	n	测试	$x - ± s$	t值	P值
对照组	30	前测	9.87±4.39	4.568	< 0.001
		后测	7.93±3.59
观察组	31	前测	10.29±4.61	7.375	< 0.001
		后测	5.81±2.26
治疗前两组均值差			0.42±1.15	0.367	0.715
治疗后两组均值差			-2.13±0.77	-2.759	0.008

Table 3

Table 4

Comparison of score of HAMA between two groups pre- and post-treatment"

组别	n	测试	$x - ± s$	t值	P值
对照组	30	前测	9.93±4.31	4.176	< 0.001
		后测	7.97±2.53
观察组	31	前测	10.42±4.41	12.101	< 0.001
		后测	6.19±3.10
治疗前两组均值差			0.49±1.12	0.435	0.665
治疗后两组均值差			-1.77±0.73	-2.443	0.018

Table 4

Table 5

Comparison of score of CPSS between two groups pre- and post-treatment"

组别	n	测试	$x - ± s$	t值	P值
对照组	30	前测	41.97±4.77	3.537	0.001
		后测	39.63±4.15
观察组	31	前测	43.23±5.52	5.609	< 0.001
		后测	37.61±4.84
治疗前两组均值差			1.26±1.32	0.952	0.345
治疗后两组均值差			-2.02±1.16	-1.748	0.086

Table 5

Table 6

频段	组别	n	测试	$x - ± s$	t值	P值
δ	对照组	30	前测	4.77±0.73	-1.588	0.123
			后测	4.87±0.63
	观察组	31	前测	4.69±0.81	-8.132	< 0.001
			后测	5.27±0.67
	治疗前两组均值差			-0.08±0.20	-0.391	0.697
	治疗后两组均值差			0.40±0.17	2.415	0.019
θ	对照组	30	前测	3.33±0.53	-4.185	< 0.001
			后测	3.48±0.47
	观察组	31	前测	3.29±0.59	-8.822	< 0.001
			后测	3.77±0.48
	治疗前两组均值差			-0.04±0.14	-0.312	0.756
	治疗后两组均值差			0.29±0.12	2.395	0.020
α	对照组	30	前测	6.94±0.57	4.137	< 0.001
			后测	6.74±0.67
	观察组	31	前测	6.98±0.61	9.043	< 0.001
			后测	6.31±0.73
	治疗前两组均值差			0.04±0.15	0.291	0.772
	治疗后两组均值差			-0.43±0.18	-2.424	0.018
β	对照组	30	前测	3.59±0.57	0.608	0.548
			后测	3.54±0.58
	观察组	31	前测	3.62±0.46	6.558	< 0.001
			后测	3.15±0.57
	治疗前两组均值差			0.04±0.13	0.268	0.789
	治疗后两组均值差			-0.39±0.15	-2.609	0.011
γ	对照组	30	前测	0.45±0.08	3.125	0.004
			后测	0.41±0.08
	观察组	31	前测	0.44±0.07	6.468	< 0.001
			后测	0.35±0.07
	治疗前两组均值差			-0.01±0.02	-0.476	0.636
	治疗后两组均值差			-0.06±0.02	-3.092	0.003

Table 6

Table 7

变量	组别	n	测试	$x - ± s$	t值	P值
ICA	对照组	30	前测	30.07±3.01	-5.159	< 0.001
			后测	32.63±3.16
	观察组	31	前测	29.71±3.07	-11.624	< 0.001
			后测	35.42±3.06
	治疗前两组均值差			-0.36±0.78	-0.459	0.648
	治疗后两组均值差			2.79±0.80	3.498	0.001
MCA	对照组	30	前测	59.07±8.35	-2.962	0.006
			后测	62.03±7.42
	观察组	31	前测	59.94±8.14	-5.804	< 0.001
			后测	66.52±7.92
	治疗前两组均值差			0.87±2.11	0.412	0.682
	治疗后两组均值差			4.48±1.97	2.280	0.026
ACA	对照组	30	前测	48.63±6.26	-1.885	0.069
			后测	50.27±5.83
	观察组	31	前测	47.94±6.04	-4.666	< 0.001
			后测	53.39±5.52
	治疗前两组均值差			-0.70±1.85	-0.443	0.659
	治疗后两组均值差			3.12±1.45	2.147	0.036
PCA	对照组	30	前测	36.20±4.82	-0.872	0.390
			后测	37.10±4.64
	观察组	31	前测	35.90±4.69	-4.624	< 0.001
			后测	40.10±5.02
	治疗前两组均值差			-0.30±1.22	-0.244	0.808
	治疗后两组均值差			3.00±1.24	2.420	0.019
VA	对照组	30	前测	29.20±3.85	-4.482	< 0.001
			后测	31.67±3.66
	观察组	31	前测	29.81±3.81	-7.043	< 0.001
			后测	34.06±3.47
	治疗前两组均值差			0.61±0.98	0.619	0.538
	治疗后两组均值差			2.40±0.91	2.625	0.011
BA	对照组	30	前测	36.40±3.70	-4.686	< 0.001
			后测	40.07±4.19
	观察组	31	前测	37.06±3.87	-8.667	< 0.001
			后测	42.65±3.82
	治疗前两组均值差			0.67±0.97	0.685	0.496
	治疗后两组均值差			2.58±1.03	2.513	0.015

Table 7

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组别	n	性别(男/女)/n	年龄/岁	教育年限/年
对照组	30	17/13	40.87±11.62	12.50±4.19
观察组	31	14/17	42.81±15.94	11.87±5.51
t/χ²值		0.807	0.544	-0.503
P值		0.369	0.588	0.617

Effect of transcranial direct current stimulation based on music therapy on insomnia: a randomized controlled trial

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