Electroacupuncture improves cognitive function and neuropsychiatric symptoms in breast cancer survivors: a pilot randomized controlled trial

BACKGROUND: We conducted a randomized, double-blinded pilot trial to compare the impact of 2 electroacupuncture (EA) regimens on co-occurring neuropsychiatric symptoms among breast cancer survivors. METHODS: Breast cancer survivors (BCS) who self-reported cognitive impairment, fatigue, insomnia, or psychological distress were randomized (1:1) to receive 10 weekly EA to target either neuropsychiatric-specific (neuropsychiatric-specific EA, nEA) or nonneuropsychiatric-specific (sham EA, sEA) acupoints. Primary endpoints were the within-group pre-post effect sizes (Glass's Δ) in symptom severities, adjusted for multiple comparisons (Padjusted). Outcomes were assessed using neurocognitive tests (CANTAB), patient-reported outcomes (PROs) (Functional Assessment of Cancer Therapy-Cognitive Function, Multidimensional Fatigue Symptom Inventory-Short Form, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30), plasma biomarkers, and neuroimaging. Responders were defined by reliable change index (for objective cognition) or minimal clinically important differences (for PROs). RESULTS: Thirty-five participants were recruited, with 30 (86%) completing all sessions. The mean (±SD) age was 58.2 (±12.2) years, and 86% reported co-occurring symptoms. Following treatment, the nEA group demonstrated significant improvements in attention (T3: Δ = 0.562, T4: Δ = 0.708, both Padjusted