A prospective randomized controlled trial aimed at assessing if electroacupuncture (EA) combined with donepezil is more effective than donepezil for improving the cognitive function of AD patients. The hypothesis of this study is as follow: * Is the short-term effect of EA combined with donepezil better than donepezil on improving cognitive function of patients with Alzheimer's disease after 12 weeks' treatment? * Whether the effect of EA combined with donepezil on improving cognitive function can last until the end of 6 months' follow-up?
* Patient registry: Participants experiencing cognitive impairment will be recruited will be recruited at Guang'anmen Hospital, Beijing, China, via web or posters. A neurologist will make the diagnosis. Randomization will be performed by the pharmacological assessment center at Guang'anmen Hospital. * Sample size: The calculation of sample size is based on the primary outcome that the change from baseline in ADAS-cog. According to previous studies \[26\], 39% of patients showed an improvement of at least 4 points on the ADAS-cog after treating by donepezil. We estimated the rate 39% in the donepezil group and 55% in the EA combined with donepezil group. 304 participants were needed to provide 80% power at a significant level of 5% using analysis of variance. The total sample size required for the study is 334 (167 each group) assuming a 10% loss to follow-up. * Quality control 1. Investigators participating in this trial will take a strict course about the process of randomization, manipulation of electroacupuncture, selection of patients, the whole process of this trial and request for filling out case report form in order to improve the internal consistency of observation between different researchers. 2. The process of randomization will be under a rigorous control. 3. This trial has a specific inclusion and exclusion criteria. 4. Both outcome assessors and statisticians will be blinding. 5. Patients will sign the informed consent voluntarily and a good relationship between researchers and patients will be established in order to improve patients' compliance. Participants will have a detailed record of the contact information easy for follow-up. 6. The standard of the drugs, acupuncture apparatus, inspection equipment are consistent for the patients in the two groups. * Outcome assessment, completion of case report forms and data management will be under a rigorous supervision.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
334
For GV16, the needle in length of 25mm will be inserted obliquely and downward towards mandibular direction slowly to a depth of 0.5. And the needle will be pulled out after "de qi" without being retained. For Shang Yintang, GV20 and GV24, the needle will be inserted with a 30°angle to a depth of about 0.5 cun to the subperiosteum until the patients have a strong sense that the needle is being heavily pressed. For EX-HN5 and KI 4 in both sides, the needle will be outward and obliquely inserted to the same depth of 1 cun and the needle will be manipulated with an even lifting and thrusting method to make the patients feel soreness and distention. The electric stimulator will be put on GV20, GV24 and EX-HN5 in both sides with a spare-dense wave, 10/50 Hz, 0.5-5.0 mA. The current intensity will be increased until the patients can not stand.
cholinesterase inhibitors (ChE-Is)
Guang'an Men Hospotal Affiliated to China Academy of Chinese Medical Sciences
Beijing, China
RECRUITINGchange of total ADAS-cog score from baseline
The maximum score of ADAS-cog is 70 including 15 items of cognitive dysfunction assessment. The higher values indicate higher degree of deficit.
Time frame: week 12 ± 3 days
change of total MMSE score from baseline
MMSE score are commonly used for estimating the severity of cognitive impairment with maximum score of 30. The questions in this scale included orientation to time, orientation to place, attention and calculation, recall of three words and visual construction.
Time frame: week 12 ± 3 days
change of total MMSE score from baseline
Time frame: week 36 ± 3 days
change of total ADCS-ADL score score from baseline
ADCS-ADL score contains 19 domains about assessment of basic and operational ability of daily living.
Time frame: week 12 ± 3 days
change of total ADCS-ADL score score from baseline
Time frame: week 36 ± 3 days
change of total QoL-AD score score from baseline
QOL-AD score which includes physical health, mental health, social and financial assessment and QOL domains is completed by both patients and caregivers.
Time frame: week 12 ± 3 days
change of total QoL-AD score score from baseline
Time frame: week 36 ± 3 days
change of total ADAS-cog score from baseline
Time frame: week 36 ± 3 days
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