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Comment on “Shiatsu as an Adjuvant Therapy for Depression in Patients With Alzheimer’s Disease: A Pilot Study”

机译:评论“指压疗法作为阿尔茨海默氏病患者抑郁症的辅助疗法:一项初步研究”

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Recently, there has been increasing interest toward nonpharmacological approaches for dementia and associated clinical manifestations, such as depression, with the common goal to improve health and quality of life of both patients and caregivers. In this scenario, the role of Shiatsu is of clinical and research interest, although to date a definitive recommendation on a systematic use in clinical practice cannot be made. To overcome the heterogeneity of the previous studies, we tested Shiatsu as an add-on treatment for late-life depression in a dedicated community of patients with mild-to-moderate Alzheimer’s disease. We found a significant adjuvant effect of Shiatsu for depression in these patients and hypothesized a neuroendocrine-mediated action on the neural circuits implicated in mood and affect regulation. However, this finding must be considered preliminary and requires confirmation in larger-scale controlled studies, possibly extending the range of outcome measures and including predictors of response. Future investigations should also include an objective assessment of the hypothalamus-pituitary-adrenocortical axis functioning. Nevertheless, starting from this pilot study, we suggest that a customized protocol applied for an adequate period in a controlled sample will represent a non-invasive and feasible advance for promoting patients’ mood and, possibly, slowing cognitive decline.
机译:近来,人们对用于痴呆症和相关临床表现(例如抑郁症)的非药理学方法越来越感兴趣,其共同目标是改善患者和护理人员的健康和生活质量。在这种情况下,指压的作用具有临床和研究意义,尽管迄今为止尚无法就临床实践中的系统使用提出明确的建议。为了克服先前研究的异质性,我们在专门的轻度至中度阿尔茨海默氏病患者社区中对指压按摩作为晚期抑郁症的附加疗法进行了测试。我们发现Shiatsu对这些患者的抑郁有显着的辅助作用,并假设了神经内分泌介导的对涉及情绪和影响调节的神经回路的作用。然而,这一发现必须被认为是初步的,并且需要在大规模对照研究中得到证实,这可能会扩大结果测量的范围,并包括反应的预测因子。未来的研究还应包括对下丘脑-垂体-肾上腺皮质轴功能的客观评估。然而,从这项初步研究开始,我们建议在对照样本中应用适当时间的定制方案将代表无创且可行的进展,以促进患者的情绪并可能减缓认知能力下降。

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