Percutaneous Mastoid Electrical Stimulator improves poststroke depression and cognitive function in patients with ischemic stroke

Backgrond Poststroke depression could lead to functional dependence, cognitive impairment and reduced quality of life. The aim of this study was to evaluate the effects of percutaneous mastoid electrical stimulator (PMES) plus antidepressant on poststroke depression and cognitive function.Methods 258 clinically depressed ischemic stroke patients within 14 d of index stroke were randomly assigned to PMES plus antidepressant (PMES group) and sham plus antidepressant (sham group). All patients underwent Montreal Cognitive Assessment (MoCA) and Hamilton Rating Scale for Depression (HRSD) test at 2 weeks (baseline), and 6 months after the stroke. The clinical outcome was defined as treatment response (≥50% reduction in HRSD) and depression remission (HRSD≤9) at 6 months.Results Compared with the sham group, PEMS group significantly improved MoCA and HRSD scoreat the end of the 6-month treatment period (P<0.001). The mean value of MoCA score change (3.50±2.55 vs 2.72±2.52; P=0.005), and HRSD score change (-11.93 ±5.32 vs -10.48 ± 6.10, P = 0.041) was significantly greater in the PMES group compared to sham group at 6 months. In fully adjusted models, PMES plus antidepressant was associated with increased treatment response rate [adjusted odds ratio (OR), 2.04; 95% confidence interval (CI), 1.15-3.63; P=0.015], and depression remission rate [adjusted OR, 1.83; 95% CI, 1.05-3.18; P=0.032]. In fully adjust models, PMES plus antidepressant was associated with decreased risk of 6-month MoCA score <26 (adjusted OR, 0.25; 95%CI, 0.09–0.70; P=0.008).Conclusion These findings demonstrate that PMES adjunctive to antidepressant therapy is highly effective in reducing depression, achieving remission in the short term, and improving cognition.