Efficacy of electroacupuncture for cervical spondylosis-related pain in patients with generalized anxiety disorder

Table 1 Baseline demographic and clinical characteristics of study participants (n = 83), mean ± SD/n (%)

Characteristic	Value
Age (years)	48.6 ± 9.7
Female sex	51 (61.4)
BMI (kg/m²)	24.3 ± 3.5
Duration of CS symptoms (years)	4.3 ± 2.8
Duration of GAD diagnosis (years)	3.1 ± 2.2
Radiological findings
Disc degeneration	83 (100)
Foraminal stenosis	62 (74.7)
Facet joint arthropathy	48 (57.8)
Uncovertebral joint arthropathy	37 (44.6)
Baseline VAS score	6.8 ± 1.4
Baseline NDI score	28.3 ± 6.2
Baseline HAM-A score	21.6 ± 5.3
Baseline GAD-7 score	14.2 ± 3.8
Neuroinflammatory markers
IL-6 (pg/mL)	3.42 ± 1.18
TNF-α (pg/mL)	8.76 ± 2.53
hs-CRP (mg/L)	2.83 ± 1.17
Concurrent medications
SSRIs/SNRIs	58 (69.9)
Benzodiazepines	45 (54.2)
NSAIDs	61 (73.5)
Muscle relaxants	42 (50.6)
Treatment adherence (%), median (IQR)	91.7 (83.3-95.8)

BMI: Body mass index; CS: Cervical spondylosis; GAD: Generalized anxiety disorder; VAS: Visual analog scale; NDI: Neck disability index; HAM-A: Hamilton Anxiety Rating Scale; GAD-7: Generalized anxiety disorder 7-item scale; IL-6: Interleukin-6; TNF-α: Tumor necrosis factor-alpha; hs-CRP: High-sensitivity C-reactive protein; SSRIs: Selective serotonin reuptake inhibitors; SNRIs: Serotonin-norepinephrine reuptake inhibitors; NSAIDs: Non-steroidal anti-inflammatory drugs; IQR: Interquartile range.

Table 2 Changes in pain, anxiety, and neuroinflammatory markers during electroacupuncture treatment (n = 83), mean ± SD/n (%)

Outcome measure	Baseline	Week 4	Week 8	Change from baseline to week 8	P value1
Pain and function
VAS score	6.8 ± 1.4	4.9 ± 1.3	3.6 ± 1.2	-3.24 ± 1.18 (-47.6%)	< 0.001
NDI score	28.3 ± 6.2	21.7 ± 5.8	15.9 ± 5.3	-12.4 ± 4.7 (-43.8%)	< 0.001
Patients achieving ≥ 30% VAS reduction		43 (52.4)	65 (78.3)
Anxiety symptoms
HAM-A score	21.6 ± 5.3	16.8 ± 4.9	13.8 ± 4.2	-7.83 ± 2.65 (-36.3%)	< 0.001
GAD-7 score	14.2 ± 3.8	10.6 ± 3.2	8.3 ± 2.7	-5.9 ± 2.1 (-41.8%)	< 0.001
Patients achieving ≥ 50% HAM-A reduction		19 (22.9)	34 (41.0)
Neuroinflammatory markers
IL-6 (pg/mL)	3.42 ± 1.18	2.83 ± 0.96	2.30 ± 0.79	-1.12 ± 0.51 (-32.7%)	< 0.001
TNF-α (pg/mL)	8.76 ± 2.53	7.25 ± 2.17	6.27 ± 1.85	-2.49 ± 1.02 (-28.5%)	< 0.001
hs-CRP (mg/L)	2.83 ± 1.17	2.36 ± 0.94	1.95 ± 0.83	-0.88 ± 0.42 (-31.1%)	< 0.001
Patients with normal IL-62	27 (32.5)	44 (53.0)	56 (67.5)
Patients with normal TNF-α2	24 (28.9)	41 (49.4)	53 (63.9)
Patients with normal hs-CRP2	30 (36.1)	48 (57.8)	60 (72.3)

¹P value represents comparison between baseline and week 8 using repeated-measures ANOVA with Bonferroni correction.

²Normal reference ranges: Interleukin-6 < 2.0 pg/mL; tumor necrosis factor-alpha < 5.5 pg/mL; high-sensitivity C-reactive protein < 1.0 mg/L.

VAS: Visual analog scale; NDI: Neck disability index; HAM-A: Hamilton Anxiety Rating Scale; GAD-7: Generalized anxiety disorder 7-item scale; IL-6: Interleukin-6; TNF-α: Tumor necrosis factor-alpha; hs-CRP: High-sensitivity C-reactive protein.