Effectiveness and safety of acupuncture in the treatment of Parkinson’s disease: A systematic review and meta-analysis of randomized controlled trials

Noh, Hyeon-seok; Kwon, Seungwon; Cho, Seung‐Yeon; Jung, Woo-Sang; Moon, Sang-Kwan; Park, Jung-Mi; Ko, Chang-Nam; Park, Seong-Uk

doi:10.1016/j.ctim.2017.08.005

Cited by 34 publications

(33 citation statements)

References 19 publications

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“…The characteristics of the included studies are shown in Table 1 . Subjective behavioral assessments employed in this study include the Unified Parkinson's Disease Rating Scale (UPDRS) ( 6 – 9 , 11 – 16 ), the Webster Scale ( 6 , 7 , 9 , 16 ), the Tension Assessment Scale (TAS) ( 9 ), the Parkinson's Disease Sleep Scale (PDSS) ( 10 , 12 , 15 ), the Postural Instability Gait Disorder (PIGD) ( 11 ), the Parkinson's Disease Quality of Life Questionnaire (PDQL) ( 11 ), the Beck Depression Inventory (BDI) ( 11 ), the Modified Fatigue Impact Scale (MFIS) ( 12 ), the 39-Item Parkinson's Disease Questionnaire (PDQ-39) ( 12 , 15 ), and the Pittsburgh Sleep Quality Index (PSQI) ( 14 ). One RCT used gait speed as an objective assessment ( 13 ).…”

Section: Resultsmentioning

confidence: 99%

“…In Noh's study, all RCTs had a performance bias and 39 of 42 RCTs had a selection bias. In addition, most studies included had a small sample size, and only seven out of 42 RCTs reported a follow-up ( 9 ). Of note, some overlaps occurred among the four meta-analyses.…”

Section: Resultsmentioning

confidence: 99%

“…A meta-analysis by Lee and Lim analyzed seven RCTs with 425 participants and found that the protocol acupuncture + classical treatment showed superior efficacy to classical treatment (weighted mean difference [WMD] = −10.73; 95% CI, −8.38 to−13.07; P < 0.001; I 2 = 0%) ( 7 ). These results are similar to those of Liu et al from 11 RCTs with 831 participants [standardized mean difference [SMD] = −1.15; 95% CI, −1.63 to −0.67; P < 0.001] ( 8 ), of Noh from five RCTs with 407 participants (WMD = −10.48; 95% CI, −13.61 to −7.34; P < 0.00001, I 2 = 47%) ( 9 ), and of Lee from two RCTs with 60 participants (WMD = −3.94; 95% CI, −6.05 to −1.84; P = 0.01; I 2 = 0%) ( 6 ).…”

Section: Resultsmentioning

confidence: 99%

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Evidence for the Use of Acupuncture in Treating Parkinson's Disease: Update of Information From the Past 5 Years, a Mini Review of the Literature

et al. 2018

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Acupuncture is an alternative therapy for Parkinson's disease (PD), but its efficacy and safety are controversial. Our previous study, which reviewed the literature from 1974 to 2012, could not find enough evidence from rigorously designed randomized, controlled trials (RCTs) to make a conclusion about the efficacy of acupuncture. Recently, more RCTs and meta-analyses have been conducted to evaluate the efficacy of acupuncture. The aim of our current study is to provide updated information in brief on this topic. In this study, we analyzed and summarized seven RCTs and four meta-analyses. Although all included studies were not of high quality, we found that there has been a tremendous progress in acupuncture research in treating Parkinson's disease (PD) during the past 5 years, based on our experience and insights into the behavioral assessments of PD. First, the numbers of RCTs and meta-analyses based on RCTs are increasing. Second, non-motor symptoms are increasingly emphasized. Third, objective behavioral assessment tools are being employed. Although recent studies can provide limited evidence for the efficacy of acupuncture, we make the following recommendations for the future investigation: First, large, multicenter, well-designed RCTs should be organized for evaluation of the efficacy of acupuncture. Second, objective assessments using novel computerized technologies should be considered. Third, target symptoms should be selected and evaluated instead of only performing global evaluations. Fourth, attention should be paid to the efficacy of scalp acupuncture. Fifth, the safety of acupuncture should be evaluated and reported.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Evidence for the Use of Acupuncture in Treating Parkinson's Disease: Update of Information From the Past 5 Years, a Mini Review of the Literature

et al. 2018

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“…The interventions in the therapy groups were mainly acupuncture or acupuncture plus medication, and the interventions in the control groups were mainly medication and sham placebo acupuncture. The conclusions from these reviews differed: 10 reviews reached the conclusion that acupuncture was effective in relieving PD symptoms, while the remaining 1 ( 47 ) reached the opposite conclusion.…”

Section: Resultsmentioning

confidence: 97%

“…However, one review compared the effects of acupuncture vs. madopar alone and found no significant difference in the UPDRS score between treatments [WMD = −2.55, 95% CI (−11.15, 6.05), P = 0.56]. In addition, Noh et al ( 47 ) compared the effects of acupuncture vs. placebo acupuncture and observed no significant effect of acupuncture on PD symptoms [MD = −2.46, 95% CI (−11.36, −6.45), P = 0.59].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Acupuncture in the Treatment of Parkinson's Disease: An Overview of Systematic Reviews

et al. 2020

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Background: The effects of acupuncture on Parkinson's disease (PD) outcomes remain unclear. The aim of this overview was to comprehensively evaluate the methodological quality and applicability of the results of systematic reviews (SRs)/meta-analyses (MAs) that examined the use of acupuncture to treat PD. Methods: Eight databases were searched to retrieve SRs/MAs on the use of acupuncture for the treatment of PD. Two reviewers independently screened and extracted the data using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) checklist to evaluate the methodological quality and using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria to assess the evidence quality of the included reviews. Results: A total of 11 SRs/MAs were included. According to the AMSTAR-2 checklist results, all included SRs/MAs were rated as very-low-quality studies. The GRADE criteria revealed 20 studies with very-low-quality evidence, 9 with low-quality evidence, 3 with moderate-quality evidence, and 0 with high-quality evidence. Descriptive analysis showed that acupuncture appears to be a clinically effective and safe treatment for PD. Conclusions: The use of acupuncture for the treatment of PD may be clinically effective and safe. This conclusion must be interpreted cautiously due to the generally low methodological quality and low quality of evidence of the included studies.

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Effectiveness of Acupuncture for Anxiety Among Patients With Parkinson Disease

Fan

Tan

et al. 2022

JAMA Netw Open

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ImportanceOne of the ordinary manifestations of Parkinson disease (PD) is anxiety, which remains untreated. Anxiety is closely associated with the accelerated progression of PD. Efficacy of acupuncture for anxiety has been reported. However, to date, there are no data on acupuncture’s effectiveness on anxiety for patients with PD.ObjectiveTo investigate the effect of acupuncture vs sham acupuncture for treating anxiety in patients with PD.Design, Setting, and ParticipantsThis is randomized, double-blinded, clinical trial enrolled patients between June 20, 2021, and February 26, 2022. Final follow-up was April 15, 2022. Patients with Parkinson disease and anxiety were allocated randomly (1:1) to receive acupuncture or sham acupuncture for 8 weeks. Acupuncture operators, outcome measures evaluators, and statistical analysts were blinded to the grouping of patients. Patients were blinded to their own grouping during the study. This study took place in the Parkinson clinic of a hospital in China.InterventionsReal acupuncture or sham acupuncture for 8 weeks.Main Outcomes and MeasuresPrimary outcome was Hamilton Anxiety Scale (HAM-A) score. Secondary outcomes were scores on the Unified Parkinson Disease Rating Scale (UPDRS), 39-item Parkinson Disease Questionnaire (PDQ-39), and serum levels of the adrenocorticotropic hormone (ACTH) and cortisol (CORT).ResultsSeventy eligible patients were enrolled, including 34 women (48.5%) and 36 men (51.4%). Sixty-four patients (91%) completed the intervention and the 8-week follow-up, including 30 women (46.9%) and 34 men (53.1%) with a mean (SD) age of 61.84 (8.47) years. At the end of treatment, the variation of HAM-A score was 0.22 (95% CI, –0.63 to 1.07; P = .62) between the real acupuncture and sham acupuncture groups. At the end of follow-up, the real acupuncture group had a significant 7.03-point greater (95% CI, 6.18 to 7.88; P < .001) reduction in HAM-A score compared with the sham acupuncture group. Four mild adverse reactions occurred during the study.Conclusions and RelevanceThis study found acupuncture to be an effective treatment for anxiety in patients with PD. These findings suggest that acupuncture may enhance the wellbeing of patients who have Parkinson disease and anxiety.Trial RegistrationChinese Clinical Trial Registry: ChiCTR2100047253

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Effectiveness and safety of acupuncture in the treatment of Parkinson’s disease: A systematic review and meta-analysis of randomized controlled trials

Cited by 34 publications

References 19 publications

Evidence for the Use of Acupuncture in Treating Parkinson's Disease: Update of Information From the Past 5 Years, a Mini Review of the Literature

Evidence for the Use of Acupuncture in Treating Parkinson's Disease: Update of Information From the Past 5 Years, a Mini Review of the Literature

Effectiveness of Acupuncture in the Treatment of Parkinson's Disease: An Overview of Systematic Reviews

Effectiveness of Acupuncture for Anxiety Among Patients With Parkinson Disease

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