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

Abstract

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.

Acupuncture for Parkinson’s Disease: Efficacy Evaluation and Mechanisms in the Dopaminergic Neural Circuit

“…Interestingly, when comparing acupuncture only with medication only, there is no significant difference in the scores. Moreover, evidence-based medicine (EBM) studies have analyzed 13 parallel RCTs and found no difference in the efficacy of acupuncture compared with medication for PD treatment [10], suggesting that acupuncture may achieve an efficacy close to that of medication. The Webster Scale is applied to assess the clinical severity of PD, rating levels of akinesia, rigidity, upper limb swing, gait, tremor, facial appearance, speech, and self-care [16].…”

“…The Webster Scale is applied to assess the clinical severity of PD, rating levels of akinesia, rigidity, upper limb swing, gait, tremor, facial appearance, speech, and self-care [16]. Compared with medication only, acupuncture and medication combined have been shown to result in a greater Webster score reduction, indicating an alleviation of clinical severity [12], and compared with medication only, acupuncture alone similarly exhibited a positive effect for decreasing the Webster score [10], suggesting that acupuncture alone may be able to effectively reduce the severity of PD. EBM reviews reveal that even with an optimized oral dose of L-DOPA, there is a risk for a worsening of movement disorders, and a variety of anti-PD drugs may also induce or exacerbate nonmotor symptoms [17].…”

“…Numerous clinical trials have shown that acupuncture exhibits significant therapeutic benefits for PD patients, reducing both motor and nonmotor symptoms. Moreover, acupuncture may help to reduce the dose and frequency of anti-PD drugs as well as alleviate their side effects [10]. The therapeutic mechanisms of acupuncture have also been shown to involve a reduction of mitochondrial dysfunction, oxidative stress, protein aggregation, impaired autophagy, and neuroinflammation [11].…”

Effect of Acupuncture on Movement Function in Patients with Parkinson’s Disease: Network Meta-Analysis of Randomized Controlled Trials

“…Therefore, when BEEV is used alone or in combination with conventional drugs for PD, neuronal degeneration is alleviated, and movement disorders are reduced [54]. Several systematic reviews and meta-analyses of RCTs have also been published about the effect and safety of several acupuncture treatment modalities on PD [13,16,17,55]. However, it is unclear which acupuncture modality has a better effect and should be considered in clinical practice and research on PD.…”

Global Trend in the Research and Development of Acupuncture Treatment on Parkinson's Disease From 2000 to 2021: A Bibliometric Analysis

“…In South Korea, this can be as high as 76% (9,10). Acupuncture is an essential complementary component to the drug therapy for PD (11). The mechanisms of the effectiveness of acupuncture for the treatment of PD remain uncertain, though an increasing number of studies revealed acupuncture's therapeutic effects both in clinical and animal experiments research for PD (12)(13)(14)(15).…”