Efficacy of electroacupuncture for the treatment of constipation in Parkinson’s disease: study protocol for a multicentre randomised controlled trial

Abstract

IntroductionConstipation is one of the most common non-motor symptoms in Parkinson’s disease (PD). Acupuncture can have a positive on chronic functional constipation and PD, but its efficacy for the treatment of constipation in PD has not yet been confirmed by high-quality clinical trials. Therefore, this study aims to evaluate the efficacy and safety of electroacupuncture (EA) in the treatment of constipation in PD.Methods and analysisThis study is a multicentre randomised controlled trial. A total of 124 qualified patients with PD and constipation will be randomly divided into the intervention group (62 participants will receive 12 weeks of EA +usual care) or the waitlist control group (62 participants will receive 12 weeks of usual care). EA will be performed three times per week from weeks 1–8, two times per week during weeks 9 and 10, and once a week during weeks 11 and 12. The primary outcome is the change in mean weekly spontaneous bowel movements from baseline to weeks 8 and 9. The secondary outcomes are the changes from baseline in mean weekly bowel movements, mean weekly stool consistency, and mean weekly straining. Other secondary outcomes include the weekly doses of defecation drugs, Visual Analogue Scale for subjective improvements in stool symptoms, Unified Parkinson’s Disease Rating Scale, and the time and number of steps required to walk 20 m. Outcomes will be assessed at baseline, week 4, 8, 12 (intervention period); as well as at week 16, 24 (follow-up period).Ethics and disseminationEthical approval has been obtained from four local ethics committees. The results of the study will be published in peer-reviewed journals and will be disseminated through national and international conferences.Trial registration numberChiCTR1900021053

Electroacupuncture Suppresses CCI-Induced Neuropathic Pain through GABAA Receptors

“…Numerous clinical studies and experimental studies have indicated the therapeutic effects of acupuncture in the treatment of pain [14,15]. Electroacupuncture (EA) is a modified form of combining traditional acupuncture with modern electrotherapy, and it refers to the stimulation of acupoints by applying a pulsating electrical current through acupuncture needles [16,17]. e therapeutic onset for EA treatment is associated with the production and release of various endogenous bioactive substances, containing monoamines, opioids, neurotrophins, adenosine, and cytokines [18][19][20]; the precise mechanism underlying the action of EA analgesia remains unknown.…”

Electroacupuncture Modulates 5-HT4R-Mediated cAMP/PKA Signaling to Improve Intestinal Motility Disorders in a Thy1-αSyn Parkinson’s Mouse Model

“…Our research group has been engaged in PD research for many years [75] and has confirmed the clinical efficacy of acupuncture for treating PD and the related mechanisms. We also found that electroacupuncture significantly improved the overall conditions, motor symptoms, and quality of life of patients with PD [40,76]. In addition, we previously observed that electroacupuncture improved constipation symptoms in patients with PD, possibly due to the improvement of peristalsis of intestinal smooth muscle.…”

“…In recent years, the efficacy of acupuncture and electroacupuncture for treating functional constipation has reached an international consensus [37][38][39]. Previous studies have shown that electroacupuncture is superior in improving constipation symptoms in patients with PD, especially in improving anorectal dynamics [40][41][42]. Although electroacupuncture can relieve constipation in patients with PD, its underlying mechanism is still unclear, which forms the basis of our research.…”

Parkinson's disease constipation effect of electroacupuncture at ST25 through colonic motility and enteric neuropathology

“…The efficacy of acupuncture in treating motor ( 12 – 14 ) and NMS, such as cognitive impairment ( 44 ), constipation ( 18 , 19 ), insomnia ( 17 ), pain ( 45 ), and anxiety ( 15 ) in patients with PD has been widely supported by studies. Alternative therapies are reported to be used by 40% of people with PD, with acupuncture being the third most commonly used alternative therapy for PD ( 46 ).…”

“…In recent years, acupuncture has received increasing attention as a noninvasive treatment method. A growing number of studies have investigated the effectiveness of acupuncture targeting PD and other related disorders, such as motor dysfunction (12)(13)(14), anxiety (15), depression (16), insomnia (17), and constipation (18,19), with some positive results. Although existing systematic evaluations and meta-analyses have shown conflicting results for acupuncture for PD constipation due to significant heterogeneity and small sample sizes (20)(21)(22)(23)(24), the fact that acupuncture was considered an effective or safe treatment for functional constipation and gastrointestinal disorders (25,26) in some randomized trials.…”