Qualitative and quantitative meta-analysis of acupuncture effects on the motor function of Parkinson's disease patients

Abstract

ObjectiveTo explore the association between acupuncture sessions and its effects on the motor function of Parkinson's Disease (PD).MethodsEight databases and two clinical trials registries were searched from inception to August 2022. Randomized controlled trials (RCTs) that compared acupuncture with sham acupuncture, or antiparkinsonian drugs, were included. After qualitative meta-analysis, a non-linear meta regression approach with restricted cubic spline was used to investigate the dose-response relationship between acupuncture sessions and their efficacy on the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) score. Subgroup meta-analysis was performed of the included studies according to the weekly acupuncture frequency. And finally, the included studies containing the determination of intermediate efficacy were compared.ResultsOf the 268 citations screened, 16 studies (462 patients of PD) were included. The qualitative meta-analysis showed that the acupuncture group had better effect on UPDRS-III scores than the control group. And the quantitative meta-analysis suggested that acupuncture dose was correlated with the reduction of UPDRS-III score in PD patients with motor symptoms. In subgroup analysis, on the one hand, when the frequency of acupuncture was no more than 3 times a week, with the increase of acupuncture session, the changes of UPDRS-III score decreased and then increased (P = 0.000). On the other hand, when acupuncture for more than 3 times a week and the dose of acupuncture treatment was <60 times, the changes of UPDRS-III score increased with the increase of acupuncture dose, but the score stopped to decrease if the dose continued to increase (P = 0.020). The comparative analysis of two quantitative RCTs found that the score improvement was more significant at the higher weekly acupuncture frequency.InterpretationThis study found that when treating PD patients with motor symptoms, acupuncture treatment may need to reach a certain dose to obtain better therapeutic effect and excessive acupuncture stimulation may cause the body to develop a certain tolerance. However, the above results still need to be verified by more high-quality clinical studies. The protocol was registered on PROSPERO International Prospective Register of Systematic Reviews (CRD42022351428).

Acupuncture therapy for Parkinson’s disease: a case report demonstrating symptomatic improvement without medication

“…Notably, the therapeutic impact surpasses placebo acupuncture, highlighting its significant clinical efficacy (10, 11). Several recently published meta-analyses also suggested that acupuncture-related therapies combined with conventional medication showed a moderate or large effect on movement function in patients with PD (6,27). Animal studies have established a scientific foundation supporting the potential of acupuncture in ameliorating symptoms observed in Parkinson's disease (7)(8)(9).…”

“…Acupuncture, an ancient technique dating back 2000 years within TCM ( 5 ), has gained widespread utilization by physicians and patients globally in alleviating clinical symptoms in PD. Recent years have witnessed a discernible rise in clinical investigations exploring the use of acupuncture for PD, often reporting positive outcomes ( 6 ).…”

Effects of acupuncture on Parkinson's disease-related constipation and roles of gut microbial ecology: study protocol for a randomized controlled clinical trial

“…Acupuncture, a popular complementary and alternative medicine approach, is recommended as therapy for PD patients based on level B evidence (32,33). Recent meta-analyses have shown that acupuncture in conjunction with conventional medication exhibits a notable positive impact on movement function in PD patients (34,35). Animal studies corroborate these ndings, suggesting acupuncture's potential in alleviating PD symptoms (36,37).…”