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

Abstract

We aimed to compare the effectiveness of some different acupuncture modalities on motor function using the unified Parkinson disease rating scale (UPDRS)-III scores of idiopathic Parkinson’s disease (PD) via pairwise and network meta-analyses (NMA) of randomized controlled trials (RCTs). The Cochrane risk of bias assessment tool was used to assess the methodological quality of the included RCTs. A frequentist approach-based random effect model NMA was performed. Seventeen RCTs with 1071 participants were included. The five following modalities were identified: combination of conventional medication (levodopa) with (1) electroacupuncture (ELEC), (2) manual acupuncture (MANU), (3) bee venom acupuncture (BEEV), (4) sham acupuncture (SHAM), and (5) conventional medication alone (CONV). In NMA on UPDRS-III, BEEV was the best modality compared to CONV (mean difference [MD]) −7.37, 95% confidence interval [−11.97, −2.77]). The comparative ranking assessed through NMA was suggested to be BEEV, MANU, ELEC, SHAM, and CONV. Regarding daily activity assessment (UPDRS-II), the magnitude of effectiveness was in the order of BEEV, ELEC, MANU, SHAM, and CONV. Combination treatment with BEEV (MANU or ELEC) and CONV can be recommended to improve motor function in PD patients. Due to the limited number of included RCTs, further NMA with more rigorous RCTs are warranted.

Effectiveness of Acupuncture in Parkinson’s Disease Symptoms—A Systematic Review

“…However, although the evidence had been inconclusive, the therapeutic potential of acupuncture in Parkinson’s disease seemed to be quite promising [ 41 , 42 ]. Thus, the present systematic review including renewed literature with recent RCTs, a large sample size and better-quality studies would be important to provide better evidence on the efficiency of acupuncture in Parkinson’s disease symptoms [ 43 ].…”

“…According to the studies analysed in the present systematic review, which includes studies published between 2011 and 2021, there seems to be evidence for a positive effect of acupuncture on improving motor and non-motor symptoms in Parkinson’s disease. In all the studies reviewed, acupuncture was more effective in alleviating the symptoms of Parkinson’s disease than no treatment or conventional pharmacological treatment alone [ 43 ]. Additionally, some studies found that when acupuncture was used as an adjuvant to pharmacology, namely levodopa, it improved its therapeutic efficacy, allowing a reduction in the dose and the occurrence of adverse effects arising from its use [ 40 ].…”

“…Although all the studies reviewed pointed out a positive effect of acupuncture, we found great discrepancies regarding the studies’ design and methodology [ 2 , 42 ]. This lack of standardisation made it difficult to compare them [ 39 , 40 , 43 ].…”

“…It is also our opinion that studies with larger sample sizes and double-blind methodologies are needed [ 43 ]. Finally, it would be also very important to promote the performance of studies with higher quality, following STRICTA and/or CONSORT recommendations, since most of the existent bibliography lacks it [ 2 , 43 ].…”

Efficacy of acupuncture for the treatment of Parkinson’s disease-related constipation (PDC): A randomized controlled trial

“…According to the American Parkinson’s Association (APA), the management of Parkinson’s disease is a multi-disciplinary effort that involves not only pharmacological but also non-pharmacological interventions ( Cutson et al, 1995 ; Goldman and Guerra, 2020 ). Acupuncture is a common non-pharmacological treatment for improving gastrointestinal and neurological symptoms ( Kwon et al, 2021 ; Fan et al, 2022a ; Yao et al, 2022 ). Studies have shown that acupuncture can improve gastrointestinal and neurological symptoms while also relieving emotional symptoms ( Wang et al, 2022a ; Ying-Jia Li et al, 2022 ).…”