Acupuncture Regulates Symptoms of Parkinson’s Disease via Brain Neural Activity and Functional Connectivity in Mice

Peripheral mast cells derive the effects of acupuncture in Parkinson's disease

This research investigates the peripheral mechanisms of acupuncture in treating Parkinson's disease (PD), a progressive neurodegenerative disorder marked by motor impairments. While the central mechanisms of acupuncture have been extensively studied, our focus lies in the peripheral mechanisms at the acupoints, the sites of acupuncture signal initiation. Employing a PD model, we analyzed the local responses to acupuncture stimulation at these points. Our key finding was a significant elevation in both the number and activity of mast cells (MCs) in the peripheral tissues following acupuncture. Intriguingly, pre-treatment with an MC stabilizer diminished the acupuncture's therapeutic effects on PD symptoms. Similarly, local anesthesia with lidocaine at the acupoints attenuated the symptom improvement typically observed with acupuncture. Meanwhile, the augmentation of MC activity induced by acupuncture was significantly impeded by cromolyn, an MC stabilizer, but remained unaffected by lidocaine. This finding suggests that MC activity is a more upstream regulator of acupuncture effects compared to nerve conduction. This study provides groundbreaking insights into the initiation and transmission of acupuncture signals, highlighting the significant role of peripheral MC modulation in PD treatment.

Global trends and hotspots in research on acupuncture for neurodegenerative diseases over the last decade: a bibliometric and visualization analysis

Objectives

This study aimed to explore the current status and trends of acupuncture for neurodegenerative diseases (NDs) in the last decade and provide new insights for researchers in future studies.

Methods

The publications concerning acupuncture treatment for NDs published between 2014 and 2023 were extracted from the Web of Science Core Collection. We used CiteSpace and VOSviewer to analyze data on numbers of annual publications, countries, institutions, cited journals, cited authors, cited references, keywords, and citation bursts about acupuncture for NDs.

Results

A total of 635 publications were obtained from 2014 to 2023. We identified the most prolific journals, countries, institutions, authors, patterns of authorship, and the main direction of future research in the field of acupuncture for NDs in the last decade. The country, institution, and journal with the most publications are China (389 articles), Beijing University of Chinese Medicine (56 articles), and Evidence Based Complementary and Alternative Medicine (42 articles), respectively. The high-frequency keywords focused on "Alzheimer's disease," "Parkinson's disease," "acupuncture," "dementia," and "electroacupuncture." The top five keywords in terms of centrality were "cerebral ischemia," "acupuncture stimulation," "fMRI," "apoptosis," and "deep brain stimulation."

Conclusion

The results from this bibliometric study provide insight into the research trends in acupuncture therapy for NDs, and the current status and trends of the past decade, which may help researchers confirm the current status, hotspots, and frontier trends in this field.

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

Background

Parkinson's disease (PD) often necessitates immediate medical intervention following diagnosis. In recent years, there has been a noticeable increase in clinical investigations assessing the efficacy of acupuncture in PD, with many studies reporting positive outcomes. Ethical guidelines commonly endorse pharmaceutical therapies for PD, leading ongoing research to combine acupuncture with standard drug-based treatments. At present, there is a conspicuous absence of dedicated clinical research exclusively examining the independent impact of acupuncture on PD treatment.

Case

In a clinical observation, we documented a case involving a 75-year-old male displaying progressive, characteristic PD symptoms, including evident limb tremors, rigidity, bradykinesia, fatigue, and additional non-motor symptoms. The patient received a confirmed diagnosis of PD. Due to the refusal of the patient to take medication, we exclusively administered acupuncture therapy. The outcomes indicated a noteworthy enhancement in the clinical symptoms of the patient solely through acupuncture intervention.

Conclusion

This case affirms that using acupuncture in isolation significantly improved both the motor and non-motor symptoms in the patient. Acupuncture could potentially serve as an alternative therapy for patients who decline or are intolerant to anti-Parkinson drugs. However, further studies are needed to assess its long-term efficacy. This case report obtained approval from the Ethics Committee of the First Affiliated Hospital of Guangzhou University of Chinese Medicine (Ethics number: K-2023-127).

Potential role of acupuncture in the treatment of Parkinson's disease: A narrative review

Background

The prevalence of Parkinson's disease (PD) has grown rapidly compared to that of other neurological disorders. Acupuncture has been used to address the complex symptoms of PD. Recently, similarities in the mechanisms of action between acupuncture and neuromodulation have received considerable attention. This review aims to summarize the evidence regarding these similarities to suggest potential role of acupuncture in the treatment of PD.

Methods

The literature from two electronic databases, PubMed and Google Scholar, was searched using the search terms 'Acupuncture', 'Parkinson's disease', 'Vagus nerve stimulation', and 'Brain functional connectivity'. We then explored the evidence for the effectiveness of acupuncture in PD and evaluated the evidence for similarities in the mechanisms of action between acupuncture and neuromodulation.

Results

Data suggests that acupuncture treatment is effective for PD symptoms by modulating inflammation and brain functional connectivity (BFC). These acupuncture effects have been shown to be similar to neuromodulation in controlling inflammation and BFC. Based on the shared mechanisms of action, potential acupuncture mechanisms that may ameliorate a wide range of PD symptoms include but are not limited to (1) vagal activation of the anti-inflammatory pathway and (2) BFC enhancement.

Conclusion

The development of acupuncture strategies based on shared mechanisms with neuromodulation will provide new treatment options for patients with PD as personalized neuromodulating therapies. Further studies are needed to gather scientific evidence for optimizing parameters in PD patients.

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

Objective

To explore the association between acupuncture sessions and its effects on the motor function of Parkinson's Disease (PD).

Methods

Eight 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.

Results

Of 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.

Interpretation

This 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).

Pathophysiology and Neuroimmune Interactions Underlying Parkinson's Disease and Traumatic Brain Injury

Parkinson's disease (PD) is a progressive neurodegenerative disorder clinically defined by motor instability, bradykinesia, and resting tremors. The clinical symptomatology is seen alongside pathologic changes, most notably the loss of dopaminergic neurons in the substantia nigra pars compacta (SNpc) and the accumulation of α-synuclein and neuromelanin aggregates throughout numerous neural circuits. Traumatic brain injury (TBI) has been implicated as a risk factor for developing various neurodegenerative diseases, with the most compelling argument for the development of PD. Dopaminergic abnormalities, the accumulation of α-synuclein, and disruptions in neural homeostatic mechanisms, including but not limited to the release of pro-inflammatory mediators and the production of reactive oxygen species (ROS), are all present following TBI and are closely related to the pathologic changes seen in PD. Neuronal iron accumulation is discernable in degenerative and injured brain states, as is aquaporin-4 (APQ4). APQ4 is an essential mediator of synaptic plasticity in PD and regulates edematous states in the brain after TBI. Whether the cellular and parenchymal changes seen post-TBI directly cause neurodegenerative diseases such as PD is a point of considerable interest and debate; this review explores the vast array of neuroimmunological interactions and subsequent analogous changes that occur in TBI and PD. There is significant interest in exploring the validity of the relationship between TBI and PD, which is a focus of this review.

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

Background

The enteric nervous system (ENS) plays a central role in developing Parkinson's disease (PD) constipation, and the regulation of the ENS may be a key component in treating PD constipation. Electroacupuncture (EA) can effectively treat constipation symptoms in PD, but research on its specific mechanisms, especially in terms of ENS, is relatively lacking. Therefore, we investigated whether EA at ST25 promotes the restoration of ENS structure and colonic motor function in the rotenone-induced PD constipation rat model.

Methods

In this study, we evaluated constipation symptoms by stool characteristics, excretion and water volume, and whole gut transit time and observed colonic motility regulation through colonic motion detection and pathological changes in the colonic myenteric nervous plexus by transmission electron microscopy and immunofluorescence staining.

Results

EA significantly improved the constipation symptoms and positively adjusted the colonic motility in rotenone-induced PD constipation rats. At the same time, EA reversed the rotenone-induced colonic myenteric nervous plexus injury and regulated the ratio of inhibitory and excitatory neurotransmitters.

Conclusion

Our results indicate that EA treatment of PD constipation may be mediated through the adjustment of ENS.