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Li Z, Niu Q, Yang K, Zhao K, Yin S, Zhu F. Acupuncture for constipation in Parkinson's disease: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2024; 103:e38937. [PMID: 39029044 DOI: 10.1097/md.0000000000038937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND Parkinson's disease (PD) is the second most common neurological disease worldwide, and there is a potential interaction between PD and constipation. PD constipation often causes significant trouble for patients and seriously affects their quality of life. Acupuncture is widely used for treating constipation and has been clinically proven. However, it is unclear whether the current evidence is sufficient to support acupuncture to improve PD constipation. METHODS We searched the Cochrane Central Register of Controlled Trials, Embase, PubMed, Web of Science, China National Knowledge Infrastructure, Wan Fang Data Knowledge Service Platform, and Chinese Scientific Journal Database (VIP database) for randomized controlled trials from inception through July 1, 2023. Randomized controlled trials (RCTs) included acupuncture, sham acupuncture, and medication for PD constipation. Stata 16.0 software and Cochrane RoB2.0 were used for data processing and migration risk analysis. RESULTS The 11 studies included a total of 960 patients. The results showed that acupuncture or acupuncture combined with conventional treatment seemed to have advantages in improving complete spontaneous bowel movements (WMD: 1.49, 95% CI: 0.86, 2.11; P < .00001), Patient-Assessment of Constipation Quality of Life questionnaire (WMD: -11.83, 95% CI: -15.67, -7.99; P < .00001), the chronic constipation severity scale (CCS) (SMD: -0.99, 95% CI: -1.40, -0.58; P < .01), and c(RRP) (WMD: 2.13, 95% CI: 0.44, 3.82; P < .05). CONCLUSION The present results show that compared with conventional treatment, acupuncture combined with conventional treatment seems to increase the number of spontaneous defecations in PD patients, improve quality of life, increase rectal resting pressure, and alleviate the severity of chronic constipation. Thus, acupuncture has the potential to treat PD constipation. However, due to the study's limitations, higher-quality RCTs are needed for verification.
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Affiliation(s)
- Zhao Li
- School of Clinical Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qun Niu
- School of Clinical Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Kai Yang
- Department of Orthopaedics, Xi'an Hospital of Traditional Chinese Medicine, Xi'an, China
| | - Keni Zhao
- Deriatric Department, Xi'an Hospital of Traditional Chinese Medicine, Xi'an, China
| | - Shao Yin
- School of Clinical Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fengya Zhu
- Traditional Chinese Medicine Department, Zigong First People's Hospital, Zigong, China
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2
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Tan W, Xie F, Zhou J, Pan Z, Liao M, Zhuang L. Efficacy and safety of acupuncture therapy for neuropsychiatric symptoms among patients with Parkinson's disease: A systematic review and meta-analysis. Clin Rehabil 2024:2692155241258278. [PMID: 38840478 DOI: 10.1177/02692155241258278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
OBJECTIVE To systematically evaluate the efficacy and safety of acupuncture therapy for neuropsychiatric symptoms in patients with Parkinson's disease. METHODS We searched eight databases from their inception until 14 April 2024, including PubMed, Cochrane Library, Embase, Web of Science, SinoMed, China National Knowledge Infrastructure, China Science and Technology Periodical Database, and Wanfang Database. The search aimed to find randomized controlled trials assessing the effectiveness of acupuncture for neuropsychiatric symptoms in patients with Parkinson's disease. Literature screening and data extraction were performed independently by the authors. Meta-analysis was conducted using RevMan V.5.3 software, and Stata 17.0 software was used for detecting publication bias and performing sensitivity analysis. RESULTS Twenty-eight studies, involving 2148 participants, met the inclusion criteria. The meta-analysis revealed that acupuncture therapy improved depression-related scale scores (standardized mean difference (SMD) = -0.70, 95%CI [-0.98, -0.42], p < 0.00001), anxiety-related scale scores (SMD = -0.78, 95% CI [-1.43, -0.14], p = 0.02), Montreal Cognitive Assessment scores (weighted mean difference (WMD) = 2.74, 95% CI [2.43, 3.05], p < 0.00001), Mini Mental State Examination scores (WMD = 2.36, 95% CI [0.78, 3.94], p = 0.003), Yale-Brown Obsessive Compulsive Scale scores, and Parkinson's Disease Questionnaire-39 scores (WMD = -2.66, 95% CI [-4.83, -0.49], p = 0.02) compared to controls. CONCLUSION This review supports the application of acupuncture to reduce the severity of neuropsychiatric symptoms including depression, anxiety, and impulse control disorders, and to improve cognition and quality of life in patients with Parkinson's disease. The adverse effects associated with acupuncture, either alone or as adjunctive therapy, were relatively minor.
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Affiliation(s)
- Weiqiang Tan
- Graduate College, Guangxi University of Chinese Medicine, Nanning, China
| | - Fengxi Xie
- Graduate College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jixi Zhou
- Graduate College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhaoquan Pan
- Graduate College, Guangxi University of Chinese Medicine, Nanning, China
| | - Muxi Liao
- Department of Acupuncture, Shenzhen Nanshan District Chinese Medicine Hospital, The First Affiliated Hospital of Guangzhou University of Chinese Medicine at Nanshan district, Shenzhen, China
| | - Lixing Zhuang
- Lingnan Acupuncture and Rehabilitation Institute, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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3
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Yan M, Fan J, Liu X, Li Y, Wang Y, Tan W, Chen Y, He J, Zhuang L. Acupuncture and Sleep Quality Among Patients With Parkinson Disease: A Randomized Clinical Trial. JAMA Netw Open 2024; 7:e2417862. [PMID: 38922617 PMCID: PMC11208974 DOI: 10.1001/jamanetworkopen.2024.17862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 04/19/2024] [Indexed: 06/27/2024] Open
Abstract
Importance Poor sleep quality greatly impairs quality of life and accelerates deterioration in patients with Parkinson disease (PD), but current remedies remain limited. Acupuncture, used as an adjunctive therapy with anti-Parkinson medications, has shown positive effects in patients with PD. However, high-quality clinical evidence to support the effectiveness of acupuncture for patients with PD and poor sleep quality is lacking. Objective To assess the safety and efficacy of real acupuncture (RA) vs sham acupuncture (SA) as an adjunctive therapy for patients with PD who have poor sleep quality. Design, Setting, and Participants This single-center randomized clinical trial was performed at The First Affiliated Hospital of Guangzhou University of Chinese Medicine in China from February 18, 2022, to February 18, 2023. Patients with PD and sleep complaints were recruited and randomized (1:1) to receive RA or SA treatment for 4 weeks. Data analysis was performed from April 12 to August 17, 2023. Intervention Treatment with RA or SA for 4 weeks. Main Outcomes and Measures The main outcome was the change in Parkinson Disease Sleep Scale (PDSS) scores measured at baseline, after 4 weeks of treatment, and at 8 weeks of follow-up. Results Of the 83 participants enrolled, 78 (94.0%) completed the intervention and were included in the analysis. Their mean (SD) age was 64.1 (7.9) years; 41 (52.6%) were men and 37 (47.4%) were women. A significant increase in PDSS scores from baseline was observed for both the RA group (29.65 [95% CI, 24.65-34.65]; P < .001) and the SA group (10.47 [95% CI, 5.35-15.60]; P < .001). Compared with the SA group, the RA group had a significant increase in PDSS scores after 4 weeks of treatment (19.75 [95% CI, 11.02-28.49]; P < .001) and at 8 weeks of follow-up (20.24 [95% CI, 11.51-28.98]; P < .001). Conclusions and Relevance In this randomized clinical trial, acupuncture proved beneficial in improving sleep quality and quality of life among patients with PD. These findings suggest that the therapeutic effects of acupuncture could continue for up to 4 weeks. Trial Registration Chinese Clinical Trial Registry Identifier: ChiCTR2200060655.
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Affiliation(s)
- Mingyue Yan
- The First Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jingqi Fan
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xin Liu
- The First Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yingjia Li
- Panyu Hospital of Chinese Medicine, Guangzhou, China
| | - Yuting Wang
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Weiqiang Tan
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuanyuan Chen
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jun He
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lixing Zhuang
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Zheng Y, Cameron AP. Sleep and Overactive Bladder in Parkinson's Disease. Urol Clin North Am 2024; 51:197-207. [PMID: 38609192 DOI: 10.1016/j.ucl.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
Patients with Parkinson's disease (PD) have disturbances in their bladder and sleep physiology that lead to nocturia and overactive bladder (OAB). These symptoms can be extremely bothersome and impact not only their quality of life (QoL) but also the QoL of their caretakers. We aim to highlight the changes in bladder and sleep physiology in PD and explore OAB/nocturia treatment strategies in this population.
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Affiliation(s)
- Yu Zheng
- Department of Urology, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI 48109, USA.
| | - Anne P Cameron
- Department of Urology, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI 48109, USA
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van Wegen EEH, van Balkom TD, Hirsch MA, Rutten S, van den Heuvel OA. Non-Pharmacological Interventions for Depression and Anxiety in Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2024:JPD230228. [PMID: 38607762 DOI: 10.3233/jpd-230228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Affiliation(s)
- Erwin E H van Wegen
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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| | - Tim D van Balkom
- Department of Anatomy & Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention, Neurodegeneration, Amsterdam, The Netherlands
| | - Mark A Hirsch
- Carolinas Medical Center, Atrium Health Carolinas Rehabilitation, Department of Physical Medicine and Rehabilitation, Charlotte, NC, USA
- Wake Forest School of Medicine, Department of Orthopedic Surgery and Rehabilitation, Winston-Salem, NC, USA
| | - Sonja Rutten
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention, Neurodegeneration, Amsterdam, The Netherlands
| | - Odile A van den Heuvel
- Department of Anatomy & Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention, Neurodegeneration, Amsterdam, The Netherlands
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Lin J, Kong Y, Chen H, Ding X, Zhou W. Effects of acupuncture on sleep quality in patients with Parkinson's disease: A systematic review and meta-analysis. Clin Rehabil 2024; 38:478-496. [PMID: 38043930 DOI: 10.1177/02692155231218535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
OBJECTIVE To systematically evaluate the evidence relating to acupuncture on the sleep quality of patients with Parkinson's disease. DATA SOURCES Six English-language (PubMed, Cochrane Library, EBSCOhost, Embase, OVID MEDLINE, and Web of Science) and four Chinese-language (China National Knowledge Infrastructure, SinoMed, China Scientific Journals Database, and Wanfang) databases were searched for pertinent studies published from database inception to 11 October 2023. METHODS Two researchers independently screened eligible studies and extracted relevant data using custom data extraction tables. Methodological quality assessment of the included studies was performed using Cochrane Handbook 5.1.0. Meta-analysis was performed using Cochrane Review Manager version 5.4. RESULTS Twenty-four studies (1701 participants) met inclusion criteria. The meta-analysis showed that acupuncture improved the Parkinson's Disease Sleep Scale, Pittsburgh Sleep Quality Index, Hamilton Anxiety Scale, Hamilton Depression Scale, Self-Rating Depression Scale, and Parkinson's Disease Questionnaire 39 scores compared with controls (all P < 0.05). CONCLUSION This review showed that acupuncture improved sleep quality, anxiety and depressive symptoms, and quality of life of patients with Parkinson's disease relative to controls.
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Affiliation(s)
- Jiamin Lin
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yue Kong
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- 900TH Hospital of Joint Logistic Support Force, Fuzhou, China
| | - Hailan Chen
- The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Xintong Ding
- The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Wenguang Zhou
- Department of Equipment, Chenggong Hospital of Xiamen University (the 73th Group Military Hospital of People's Liberation Army), Xiamen, China
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7
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Zhu F, Yin S, Ma T, Li L, Li S, Liu J, Wang Y, Mao S, Wu J. An overview of systematic reviews of acupuncture for neurodegenerative disease. Asian J Psychiatr 2024; 91:103882. [PMID: 38150809 DOI: 10.1016/j.ajp.2023.103882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/24/2023] [Accepted: 12/15/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Acupuncture has been widely used in the treatment of neurodegenerative diseases and a large number of systematic reviews (SRs) have been published, but the results are controversial. Therefore, it is necessary to comprehensively summarize and objectively evaluate the clinical evidence of acupuncture for neurodegenerative diseases. OBJECTIVE To evaluate the SRs that assess the efficacy and safety of acupuncture for neurodegenerative diseases. This overview is intended to provide evidence for clinical decision making by healthcare providers and policymakers and to provide evidence for clinical decision making by healthcare providers and policymakers and to provide recommendations for researchers to conduct high quality SRs and clinical studies. METHODS We searched four Chinese databases (SinoMed, CNKI, Wanfang and VIP) and four international databases (Cochrane Library, Embase, PubMed and Web of Science) for SRs of acupuncture for neurodegenerative diseases. The search period ran from the beginning of the database to March 5, 2023. Literature screening and data extraction were performed independently by two individuals. Methodological quality, risk of bias and associated evidence levels were assessed for all SRs using AMSTER 2, ROBIS and GRADE tools. In addition, the RCT overlap between SRs was calculated by corrected coverage area (CCA). We also conducted quantitative synthesis or descriptive analysis of the relevant data. RESULTS Finally, we identified 53 SRs (three were qualitative descriptions and fifty were meta-analyses). Under AMSTAR 2, only one SR was rated as moderate quality, six SRs as low quality and 46 SRs as very low quality. According to ROBIS, 33 SRs were rated as a high risk of bias and 20 as a low risk of bias. Cognitive functions in neurodegenerative diseases, activities of daily living and the motor and non-motor outcomes associated with PD were included to summary description. The pooled results show that acupuncture combined with conventional treatment may have an overall advantage over conventional treatment, but the quality of evidence is low. Specific adverse reactions/events were reported in 20 SRs. Common needle-related adverse events included pain, dizziness, bleeding, or subcutaneous hematoma. No severe adverse events were reported in any SRs. CONCLUSION Evidence suggests that acupuncture is generally effective and relatively safe for cognitive function and activities of daily living in neurodegenerative diseases. In addition, acupuncture may have some benefits in improving motor and non-motor symptoms in patients with PD. However, high-quality RCTs and SRs are still needed to further clarify the efficacy and safety of acupuncture in treating neurodegenerative diseases.
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Affiliation(s)
- Fengya Zhu
- Zigong First People's Hospital, Zigong, China; Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shao Yin
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tingting Ma
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Liuying Li
- Zigong First People's Hospital, Zigong, China; Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Siyun Li
- Zigong First People's Hospital, Zigong, China; Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Junqian Liu
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuan Wang
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Siyi Mao
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jie Wu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
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Angelopoulou E, Stanitsa E, Karpodini CC, Bougea A, Kontaxopoulou D, Fragkiadaki S, Koros C, Georgakopoulou VE, Fotakopoulos G, Koutedakis Y, Piperi C, Papageorgiou SG. Pharmacological and Non-Pharmacological Treatments for Depression in Parkinson's Disease: An Updated Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1454. [PMID: 37629744 PMCID: PMC10456434 DOI: 10.3390/medicina59081454] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/19/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023]
Abstract
Depression represents one of the most common non-motor disorders in Parkinson's disease (PD) and it has been related to worse life quality, higher levels of disability, and cognitive impairment, thereby majorly affecting not only the patients but also their caregivers. Available pharmacological therapeutic options for depression in PD mainly include selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, and tricyclic antidepressants; meanwhile, agents acting on dopaminergic pathways used for motor symptoms, such as levodopa, dopaminergic agonists, and monoamine oxidase B (MAO-B) inhibitors, may also provide beneficial antidepressant effects. Recently, there is a growing interest in non-pharmacological interventions, including cognitive behavioral therapy; physical exercise, including dance and mind-body exercises, such as yoga, tai chi, and qigong; acupuncture; therapeutic massage; music therapy; active therapy; repetitive transcranial magnetic stimulation (rTMS); and electroconvulsive therapy (ECT) for refractory cases. However, the optimal treatment approach for PD depression is uncertain, its management may be challenging, and definite guidelines are also lacking. It is still unclear which of these interventions is the most appropriate and for which PD stage under which circumstances. Herein, we aim to provide an updated comprehensive review of both pharmacological and non-pharmacological treatments for depression in PD, focusing on recent clinical trials, systematic reviews, and meta-analyses. Finally, we discuss the pharmacological agents that are currently under investigation at a clinical level, as well as future approaches based on the pathophysiological mechanisms underlying the onset of depression in PD.
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Affiliation(s)
- Efthalia Angelopoulou
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (E.A.); (E.S.); (A.B.); (D.K.); (S.F.); (C.K.)
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Evangelia Stanitsa
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (E.A.); (E.S.); (A.B.); (D.K.); (S.F.); (C.K.)
| | - Claire Chrysanthi Karpodini
- Sport and Physical Activity Research Centre, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton WV1 1LY, UK;
| | - Anastasia Bougea
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (E.A.); (E.S.); (A.B.); (D.K.); (S.F.); (C.K.)
| | - Dionysia Kontaxopoulou
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (E.A.); (E.S.); (A.B.); (D.K.); (S.F.); (C.K.)
| | - Stella Fragkiadaki
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (E.A.); (E.S.); (A.B.); (D.K.); (S.F.); (C.K.)
| | - Christos Koros
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (E.A.); (E.S.); (A.B.); (D.K.); (S.F.); (C.K.)
| | | | - George Fotakopoulos
- Department of Neurosurgery, General University Hospital of Larissa, 41221 Larissa, Greece;
| | - Yiannis Koutedakis
- Functional Architecture of Mammals in Their Environment Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 38221 Volos, Greece;
| | - Christina Piperi
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Sokratis G. Papageorgiou
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (E.A.); (E.S.); (A.B.); (D.K.); (S.F.); (C.K.)
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Hsu WT, Hsu CM, Hung SC, Hung SY. Acupuncture Improves Sleep Disorders and Depression among Patients with Parkinson's Disease: A Meta-Analysis. Healthcare (Basel) 2023; 11:2042. [PMID: 37510483 PMCID: PMC10379076 DOI: 10.3390/healthcare11142042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/09/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
Parkinson's disease (PD) is associated with a range of non-motor symptoms that lack effective treatments. Acupuncture is a popular alternative therapy for PD patients that has been shown to improve motor symptoms. However, the efficacy of acupuncture in treating non-motor symptoms has remained controversial. The goal of our study was to systematically assess the existing evidence for acupuncture's efficacy in treating PD non-motor symptoms of sleep disorders, depression, anxiety, and fatigue. We conducted a meta-analysis of clinical trials by searching Pubmed, Embase, CINAHL, and Web of Science as electronic databases to evaluate acupuncture treatment for PD non-motor symptoms. Thirteen clinical trials met our inclusion criteria, and their methodological quality was assessed using the modified Jadad scale, indicating a moderate overall quality. Our results showed that acupuncture improved PD-related sleep disorders and depression but had no effect on anxiety and fatigue. Our meta-analysis suggests that acupuncture can be used as a complementary treatment for sleep disturbances and depression in PD patients and may exhibit a dual therapeutic effect on motor and non-motor symptoms. However, further well-designed clinical trials with larger sample sizes are needed to confirm these findings. Overall, our study highlights the potential of acupuncture as a viable complementary therapy for the treatment of PD non-motor symptoms of sleep disorders and depression, which can improve the quality of life of PD patients.
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Affiliation(s)
- Wei-Ti Hsu
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 40402, Taiwan
- Department of Anesthesiology, China Medical University Hospital, Taichung 40447, Taiwan
| | - Chieh-Min Hsu
- Department of Anesthesiology, China Medical University Hospital, Taichung 40447, Taiwan
| | - Shao-Chi Hung
- Department of Anesthesiology, China Medical University Hospital, Taichung 40447, Taiwan
| | - Shih-Ya Hung
- Graduate Institute of Acupuncture Science, China Medical University, Taichung 40402, Taiwan
- Division of Surgery, Department of Medical Research, China Medical University Hospital, Taichung 40447, Taiwan
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10
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Yu B, Ma SQ, Huang HP, Zhong Z, Yu S, Huang K, Zhang LY, Li MY, Yao L. Research methods and efficacy of acupuncture in the treatment of Parkinson's disease: a scoping review of systematic reviews and meta-analyses. Front Neurol 2023; 14:1196446. [PMID: 37332994 PMCID: PMC10272821 DOI: 10.3389/fneur.2023.1196446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/16/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction Research on acupuncture for Parkinson's Disease is growing rapidly. A scoping review examines emerging evidence and is important to guide policy and practice. The purpose of this scoping review was to examine the breadth and methodological quality of systematic reviews and meta-analyses, and to map the quality of evidence of these studies to evaluate the efficacy of acupuncture for treatment of PD. Methods Seven literature databases were searched. Two researchers independently screened the literature and extracted relevant information (such as general characteristics, inclusion criteria, study results, and report quality).The inclusion criteria include publicly published systematic reviews/meta-analyses/systematic reviews of acupuncture treatment for Parkinson's disease. The research subjects are any patients who meet the diagnostic criteria for Parkinson's disease, and intervention measures include acupuncture treatment including electro acupuncture, scalp acupuncture, or combination with other treatment methods. The outcome indicators are all types of results related to PD and the effective measurement tools used. Results A total of 23 systematic reviews and/or meta-analyses of studies were included. Most of the articles were published between 2019 and 2023 (47.8%). A total of 14 articles (60.9%) were evaluated and classified, and 89 (36.8.1%) of the 242 included articles were of medium and high quality. Discussion This study comprehensively evaluates the quality and research methods of incorporating SRs/MAs, and concludes that acupuncture treatment for Parkinson's disease may be significant. Considering the shortcomings in research design and methodology, it is not possible to draw conclusions on the evidence of acupuncture treatment for PD at this stage, but it does not mean that acupuncture treatment is ineffective. We hope to focus on improving research design and methods in the study of acupuncture treatment for Parkinson's disease, an increase the credibility of research results.
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Affiliation(s)
- Bin Yu
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Shi-qi Ma
- College of Acupuncture and Massage, Changchun University of Chinese Medicine, Changchun, China
| | - Hai-peng Huang
- Institute of Acupuncture and Tuina, Northeast Asia Academy of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Zhen Zhong
- College of Acupuncture and Massage, Changchun University of Chinese Medicine, Changchun, China
| | - Shuo Yu
- College of Acupuncture and Massage, Changchun University of Chinese Medicine, Changchun, China
| | - Ke Huang
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Li-ying Zhang
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Meng-yuan Li
- Institute of Acupuncture and Tuina, Northeast Asia Academy of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Lin Yao
- Institute of Acupuncture and Tuina, Northeast Asia Academy of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
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11
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Li YJ, Leong II, Fan JQ, Yan MY, Liu X, Lu WJ, Chen YY, Tan WQ, Wang YT, Zhuang LX. Efficacy of acupuncture for the treatment of Parkinson's disease-related constipation (PDC): A randomized controlled trial. Front Neurosci 2023; 17:1126080. [PMID: 36866329 PMCID: PMC9972583 DOI: 10.3389/fnins.2023.1126080] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 01/30/2023] [Indexed: 02/16/2023] Open
Abstract
Objective To evaluate the efficacy of acupuncture in treating Parkinson's disease-related constipation (PDC). Materials and methods This was a randomized, controlled trial in which patients, outcome assessors, and statisticians were all blinded. Seventy-eight eligible patients were randomly assigned to either the manual acupuncture (MA) or sham acupuncture (SA) groups and received 12 sessions of treatment over a 4-week period. Following treatment, patients were monitored until the eighth week. The primary outcome was the change in weekly complete spontaneous bowel movements (CSBMs) from baseline after treatment and follow-up. The Constipation Symptom and Efficacy Assessment Scale (CSEAS), the Patient-Assessment of Constipation Quality of Life questionnaire (PAC-QOL), and the Unified Parkinson's Disease Rating Scale (UPDRS) were used as secondary outcomes. Results In the intention-to-treat analysis, 78 patients with PDC were included, with 71 completing the 4-week intervention and 4-week follow-up. When compared to the SA group, weekly CSBMs were significantly increased after treatment with the MA group (P < 0.001). Weekly CSBMs in the MA group were 3.36 [standard deviation (SD) 1.44] at baseline and increased to 4.62 (SD, 1.84) after treatment (week 4). The SA group's weekly CSBMs were 3.10 (SD, 1.45) at baseline and 3.03 (SD, 1.25) after treatment, with no significant change from baseline. The effect on weekly CSBMs improvement in the MA group lasted through the follow-up period (P < 0.001). Conclusion Acupuncture was found to be effective and safe in treating PDC in this study, and the treatment effect lasted up to 4 weeks. Clinical trial registration http://www.chictr.org.cn/index.aspx, identifier ChiCTR2200059979.
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Affiliation(s)
- Ying-Jia Li
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ian-I Leong
- The First Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jing-Qi Fan
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ming-Yue Yan
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xin Liu
- The First Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wei-Jing Lu
- The First Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuan-Yuan Chen
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wei-Qiang Tan
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yu-Ting Wang
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Li-Xing Zhuang
- Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China,*Correspondence: Li-Xing Zhuang,
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Song LZX, Li Y, Qian X, Xu N, Yu Z, Dai JW, Xu B, Hu XM. Parkinson's disease constipation effect of electroacupuncture at ST25 through colonic motility and enteric neuropathology. Front Neurol 2023; 13:1092127. [PMID: 36733445 PMCID: PMC9888431 DOI: 10.3389/fneur.2022.1092127] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
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.
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Affiliation(s)
- Li-zhe-xiong Song
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China,School of Acupuncture-Moxibustion and Tuina, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yuan Li
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China,School of Acupuncture-Moxibustion and Tuina, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xu Qian
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China,School of Acupuncture-Moxibustion and Tuina, Nanjing University of Chinese Medicine, Nanjing, China
| | - Na Xu
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China,School of Acupuncture-Moxibustion and Tuina, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhi Yu
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China,School of Acupuncture-Moxibustion and Tuina, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jing-wen Dai
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China
| | - Bin Xu
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China,School of Acupuncture-Moxibustion and Tuina, Nanjing University of Chinese Medicine, Nanjing, China,*Correspondence: Bin Xu ✉
| | - Xuan-ming Hu
- Acupuncture Department, Nanjing Hospital of Traditional Chinese Medicine, Affiliated to Nanjing University of Traditional Chinese Medicine, Nanjing, China,Xuan-ming Hu ✉
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