Evidence for the Use of Acupuncture in Treating Parkinson's Disease: Update of Information From the Past 5 Years, a Mini Review of the Literature

Abstract

Acupuncture is an alternative therapy for Parkinson's disease (PD), but its efficacy and safety are controversial. Our previous study, which reviewed the literature from 1974 to 2012, could not find enough evidence from rigorously designed randomized, controlled trials (RCTs) to make a conclusion about the efficacy of acupuncture. Recently, more RCTs and meta-analyses have been conducted to evaluate the efficacy of acupuncture. The aim of our current study is to provide updated information in brief on this topic. In this study, we analyzed and summarized seven RCTs and four meta-analyses. Although all included studies were not of high quality, we found that there has been a tremendous progress in acupuncture research in treating Parkinson's disease (PD) during the past 5 years, based on our experience and insights into the behavioral assessments of PD. First, the numbers of RCTs and meta-analyses based on RCTs are increasing. Second, non-motor symptoms are increasingly emphasized. Third, objective behavioral assessment tools are being employed. Although recent studies can provide limited evidence for the efficacy of acupuncture, we make the following recommendations for the future investigation: First, large, multicenter, well-designed RCTs should be organized for evaluation of the efficacy of acupuncture. Second, objective assessments using novel computerized technologies should be considered. Third, target symptoms should be selected and evaluated instead of only performing global evaluations. Fourth, attention should be paid to the efficacy of scalp acupuncture. Fifth, the safety of acupuncture should be evaluated and reported.

Keywords: Parkinson's disease; acupuncture; behavioral assessment; efficacy/safety; electroacupuncture; non-motor symptoms.

Figure 1

Information of the included literatures. (A) Flow chart of the literature selection protocol. PD, Parkinson's disease; RCT, randomized, controlled trial; WHO, World Health Organization. (B) Quality evaluation of included studies. OQAQ, Overview Quality Assessment Questionnaire. Strengths: E, Good searching strategy including enough RCTS; QE, Qualify of involved RCTs was evaluated; PA, Placebo acupuncture. Weaknesses: SB, Selection bias; RB, reporting bias; PB, Publication bias; SS, Small samples; NR, Adverse events unreported; NS, No sensitivity analysis NF, No follow up.