Journal name: eClinicalMedicine
Manuscript tile: Electroacupuncture for motor dysfunction and constipation in patients with Parkinson’s disease: a randomized controlled multi-centre trial
Background Motor disturbances and non-motor disturbances such as constipation are the main factors affecting the quality of life in patients with Parkinson’s disease (PD). We investigated the efficacy and safety of electroacupuncture combined with conventional pharmacological treatment on motor dysfunction and constipation in PD.
Methods In this multi-centre randomised controlled trial, we enrolled 166 eligible participants between September 19, 2018 and September 25, 2019 in four hospitals in China. Participants were randomly assigned (1:1) to the electroacupuncture (EA) group and the waitlist control group. Each participant in both groups received the conventional pharmacological treatment, EA group received 3 sessions of electroacupuncture per week for 12 weeks. The primary outcome was the change in the Unified Parkinson’s Disease Rating Scale (UPDRS) score from baseline to week 12. The secondary outcomes included the evaluation of functional disability in motor symptoms and constipation, the adherence and adverse events were also recorded. Registered with Chictr.org.cn, ChiCTR1800019517.
Findings At week 12, the change in the UPDRS score of the EA group was significantly higher than that of the control group, with a difference of −9.1 points (95% CI, −11.8 to −6.4), and this difference continued into weeks 16 and 24. From baseline to week 12, the 39-item Parkinson Disease Question (PDQ-39) decreased by 10 points (interquartile range, IQR −26.0 to 0.0) in the EA group and 2.5 points (IQR: −11.0 to 4.0) in the control group, the difference was statistically significant. The time and steps for the 20-m walk at week 12, as well as the changes from baseline in the EA group, were comparable with that in the control group. But the EA group had a greater decrease than the control group from baseline in the times for 20-m walks at weeks 16 and 24. From week 4 to week 24, the median values of spontaneous bowel movements (SBMs) per week in the EA group were higher than that in the control group, the differences were all statistically significant. The incidence of EA-related adverse events during treatment was low, and they are mild and transient.
Interpretation The findings of our study suggested that compared with conventional pharmacological treatment, conventional pharmacological treatment combined with electroacupuncture significantly enhances motor function and increased bowel movements in patients with PD, electroacupuncture is a safe and effective treatment for PD.
Evidence before this study
Using the search terms “acupuncture”, “electroacupuncture” or “moxibustion” in combination with “Parkinson's disease”, we searched PubMed for studies including clinical trials, randomized controlled trials, systematic reviews, and meta-analyses from the inception of the database to September 31, 2021. Although more than 60 trials report acupuncture-related therapies treatment for Parkinson's disease (PD), the quality of these evidences are not optimal, include inadequate follow-up duration, treatment regimens are complex, and lack of conclusive evidence of electroacupuncture's efficacy in relieving motor and non-motor symptoms. A multi-centre randomised controlled trial is urgently needed to investigate the efficacy of electroacupuncture for treating motor dysfunction and constipation in patients with PD.
Added value of this study
To our knowledge, this is the first multi-centre, randomised, controlled, 12-week follow-up clinical trial that evaluated the efficacy and safety of electroacupuncture for PD. The study provides stronger evidence that 12 weeks of electroacupuncture was safe and effective in enhancing motor function and bowel movements in patients with PD, and that this effect maintained for at least 12 weeks.
Implications of all the available evidence
The effect of current medication for PD gradually diminishes over time, resulting in motor fluctuations and medication side effects. Our study suggested that compared with conventional treatment, electroacupuncture significantly enhances motor function and bowel movements in patients with PD. The conclusions of this study could encourage further investigation into clinical use of electroacupuncture as a safe and effective complementary treatment for motor dysfunction and constipation symptoms in patients with PD.
This report was published at a Lancet journal. The improvement of acupuncture is very impressive.
Electroacupuncture for motor dysfunction and constipation in patients with Parkinson’s disease: a randomised controlled multi-centre trial. https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(22)00543-0/fulltext