Electroacupuncture Provides Additive Benefits for Motor Function and Bowel Movements in Parkinson Disease
During a 12-week treatment period, investigators observed greater reduction in change from baseline in UPDRS score for those on electroacupuncture than just on PD medication alone.
Huangan Wu
Findings from a 12-week, multicenter, randomized controlled trial showed that the combination of conventional pharmacological treatment with electroacupuncture (EA) was safe, and significantly improved motor function and increased bowel movements in patients with Parkinson disease (PD).
Each participant in both groups received the conventional pharmacological treatment, while the EA group received 3 sessions of EA per week. After 12 weeks of treatment, the change in Unified Parkinson’s Disease Rating Scale (UPDRS) score from baseline was –5.3 (adjusted mean, 95% CI, –6.9 to –3.9) vs 3.9 (adjusted mean, 95% CI, 1.7-6.1) in the control group (between-group difference, –9.1; 95% CI, –11.8 to –6.4).
In addition to acknowledging that EA is a safe and effective treatment, study authors, including senior investigator Huangan Wu, Shanghai University of Traditional Chinese Medicine, concluded that "Further studies are needed to understand the long-term efficacy and mechanism of EA interventions on PD."
While change in UPDRS score served as the primary outcome, the study evaluated other secondary outcomes including functional disability in motor symptoms and constipation, adherence, and adverse events (AEs). Patients included were aged between 40 and 80 years, had PD for at least 6 months, and were in stages 1-4 of the Hoehn and Yahr (H&Y) scale. Individuals with constipation were eligible if the course of the disease was more than 3 months, and if the number of spontaneous bowel movements (SBMs) is less than 3 times per week.
After excluding 29 patients, the intention-to-treat population included 166 individuals with PD, randomly assigned 1:1 to either EA (n = 83) or control (n = 83). The EA group received 30-min sessions of EA treatment on the basis of conventional pharmacological treatment, 3 times each week for 12 weeks, for a total of 36 sessions. All EA treatments were performed by senior acupuncturists with at least 2 years of service who used the same standardized protocol.
On secondary outcomes, at the conclusion of the study, investigators found changes in UPDRS II and III scores that were similar to the UPDRS score result, at week 4, 8, 16, and 24. Relative to controls, those on EA showed greater decreases in 20-m walk at week 16 and 24 as well (P <.01).
The 39-item Parkinson Disease Question (PDQ-39), used to evaluate the change in health-related quality of life, was more reduced through EA after 12 weeks (P <.001). At all observed time points through 24 weeks, the number of SBMs in the EA group continued to improve (P <.05). No differences were found between groups in Visual Analogue Scale (VAS) score; however, the EA group demonstrated greater decrease from baseline in chronic constipation severity scale (CCS) after 12 weeks, and patient assessment of constipation quality of life (PAC-QOL) between week 8 and 12 (P <.01).
Between the 2 groups, there were no significant differences in proportion of concomitant medications, as well as no differences in the proportion of compliance with treatment and complete treatment course (P >.05). AEs occurred in 13.3 of those in the EA group vs 7.2% of controls, with the most common acupuncture-related AEs that included local ecchymosis, abdominal pain, dizziness, and local hematoma. Headache, dizziness, fever, and diarrhea, were among the main non-acupuncture-related AEs observed; however, most of these occurred in the control group. Notably, there were no withdrawals from the study because of AEs, and no serious AEs observed.
In a subgroup analysis for change of UPDRS score at 12 weeks, both male and female patients with PD in the EA group had greater reduction in scores than controls. Additionally, outcomes were also similar in patients aged 60 and younger, as well as those aged over 60 years.
