3Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University
4Stroke and Neurological Disorders Center, Kyung Hee University Korean Medicine Hospital at Gangdong
Correspondence to: 박성욱, 서울시 강동구 동남로 892 강동경희대학교병원 뇌신경센터 한방내과, Tel: +82-2-440-6217, Fax: +82-2-440-7171, E-mail: seonguk.kr@gmail.com
Received July 16, 2021 Revised August 11, 2021 Accepted August 12, 2021
Abstract
Objectives
The objective of this study was to summarize clinical studies conducted over the last five years that investigated the effect of acupuncture on Parkinson’s disease and to propose a better process of study.
Methods
Research Information Sharing Service (RISS), Korea Studies Information Service (KISS), Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, and China National Knowledge Infrastructure (CNKI) were systemically searched for clinical trials that had investigated the effect of acupuncture on the course of Parkinson’s disease from May 2016 to April 2021.
Results
A total of 23 studies met all the inclusion criteria. In most reports, acupuncture had significant positive effects on the course of Parkinson’s disease. Furthermore, there were no serious adverse events associated with acupuncture in any of the studies. In addition to the acupuncture methods that showed effectiveness in previous studies, various types of acupuncture have been used to treat sub-symptoms of Parkinson’s disease. The outcome measures were subdivided through individual symptom evaluation and mechanical analysis. Follow-up assessments were also performed to analyze the continuous effect.
Conclusion
In the clinical studies conducted over the last five years, many studies investigated the various types of acupuncture used to treat Parkinson’s disease and the segmentation and diversification of outcome measures focusing on individual symptoms, and a new approach for excluding placebo effects through follow-up studies has been made. Further attempts like these are needed to overcome methodological flaws in studies on the effects of acupuncture on Parkinson’s disease.
GV17, GB19, Ex-HN1, temporal three-needle (located 2 cun to the hairline straight up from the tip of ear; the other two are 1 cun next to the first point bilaterally)
PD, 67.32±10.03/66.82±9.67, 7.32±5.13/7. 68±4.97, NR
Gongshi cerebral needle + CM (dopaserazid e) (n=30)
CM (dopaserazide ) (n=30)
2courses (1 course=1 time/d for 10d+1time/2d for 10d+rest for 10d)
midline of the top of the head, from the highest point of the occipital tuberosity to the front hair, set a point every 1.5 ~ 2cm, generally take 1 to 2 points each time
the tip of the coronal sagittal point (the junction of the frontal bone and the nape bone, the intersection of the coronal suture and the sagittal suture), 5cm below the occipital tuberosity and 4cm outward.
images of brain local area by fMRI
Increased local consistency in brain areas such as bilateral hippocampus, left amygdala, left insula, bilateral superior temporal gyrus, left middle temporal gyrus, left inferior frontal gyrus, bilateral putamen, left caudate nucleus, bilateral lateral globus pallidus, corpus callosum
Balance outcome measures by BalanSens TM (BioSensics LLC, Boston, Mass., USA): COGAP sway, COGML sway, COGML/AP sway, ankle sway, hip sway, ankle/hip sway, Short FES-1, BBS
LOS by NeuroCom Balance Master (NeuroCom® International, Inc. Oregon, USA): RT (s), MVL (°/s), EPE (%), MXE (%), DCL (%)13), PIGD score-UPDRS III20,21), FES-I28)
Gait disturbance
30m walking time(s) and steps, FOGQ
20m walking time (s)11), 20m average step length (m)11), GAITRite parameters by GAITRite (CIR Systems Inc, New Jersey, USA) : velocity (cm/s), cadence (steps/min), stride length (cm), stride time (s), single support time (s), double support time (s), swing time (s), swing %cycle26), Gait parameters by LEGSys™ (BioSensics LLC, Boston, MA) : speed (m/s), stride (m), cadence (steps/min), double support (%), midswing (º/s) during STHW, DTHW, STFW, DTFW28), Walk and balance function by NeuroCom Balance Master (NeuroCom® International, Inc. Oregon,USA): WLK (step length (cm), gait speed (m/min)), SNT (turning sway angle (°), turning time (s)), TUGT (s)25), PIGD score-UPDRS III20,21)
Non-motor symptoms
Disturbances in autonomic function
constipation
PAC-QOL24), anorectal dynamic exam: resting rectal pressure (kPa), anal canal resting pressure (kPa), anal systolic pressure (kPa), initial rectal sensory volume (ml), maximum tolerable volume (ml)24), total effective rate by Cleveland scale and Bristol scale24)
urinary disorders
Changes in urination frequency over 24 h, frequency of incontinence over 24 h, average urine volume at a time
* Indicates a significant difference of pre, post treatment (p<0.05)
BVA: Bee Venom Acupuncture; BDI: Beck Depression Inventory; CM: Conventional Medicine; MA: Manual Acupuncture; PIGD: Postural Instability and Gait Disturbance; PDQL: Parkinson’s Disease Quality of Life Questionnaire; UPDRS: Unified Parkinson’s Disease Rating Scale; MXE: Maximum Excursion in postural stability by NeuroCom Balance Master (NeuroComR International, Inc. Oregon,USA); DCL: Directional Control in postural stability by NeuroCom Balance Master; MFI-GF: General Fatigue score of the Multidimensional Fatigue Inventory; NS: Normal Saline; PDQ-39: Parkinson’s Disease Questionnaire-39; GDS: Geriatrics Depression Scale; ESS: Epworth Sleepiness Scale
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