Results of a randomized controlled trial show that acupuncture is an effective treatment for anxiety in patients with Parkinson’s disease (PD).
Both dummy and real acupuncture relieved PD-related anxiety at the end of the 8-week treatment, but only real acupuncture had a lasting effect two months after treatment ended.
The researchers note that the early effect of placebo acupuncture in the Chinese is not surprising.
Li-Shing Zhuang, PhD, at the Guangzhou University of Traditional Chinese Medicine in Guangdong, China, explained in an email to Medscape Medical News.
Therefore, the patient usually trusts acupuncture as an effective treatment, which leads to the curative effect of the pseudo-needle at the end of the treatment.
However, while acupuncture may produce “a placebo effect in a short time, this effect will disappear over time, while the therapeutic effect remains at a constant level,” Chuang said.
“Based on our findings, acupuncture should be recommended for anxiety in Parkinson’s,” Chuang added.
The study was published online on September 21 in JAMA Network is open.
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Anxiety is common in patients with Parkinson’s disease, but targeted therapy for anxiety associated with Parkinson’s disease is limited.
The results are based on a randomized, double-blind trial of 64 men and women with Parkinson’s disease and anxiety, in which half received real therapy or half received acupuncture three times a week for 8 weeks. The primary outcome was the Hamilton Anxiety Scale (HAM-A) score.
At the end of treatment, the mean change from baseline in HAM-A score was not statistically significant between the true and sham acupuncture groups (-4.38 vs -4.16; difference 0.22; s = .62).
However, two months after the end of treatment, the real acupuncture group had a significant 7.03 point decrease in the HAM-A score compared to the sham acupuncture group (-7.56 vs -0.53; s <.001).
Zhuang noted that the difference from real acupuncture is not only statistically significant, but also reaches the “Minimum Clinically Significant Difference (MCID) value, so the results of this study are clinically significant.”
Since there is no consensus on the MCID for HAM-A, the researchers used an anchor-based method to calculate the MCID.
A similar proportion of the real (65.6%) and sciatica (62.5%) acupuncture groups reached an MCID of 4 and showed clinical improvement in anxiety at the end of treatment.
At the end of the 2-month follow-up period, 86.8% of patients in the real acupuncture group had reached MCID compared to only 6.4% of patients in the sham group.
There was also an improvement in secondary outcomes with true acupuncture after two months of follow-up, including scores in Unified. Parkinson’s disease Rating scale (UPDRS), 39-item Parkinson’s disease questionnaire (PDQ-39), and serum adrenocorticotropic hormone (ACTH) levels.
buffer against anxiety
After accessing the comment, Shaheen Lakhan, a neurologist and researcher from Boston, Massachusetts, who was not involved in the study, said the finding was that after 8 weeks, both placebo and real acupuncture produced an anti-anxiety effect in 100% of the Chinese population. With a massive cultural expectation bias does not surprise him.
“I cannot say the same regarding the follow-up period – the full 8 weeks after treatment was stopped – anxiety was re-measured and there was a clear and significant clinical improvement between the real acupuncture and the sham groups,” Lakhan said. Medscape Medical News.
He noted that “the anxiety of the sham group returned to baseline levels before any intervention, while the real acupuncture group not only maintained the anti-anxiety response, but also made more gains after stopping treatment.”
Lakhan said it’s important to note that anxiety is essentially a disorder of cognition and autonomic function with a two-way relationship.
Patients with anxiety have cognitive inflexibility (inability to adapt to the environment, stimuli, and threats) and autonomic regulation disorder (hyperstimulation of heart rate, blood pressure, and other physiology), and the disorder either makes the other worse.
“In some neurodegenerative disorders such as Parkinson’s, the autonomic nervous system is particularly weak and progressive which leads to a failure to adapt. Acupuncture, I suppose, actually trains the fight-and-fight nervous system (parasympathetic and emotional) so that it can protect,” Lakhan said. of anxiety.
“This study was not designed to prove my assumptions. Importantly, they did not collect measures of autonomic function at baseline nor after treatment.”
“However, it is the empirical data that supports further clinical research to ultimately prove (or refute) that standardized acupuncture is an effective treatment for patients with anxiety and underlying progressive neurodegenerative diseases,” Lakhan said.
The The study was supported by the National Natural Science Foundation of China, the National Administration of Traditional Chinese Medicine, and the Guangdong Administration of Traditional Chinese Medicine. Chuang and Lakhan did not make any relevant disclosures.
Gamma neto is open. Posted online September 21, 2022. full text.