Acupuncture effectively reduces anxiety levels in patients with Parkinson disease (PD), according to a Chinese randomized controlled study published in JAMA Network Open.
Anxiety symptoms are present in about 31% of patients with PD. Generally, anxiety is left untreated in this population and is usually evidence with patients experiencing a lack of concentration, continuous feeling of worry, muscle tension, and increased severity of tumors, according to the study researchers. For the study, researchers assessed the effects of acupuncture compared with sham acupuncture for the treatment of anxiety in patients in with PD.
Researchers conducted a randomized, double-blinded, placebo-controlled trial between June 20, 2021 and February 26, 2022 with the last follow-up taking place on April 15, 2022. They enrolled 70 patients with PD and randomly assigned them into intervention and control groups. Only 64 (91%) patients — 34 men and 30 women; mean aged 61.8 years — fully completed the 8-week intervention plus the 8-week follow-up.
Patients in the intervention group received acupuncture at specific points, while individuals in the control group received sham acupuncture at these points. Each session consisted of 30 minutes of acupuncture or sham treatment once per day 3 times per week for 8 weeks.
The researchers analyzed specific measurements for all patients at baseline, 8 weeks, and another 8 weeks following the last treatment. Outcomes included the Hamilton Anxiety Scale (HAM-A) score, the Unified Parkinson Disease Rating Scale (UPDRS), the 39-item Parkinson Disease Questionnaire (PDQ-39), and blood serum levels for both adrenocorticotropic hormone (ACTH) and cortisol.
Patients in the acupuncture group demonstrated reduced anxiety compared with baseline measurements on the HAM-A score (mean reduction: 4.38; 95% CI, -5.12 to -3.63; P <.001). While anxiety scores between the 2 groups did not differ significantly by week 8 when treatment ended (difference: 0.22; 95% CI, -0.63 to 1.07; P =.62), patients in the acupuncture group demonstrated significantly lower levels of anxiety on HAM-A scores compared with those in the sham group after 8 weeks of follow-up (difference: 7.03; 95% CI, 6.18 to 7.88; P <.001).
Following a similar trend, scores on the UPDRS I and the PDQ-39 emotional well-being (EW) sections — indicating patient mental status — did not differ between groups at the end of treatment at week 8. These 2 scores decreased significantly in the real acupuncture group after the 8-week follow-up period compared with the sham group (UPDRS I difference: 3.40; 95% CI, 2.36 to 4.45; P <.001; PDQ-39-EW difference: 2.13; 95% CI, 1.15 to 3.10; P <.001).
Overall UPDRS and PDQ-39 scores differed significantly between groups only after the 8-week follow-up and not at the end of treatment (UPDRS point difference: -3.40; 95% CI, 2.36 to 4.45; P <.001; PDQ-39 point difference: 9.59; 95% CI, 2.70 to 16.49; P =.02).
Serum ACTH levels differed between individuals in the groups after 8 weeks of acupuncture treatment (difference: 2.16; 95% CI, 0.90 to 3.45; P <.001), whereas cortisol levels did not change after treatment.
Study limitations included bias in HAM-A scoring even without anxiety, lack of generalizability outside of the Chinese population, and possible cultural influences affecting the sham acupuncture response.
“These findings suggest that acupuncture may improve overall motor functions and wellbeing of patients with PD by ameliorating the anxiety,” the researchers concluded.
Disclosure: One study author declared a patent conflict of interest. Please see the original reference for a full list of authors’ disclosures.
Fan JQ, Lu WJ, Tan WQ, et al. Effectiveness of acupuncture for anxiety among patients with Parkinson disease: randomized clinical trial. JAMA Netw Open. Published online September 21, 2022. doi:10.1001/jamanetworkopen.2022.32133