What do we know so far about acupuncture treatment with amyotrophic lateral sclerosis?

Recently an article summarized our understanding about acupuncture to amyotrophic lateral sclerosis (ALS). The article was published in journal of Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration.

Pre-clinical model studies showed that acupuncture stimulation improved motor neuron survival and delayed loss of motor performance and this was accompanied by reduced inflammatory reaction in acupuncture treated group compared with control group. However, there were many flaws in the designs of studies, including small sample size, non-blind raters.

Clinical studies from separate three groups revealed that effect of acupuncture treatment varied from achieving significant improvement in motor function in some patients to minor alleviation in other patients. However, there was incomplete detail regarding the ALS diagnoses, lack of a control group, failure to use validated ALS outcome measures in those reports.

Nonetheless, some evidence suggests that acupuncture can at least alleviate two common ALS symptoms: pain and spasticity with little adverse effect.

Reference

The ALSUntangled Group (2015) ALSUntangled No. 28: Acupuncture, Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 16:3-4, 286-289, DOI:10.3109/21678421.2015.1039240.    http://www.tandfonline.com/doi/full/10.3109/21678421.2016.1172818

Objective assessment of efficacy of electroacupuncture in the treatment of gait disorder in Parkinson’s disease

A report was just published to confirm the efficacy of electroacupuncture treatment on gait in patients with Parkinson’s, by using body-worn sensors, an objective monitoring device. The pilot study was published by journal PLOS one.

Parkinsonian gait is mainly characterized by general slow movement, in particular by a reduction of gait speed and stride length. The progressive nature of symptoms leads to the freezing of gait and falls. Parkinsonian gait tends to be difficult treated, as drug treatment and deep brain stimulation have limited efficacy. Acupuncture has been effectively used to relieve parkinsonian symptoms; however, its efficacy remains controversy.

Recently Dr. H Lei and colleagues in the United States conducted a clinical study by using wearable sensor technology, to objectively assess the efficacy of acupuncture treatment on gait in patients with Parkinson’s. PD patients were randomly allocated into real acupuncture group (n=10) and sham acupuncture group (n=5). In real group, electroacupuncture was applied on different acupoints on the scalp, body and limbs, for 30min, once a week for 3 weeks. In sham group, acupuncture needles were applied just under skin, ca 4mm at non-acupoints on the scalp, body and limbs without stimulation. The participants and assessors were masked to eliminate potential bias effect. Outcomes were monitored at baseline and after completion of treatments. Measurements included gait analysis perimeters. In addition, Unified Parkinson's Disease Rating Scale (UPDRS), short Falls Efficacy Scale-International (FES-I), and visual analog scale (VAS) for pain were utilized.

Results showed that electroacupuncture treatment statistically significantly improved gait symptoms judged by all gait objective measurements compared with sham acupuncture control group. In particular gait speed was markedly improved compared with sham control.

This was the first participants- and assessors- masked randomized control study that, using body-worn sensor technology to objectively assess potential benefits of EA in enhancing spatio-temporal parameters of gait in PD patients.

Reference

Lei H et al., A Pilot Clinical Trial to Objectively Assess the Efficacy of Electroacupuncture on Gait in Patients with Parkinson's Disease Using Body Worn Sensors. PLoS One. 2016 May 26;11(5):e0155613.   http://www.ncbi.nlm.nih.gov/pubmed/27227460 

Acupuncture helps improve both motor and non-motor symptoms of Parkinson’s disease

Literature review study found that acupuncture treatment alleviated both motor and non-motor symptoms of Parkinson’s disease according to a report published in journal of CNS Neuroscience and Therapeutics.

In this article, we have studied the clinical reports of acupuncture treatment for Parkinson’s, which were listed in Medline, PubMed, EMBASE, CNKI, and CINAHL databases in the past 15 years. It was found that acupuncture either manual or electroacupuncture stimulation at specific acupoints relieved some motor symptoms in patients with Parkinson’s and markedly improved many non-motor symptoms such as psychiatric disorders, sleep problems, and gastrointestinal symptoms. When it was used as an adjunct for levodopa, acupuncture improved therapeutic efficacy and reduced dosage and the occurrence of side effects of levodopa.

Although the evidence for the effectiveness of acupuncture for treating PD is inclusive, data from the reviewed studies showed that therapeutic potential of acupuncture in treating Parkinson’s seems rather promising. More studies, either comparative effectiveness research or high-quality placebo-controlled clinical studies should be conducted.

Reference

Zeng BY & Zhao K, Effect of Acupuncture on the Motor and Nonmotor Symptoms in

Parkinson’s Disease—A Review of Clinical Studies. CNS Neurosci Ther. 2016 Feb 4. doi: 10.1111/cns.12507.    http://www.ncbi.nlm.nih.gov/pubmed/26843036

Acupuncture alleviated gait disturbance in patients with Parkinson’s

Acupuncture stimulation at some specific acupoints relieved gait disturbance immediate after acupuncture in PD patients according to a report published in the Journal of American Geriatrics Society.

Gait disturbance is one of the most common symptoms of Parkinson’s. A typical parkinsonian gait is characterised as slower speed, shorter arm swings, shorter stride length, longer double support time and faster cadence than healthy individuals. Gait dysfunction is regarded as one of the important symptoms of Parkinson’s and affects the quality of life of patients with Parkinson’s.

Recently doctors in Japan conducted a small clinical study to assess the short-term effect of acupuncture on gait disturbance in Parkinson’s. Patients with Parkinson’s were given acupuncture at following acupoints: ST36, SP6, LV3, LI4 and LI11. Gait function in PD patients were measured using a portable gait rhythmogram, a small device that measures three dimensional accelerations affecting gait associated with voluntary limb and trunk movements before and after acupuncture.

It was found that after acupuncture stride length, walking acceleration and gait speed, indicators of gait function significantly increased compared the baseline.

Authors suggested that acupuncture was as good as or better than the conventional treatment with gait disturbance in Parkinson’s. However, clinical study with controlled and large sample size should be conducted to evaluate efficacy of acupuncture treatment.

Reference

S Fukuda et al., Acupuncture for Gait Disturbance in Parkinson's Disease: Immediate Effects of Acupuncture Treatment. J Am Geriatr Soc. 2015 Oct;63(10):2189-90.    http://onlinelibrary.wiley.com/doi/10.1111/jgs.13690/abstract

Acupuncture add-on treatment improved both motor and non-motor symptoms in Parkinson’s disease

Acupuncture plus anti-parkinsonian drug significantly improved motor symptoms and non-motor symptoms in patients with Parkinson’s, and particularly efficacious at early stage of Parkinson’s. Acupuncture add-on treatment also markedly reduced nitric oxide level serum compared with anti-parkinsonian drug along group. A clinical study was recently reported in the journal of Evidence-Based Complementary and Alternative Medicine.

Parkinson’s is caused by the loss of dopamine and other neurotransmitters in central nervous system and is characterized by the motor dysfunction such as bradykinesia, resting tremor, rigidity and gait and postural imbalance. Although many non-motor symptoms developed before or parallelly with motor symptoms they were not always diagnosed and properly treated. Anti-parkinsonian drugs such as dopamine agonists are used to treat motor-related symptoms and have some severe side effects e.g. involuntary movement; while many non-motor symptoms were left untreated or mistreated, leading to significantly downgrad the quality of life of the PD patients. 

Acupuncture has been used to treat resting tremor and many motor and non-motor symptoms. However efficacy of acupuncture treatment in Parkinson’s is inconsistent and controversial.

Recently researchers led by Dr. Z Wei in China carried out a clinical study to assess the efficacy of acupuncture add-on in PD in particular to evaluate on both motor and non-motor effect. Fifty patients with Parkinson’s treated with levedopa were divided into acupuncture add-on group (n=30) and drug alone group (n=20). While all patients were continually taking their route anti-parkinsonian drug levedopa, patients in acupuncture add-on group were given electroacupuncture at bilateral GF20, LI4 and central DU14 and DU16 for 30 each time, once every 3 days. Ten-treatment was a course and two course in total within 2 months. Outcome measures for both motor-function (UPDRS III scores) and non-motor conditions such as depression and sleep disturbance and questionnaire for quality of life were assessed before and after the treatment.

Data showed that acupuncture add-on treatment significantly improved many motor functions such tremor, bradykinesia, and rigidity and non-motor conditions e.g. depression and sleep disturbance compared with drug alone group. Biochemical studies revealed that many inflammatory-related markers such as TNF-alpha,IL-1beta,and PGE2 were significantly reduced in acupuncture add-on group compared with drug alone group.

Authors concluded that acupuncture add-on is effective on most motor symptoms and some non-motor symptoms in particular at the early stage of Parkinson’s. Anti-inflammatory effect may be the underlying mechanism of acupuncture add-on treatment in Parkinson’s.

Reference:

F Wang et al., Effect and Potential Mechanism of Electroacupuncture Add-On

Treatment in Patients with Parkinson’s Disease. Evidence-Based Complementary and Alternative Medicine, Volume 2015, Article ID 692795,11 pages.     http://www.hindawi.com/journals/ecam/2015/692795/

Acupuncture may be more effective than drugs in treating Alzheimer’s disease

Acupuncture may be more effective than drugs in treating Alzheimer’s disease (AD). Acupuncture improves effect of drugs for treating AD in terms of enhancing cognitive function. A systematic review study reported its data in the journal Medicine.

There is increasing number of reports regarding clinical trials of acupuncture treatment for AD during past 10 years. Most of studies were performed in China and were published in Chinese. The effectiveness and safety of acupuncture on AD has not been systematic reviewed until recently.

Dr. Zhou and colleagues in China evaluated the effectiveness and safety of acupuncture in treating AD by systematic review and meta-analysis. Meta-analysis is a statistical technique used for contrasting and combining results from different studies in the hope of identifying patterns among studies. Ten randomized controlled studies with a total of 585 subjects were used in the study. 

They found that the combined results from 6 randomized controlled studies showed acupuncture is better than drug at improving scores on the Mini Mental State Examination (MMSE) scale, indicating the enhancement in the cognitive function. Evidence from pooled data of 3 trials revealed that acupuncture plus drug denepezil was more effective at improving MMSE scale than denepezil alone. In a broad review they found that only 2 out of 141 acupuncture clinical trials reported the incidence of acupuncture-related adverse effect. Only 7 of 3416 patients reported to have adverse reactions relevant to acupuncture.

Authors conclude that “Acupuncture may be more effective than drugs and may enhance the effect of drugs for treating AD in terms of improving cognitive function. Acupuncture may also be more effective than drugs at improving AD patients’ ability to carry out their daily lives.”

However, more clinical studies with better protocol design and better standards are urgently needed to prove the effectiveness of acupuncture in treating AD in more countries.

Reference:

J Zhou et al., The effectiveness and safety of acupuncture for patients with Alzheimer disease: a systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2015 Jun; 94(22):e933.

http://www.ncbi.nlm.nih.gov/pubmed/26039131

Recent development in acupuncture for Alzheimer’s disease

Alzheimer’s disease is the most common form of dementia in the elderly people and is associated with progressive loss of memory and cognitive function. Because the cause of Alzheimer’s is unclear there is no cure for the condition.

Acupuncture has been used to improve memory and cognitive function in China for a long time and got increasingly attention around the world due to its well tolerance and minor side effect. However, the mechanism of acupuncture and its effectiveness on Alzheimer’s is not clear due to lack of scientific studies. Here some recent development of acupuncture from both basic research and clinical studies are summarized.

Recent search reports showed that acupuncture stimulation at DU20 and BL23 acupoints 30 min a day for 18 days with a rest every 7 days improved learning and memory function in Alzheimer’s model compared with control. Biochemical studies revealed that acupuncture stimulation suppressed the apoptosis, a cell death process in the hippocampus region, a vulnerable brain area to Alzheimer’s. Acupuncture decreased apoptosis enhancing molecules and increased apoptosis resistant molecules in the Alzheimer’s model brain which was not seen in the control. In another study, scientists looked the changes in neuronal activity of different brain regions using functional brain imaging technique – positron emission tomography (PET). They found that acupuncture stimulation at ST36 acupoint showed greater activity in the brain regions such as hippocampus, amygdalae and temporal lobe that are linked with memory and cognitive function. However stimulation at a sham acupoint showed increased activity in different brain areas.

A clinical acupuncture study showed that the patients with Alzheimer’s were given acupuncture at GV24, GV20, GB20, GB12, CV17, CV12, CV6, SP10 and ST36 and the other acupoints depending on the symptoms and physical signs, once a day, 6 days a week and 4 weeks as a session for total 4 sessions. In the control group, donepezil, a acetycholinesterase inhibitor, was given for the same time period. The minimum mental state examination (MMSE), the activity of daily living scale (ADL), Alzheimer's disease assessment scale-cognition (ADAS-cog) and the digit span (DS) were monitored before treatment and assessed again after treatment. It was found that both acupuncture and drug treatment improved the MMSE, ADL and DS scores, decreased ADAS-cog scores compared with the scores recorded before treatment. The study showed that acupuncture treatment has the same effect as the drug treatment for patients with Alzheimer’s, without side-effects.

References:

Guo HD et al., Electroacupuncture Suppressed Neuronal Apoptosis and Improved Cognitive Impairment in the AD Model Rats Possibly via Downregulation of Notch Signaling Pathway. Evidence-Based Complementary and Alternative Medicine Volume 2015, Article ID 393569, 9 pages.  http://www.hindawi.com/journals/ecam/2015/393569/

Lu Y et al., Brain areas involved in the acupuncture treatment of AD model rats: a PET study. BMC Complementary and Alternative Medicine 2014, 14:178.   http://www.biomedcentral.com/1472-6882/14/178

Gu W et al., [Clinical observation of Alzheimer's disease treated with acupuncture]. Zhongguo Zhen Jiu. 2014 Dec;34(12):1156-60.  http://www.ncbi.nlm.nih.gov/pubmed/25876339

Acupuncture improved non-motor symptoms of Parkinson’s disease

Acupuncture treatment alleviated many non-motor symptoms of Parkinson’s including pain, depression, anxiety, hot flashes and paroxysmal sweating in a patients with Parkinson’s. This is a case report published in the journal of Case Reports of Neurological Medicine.

Non-motor symptoms occur in virtually all patients with Parkinson’s. Non-motor symptoms range from autonomic dysfunction, psychiatric disorders, sensory symptoms, gastrointestinal syndromes and many others. Acupuncture is very effective in relieving many non-motor symptoms without side-effect.

Recently Dr. Iseki and colleagues in Japan used acupuncture to treat multiple non-motor symptoms of a patient with PD. An 81-year-old woman with a 5-year history of right-dominant lower leg pain was admitted into the hospital. Although she was prescribed various kinds of pain killers her pain was not satisfactorily relieved. She was diagnosed with Parkinson’s 3 year ago due to her mask-like face and bradykinesia and around that time suffered from severe hot flashes and paroxysmal sweating which was not associated with the levodopa treatment. The patient was given acupuncture treatment 5 times per week for 2 weeks. Assessments including Visual Analogue Scale (VAS) for pain, Hamilton Depression Scale (HAM-D) for depression and the Unified Parkinson’s Disease Rating Scale (UPDRS) score were performed before and after acupuncture treatment.

It was found that immediately after every acupuncture session patient felt that her legs had become light. Two weeks after acupuncture her lower leg pain became milder. VAS scores were markedly reduced. The daily attack of hot flashes and paroxysmal sweating were decreased to about three time a week. Depression and anxiety were obviously lessened and HAM-D scores reduced from 18 to 9. The UPDRS total score reduced from 59 to 46. Her steps became larger and her bradykinesia was improved.

This is another report showing that acupuncture is beneficial to PD patients suffering from both non-motor and motor symptoms.

Reference

Iseki C et al.,  Acupuncture Alleviated the Nonmotor Symptoms of Parkinson's Disease including Pain, Depression, and Autonomic Symptoms. Case Rep Neurol Med. 2014;2014:953109. doi: 10.1155/2014/953109. http://www.hindawi.com/journals/crinm/2014/953109/ 

Moxibustion improved bladder function in multiple system atrophy

Moxibustion performed at specific acupoints significantly decreased nocturnal urine output of a patient with multiple system atrophy (MSA). A case report was published in the journal of Internal Medicine.

Dr. Ryuji Sakakibara and colleagues in the Chiba University of Japan reported a case study of therapeutic effect of moxibustion on autonomic symptoms of MSA. A 65-year-old man diagnosed as MSA-parkinsonian form. He had urinary urgency but failed to evacuate his bladder properly. Although his daytime urine output was 300ml, his nighttime urine output was 2000ml. Biochemical test found that plasma levels of circadian arginine vasopressin rhythm (C-AVP-R) was significantly decreased in nighttime. Moxibustion was performed at specific acupoints such as Ren3, ST30, SP6 and KI5 once a day, 3 times a week for 6 months. Two months following moxibustion, nighttime urine output ratio gradually decreased to 87%, and it reached 75% by the end of 6-month treatment. Nighttime plasma levels of C-AVP-R were normalized by the end of treatment.

This case report suggests that moxibustion is able to improve bladder function by normalizing disturbed C-AVP-R levels in patient with MSA.

Reference:

Sakakibara R et al., Moxibustion, an alternative therapy, ameliorated disturbed circadian rhythm of plasma arginine vasopressin and urine output in multiple system atrophy. Intern Med. 2007;46(13):1015-8.   http://www.ncbi.nlm.nih.gov/pubmed/17603243

Acupuncture helps improving bladder dysfunction in Parkinson’s patients

Acupuncture in combination with lower dose of tolterodine not only significantly improved urinary function but the motor functions of Parkinson’s disease (PD) patients with overactive bladder syndrome. According to a report published in the journal of Chinese Acupuncture & Moxibustion.

Many PD patients developed some non-motor symptoms including bladder dysfunction such as overactive bladder syndrome – urinary frequency, urgency, and leakage which could be very severe and significantly impacted on patient’s quality of life. Conventional treatment for urinary dysfunction such as tolterodine can temporarily improve bladder function but has many unpleasant side effects.

Dr Chen Yi-Liang and colleagues in China carried out a clinical study to assess the therapeutic effect of acupuncture plus lower dosage of tolterodine on PD patients with overactive bladder syndrome. PD patients with overactive bladder syndrome were divided into two groups. Combination group (n=30) were treated with electroacupuncture (once a day, 6 time a week for 6 weeks), plus tolterodine 1mg, twice a day for 6 weeks. Drug group (n=30) was given tolterodine 2mg, twice a day for 6 weeks. Urinary functions and UPDRSIII scores were assessed before and after completion of treatment.

At the end of study although both groups showed significant improvement in urinary function, the improvement was greater in combination group. Moreover patients in combination group experienced better motor functions jugged by significant changes in UPDRSIII scores. The occurrence of side effects was also markedly less in combination group than those of drug only group.

The study showed that acupuncture indeed is a treatment for multi targets not only improve non-motor symptoms but motor symptoms as wells.

Reference:

Chen YL et al., [Parkinson's disease combined with overactive bladder syndrome treated with acupuncture and medication]. Zhongguo Zhen Jiu. 2012 Mar;32(3):215-8.     http://www.ncbi.nlm.nih.gov/pubmed/22471132

Acupuncture helps reverse symptoms of multiple system atrophy

Although there is no cure for multiple system atrophy (MSA) also called shy dragger syndrome, alternative medicine such as acupuncture is very effective in relieving many symptoms or even reverse them.

Dr. Colet Lahoz in the United State has had success in treating patients with MSA using acupuncture treatment, plus herbal medicine and dietary supplements. She found that patients responded well to aggressive acupuncture therapy, incorporating with electrical stimulation.

Within 32 MSA patients treated, 30 patients experienced improvement in their symptoms. Patients showed varying degrees of improvement, some as early as 2 weeks after starting treatments and continued to gain improvement as long as they stayed with the program. This is an important since MSA is characterized by rapid deterioration, resulting in death usually within 7-10 years following diagnosis.

It was noted that patients who were not taking prescription medications responded faster than those who were taking drugs. For example, the patients who were not taking blood pressure medication experienced better results from the acupuncture than those who were taking drugs for orthostatic hypotension.

Although the cause of MSA is unclear, inflammation, dysfunction in immune system and autonomic system are all believed to be involved in the development of MSA. Acupuncture as many preclinical and clinical studies reported that it reduces inflammation, modulates immune system and autonomic system, leading to normalizing haemostasis and improve many conditions.

Reference:

Lahoz SC, Shy dargger syndrome demonstrate syndrome reversal using acupuncture, herbal medicine and hypnotherapy.  http://eastwest-mn.home.comcast.net/~eastwest-mn/Shy_Drager_Syndrome.htm

Acupuncture technique, Qin’s eight scalp needles helps relieve symptoms of Parkinson’s disease

Qin’s eight scalp needles, another acupuncture technique is reported improved both motor and non-motor symptoms of Parkinson’s, in the journal Zhonggou Zhen Jiu (Chinese Acupuncture & Moxibustion).

The term, the eight scalp needles, has been developed by Professor Qin Liang-Fu. It includes bilateral GB8 (Shuaigu), GB15 (Toulinqi) and GB20 (Fengchi), as well as Baihui (GV20) and Yintang (Ext2). Based on his years of clinical experience, he observed the importance of Governor Vessel meridian for limb disorders and miscellaneous diseases and that the similarity between the cephalic motor region distribution and relevant scalp acupoints of many meridians. Professor Qin then proposed the eight scalp needles which, in combination with different body acupoints, has been shown effectively in treating neurodegenerative disorders such as Parkinson’ and multiple sclerosis.

Qin’s eight scalp needles in combination with other body acupoints has been show improving tremor, rigidity, slow movement, anxiety and depression, and enhanced memory function, sleep quality and decreased UPDRS scores in Parkinson’s patients.

Qin’ eight scalp needles and “the seven acupoint of cranial base” reported here before show the diversity of acupuncture techniques used to treat Parkinson’s in China.

Reference:

Dong J & Cui HS, Clinical experience of Qin’s eight scalp needles for treatment of Parkinson’s disease. Zhongguo Zhen Jiu. 2014 May;34(5):491-4.    http://www.ncbi.nlm.nih.gov/pubmed/25022128

Acupuncture helps improve fatigue in patients with multiple sclerosis resistant to amantadine

Acupuncture treatment improved fatigue symptom in multiple sclerosis patients who are resistant to drug amantadine, according to a report published in journal Acupunct Medicine.

Fatigue is one of the most common symptoms of multiple sclerosis that has significant negative impact on the quality of life of patients with the condition. After long term medication such as amantadine which is the main drug used in fatigue treatment in multiple sclerosis, many patients developed resistant to the drug. So alternative therapy is urgently needed for them to keep the symptoms under control.

Doctors in Iran conducted a clinical study to evaluate the efficacy of acupuncture on fatigue of patients with multiple sclerosis resistant to amantadine. Twenty patients who were resistant to amantadine were given acupuncture treatment 30 mins a day, on every other day, in total 12 sessions within 4 weeks. Changes in fatigue were assessed by Fatigue Severity Scale before and after treatment. At the end of acupuncture treatment 5 of 20 patients who were resistant to amantadine responded to acupuncture plus amantadine treatment. The scores of Fatigue Severity Scale were significantly reduced within patients resistant to amantadine.

Authors suggest that acupuncture is effective in treating fatigue in proportion of patients with fatigue resistant to amantadine treatment.

Reference:

Foroughipour M et al., Amantadine and the place of acupuncture in the treatment of fatigue in patients with multiple sclerosis: an observational study. Acupunct Med2013;31:27–30.    http://www.ncbi.nlm.nih.gov/pubmed/23151355

Progress in early diagnosis of Parkinson’s disease

Early diagnosis of Parkinson’s disease is crucial to effectively slow down the progression of condition. A study, reporting that 181 genes in the blood showed a similar expression trend both in Parkinson’s patients and normal subjects, was published in Journal Biomedical and Environmental Sciences.

So far Parkinson’s can be diagnosed according to medical history and neurological symptoms. At this stage, majority of dopamine cells in the brain have already degenerated. How to diagnose the condition at the possible early stage is very important to slow down the progression of neurodegeneration in Parkinson’s.

Scientists in China recently analysed gene expression profiles of Parkinson’s in blood in order to find candidate genes in the blood for its early diagnosis. Using high-throughput cell biology techniques they analysed blood sample from 27 patients with PD and 26 control subjects and found that 181 genes in blood exhibited the similar expression profile trend within PD patients and control subjects. Those genes possess important biological process function and can be potential candidates of serum markers for early diagnosis of Parkinson’s.

The findings of study are promising for the early diagnosis of Parkinson’s. In the future, when the biomarkers can reliably indicate the early symptoms of Parkinson’s early acupuncture treatment to patients may be able to stop or slow down the disease progression, as suggested by the reports of basic and clinic acupuncture studies.

Reference:

Zhang Y et al., Bioinformatics Analysis Raises Candidate Genes in Blood for Early Screening of Parkinson’s Disease. Biomed Environ Sci, 2014; 27(6): 462-465.  http://www.ncbi.nlm.nih.gov/pubmed/24961856

Acupuncture improves PD symptoms and helps Parkinson’s patients gradually stop medication.

An acupuncture technique called “the seven acupoints of the cranial base” is reported to improve clinical symptoms of Parkinson’s disease (PD) and help Parkinson’s patients gradually stopped medications for two weeks after acupuncture treatment. It was published in journal Chinese Acupuncture & Moxibustion recently.

The seven acupoints of cranial base consists of DU15, bilateral BL10, GB20 and GB12 and is located at the very place of cranial bottom. It is believed that the function pattern of the seven acupoints echoes the brain resting-state network.

Researchers in China conducted the clinical study to assess the effectiveness of the seven acupoints of the cranial base in patients with Parkinson’s. Forty nine patients with Parkinson’s were assessed using Webster scores and categorized as early illness (<10 scores, n=4), moderate (11-20 scores, n=43) and advanced (21-25 scores, n=2). Before acupuncture 36 patients were treated with Madopar other patients were given other medications. All patients were given electroacupuncture at the seven acupoints for 30min, 3 times a week.

Patients with early stage of PD stopped taking medication after 3 times of acupuncture, but continued acupuncture treatment for a further 6 times. Patients with moderate PD reduced their medication to half dosage after having 3-time acupuncture, and stopped taking medication after 6^th acupuncture, but continued acupuncture treatment for a further 6 times. Advanced patients reduced their medication by a third after 3-time acupuncture, and reduced their medication to half dosage after 6^th acupuncture treatment, then stopped medication after 10^th acupuncture, but continued acupuncture treatment for a further 9 times. There was no adverse effect and complication during and after acupuncture treatment.

Before acupuncture the average of Webster scores was 16.74±3.35 and it was significantly reduced to 11.50±4.17 after acupuncture treatment. Approximately 87% of patients with PD stopped medication for two weeks after last acupuncture treatment and maintained good improvement of their symptoms.

It will be interesting to know the outcome of the follow-up study.

Reference:

Yuan Y et al., [Forty-nine cases of Parkinson's disease treated by acupuncture adjunctive therapy]. Zhongguo Zhen Jiu. 2014 Jan;34(1):53-4. Chinese. 

Acupoint injection of Enercel improved neurological function in patients with amyotrophic lateral sclerosis

Acupuncture could significantly improve neurological functions in patients with amyotrophic lateral sclerosis as shown in a case report in journal Acupunct Meridian Study.

Amyotrophic lateral sclerosis (ALS), one of motor neuron diseases, is a neurodegenerative disorder. It is characterized by the rapidly progressive muscle weakness leading individuals to loss their strength and the ability to move their arms, legs and body, and accompanied by impaired swallowing, speech and breathing. The cause of the disease is not known and there is no cure for the condition. The available medication such as Rilutek has been shown only to temporally prolong survival time with many side effects.

Researchers in the United State reported an acupuncture case study after seeing markedly improvement in patients with ALS. Two patients with ALS were treated with acupoint injections of Enercel (an herbal preparation consisting of small diluted amount of a variety of plants). Neurological conditions were assessed before and after treatment and the follow-up. The treatment was carried out at the specific acupoints once a day, 5 days a week for 4 weeks.

Patient 1 was a 59-year-old female with one year history of ALS. Before treatment, she showed a flaccid paralysis of all extremities and impaired speech and swallowing. After treatment she demonstrated a significant improvement in motor strength in her hands and feet, in speech and swallowing. A 3-month follow-up assessment found her clinical status slowly worsened but was still improved compared with baseline.

Patient 2 was a 49-year-old male with 16-month history of ALS and had an impaired speech and a mild motor loss of upper extremities and the left leg. Following 4-week treatment his motor function returned to normal and his speech is understandable. The patient continued to have the same treatment during 3-month follow-up and his improvement was maintained.

The case study showed that acupoint injection with Enercel significantly improved neurological conditions in patients with ALS. However, continuous treatment may be necessary to maintain the improvement.

Reference:

Liang S et al., Significant neurological improvement in two patients with amyotrophic lateral sclerosis after 4 weeks of treatment with acupuncture injection point therapy using enercel. J Acupunct Meridian Stud. 2011 Dec;4(4):257-61.   http://www.ncbi.nlm.nih.gov/pubmed/22196509

Acupuncture improves certain aspects of motor symptoms in Parkinson’s disease

Electroacupuncture improved gait, balance and postural transitions in patients with Parkinson’s, suggests in a study published in journal Neurology.

Gait and balance disturbance, and postural instability are parts of motor dysfunction of Parkinson’s. They are predicators of falling risk and impaired quality of life and have emerged as major therapeutic concerns in Parkinson’s treatment.

In a pilot study, researchers in Arizona, the United States, using objective modalities based on innovative body worn sensors technology, assessed the effect of acupuncture on gait and balance in Parkinson’s patients. Eight patients with Parkinson’s were treated with electroacupuncture once a week for three weeks. Outcomes assessed at baseline prior to and at the end of the treatment. Measurements include many aspects of gait, balance and quality of life. At the end of treatment gait, balance and postural transitions were all markedly improved in acupuncture group compared to control group. Further, improvement in gait, balance and postural transitions in acupuncture group were significantly better compared to the pre-treatment scores, while there is no change in control group compared to baseline.

Authors conclude that electroacupuncture is an effective treatment in improving certain aspects of motor symptoms of Parkinson’s.

Reference:

Lei H et al., Objective Assessment of Electro-acupuncture Benefit for Improving Balance and Gait in Patients with Parkinson’s Disease (P3.074). Neurology April 8, 2014 vol. 82 no. 10 Supplement P3.074.    http://www.neurology.org/content/82/10_Supplement/P3.074

Acupuncture and levodopa in combination enhanced the benefits of levodopa and reduced levodopa-induced dyskinesia

Combined acupuncture and levodopa greatly enhanced motor functions of levodopa treatment and reduced levodopa-induced side effects such as dyskinesia in a Parkinson’s model, according to a study recently published in journal Brain Research.

Levodopa is the most effective drug for alleviating motor symptoms of Parkinson’s. However, more than 50% of PD patients treated with levodopa develop adverse effects such as dyskinesia, hallucination, insomnia. Among these, levodopa-induced dyskinesia is the most debilitating and severe side effect and in many cases worsen than PD symptoms. This has a great impact on the quality of life of patients with PD.

Researchers in Korea investigated whether combination of acupuncture and levodopa improves motor function in PD mice model and simultaneously alleviates dyskinesia. In combined group PD mice were treated with acupuncture at acupoint GB34 and levodopa (7.5mg/kg). In levodopa alone group PD mice was treated with standard dose of levodopa (15mg/kg). PD mice in control group were given non-acupoint treatment. Acupuncture was given once a day for 7 days. Behavioural results showed that PD mice in combined group displayed motor function improvement that was comparable to that of levodopa (15mg/kg) alone group, and the combined group significantly reduced levodopa-induced dyskinesia. Biochemical study found that the combination treatment significantly reduced abnormally elevated brain chemicals that are closely linked with motor function and occurrence of dyskinesia.

This study suggests that acupuncture can be used as an adjunct with levodopa to enhance the efficacy of levodopa and reduce the adverse effects in treatment of Parkinson’s.

Reference:

Kim SN et al., Combined treatment with acupuncture reduces effective dose and alleviates adverse effect of L-dopa by normalizing Parkinson's disease-induced neurochemical imbalance. Brain Res. 2014 Jan 28;1544:33-44.   http://www.ncbi.nlm.nih.gov/pubmed/24321617  

Can acupuncture help patients with multiple system atrophy?

Multiple system atrophy (MSA) is a neurodegenerative disorder characterized by the loss of nerve cells in the specific brain areas. The neuronal degeneration impairs body’s movement, balance and autonomic functions including blood pressure, heart rate, bladder control and digestion. There are three types of MSA. Parkinsonian type includes slow movement, mild tremor and stiff muscles similar to those of Parkinson’s. Cerebellar type is characterized by the loss of balance and tendency to fall, slurred-speech and visual disturbance. The third is the combination type which may include symptoms of both types. MSA occurs in people at their 50s or 60s and affects more men than women. The cause of MSA is unclear. There is currently no cure for it. The standard medication is for symptom relief only.

One of unique approaches of acupuncture therapy is to treat multiple symptoms simultaneously. Acupuncture helps improve bowel and bladder function, blood pressure, double vision, impairment of speech and motor functions. In combination with herbal medicine and life style changes, acupuncture significantly enhances the quality of life of many patients with MSA.

Scalp acupuncture increased dopamine release in the striatum of Parkinson’s disease models

Although scalp acupuncture is relatively new compared with body acupuncture it has been used to effectively treat neurological disorders such as stroke. Scalp acupuncture not only accelerated the functional recovery, also alleviated many post-stroke complications alone or in combination with rehabilitation training courses.

Scalp acupuncture has gained increasingly attention in Parkinson’s disease (PD) research and treatment. Scalp acupuncture studies in PD models reported that scalp acupuncture stimulation modulated expression of many biomarkers in favour of survival of dopaminergic neuron in brain. For example, scalp acupuncture increased release of neurotrophic factor; inhibited apoptotic cell death process, protected dopaminergic neurons against toxin insults. This led to the increased release of dopamine in the striatum, the important movement regulatory centre in the brain, leading to better functional recovery.

Although studies of body acupuncture also reported its neuroprotection in PD models it did not increase dopamine content in the striatum. It is conceivable that combination of scalp acupuncture and body acupuncture should increase neuroprotection and dopamine levels in the brain. This will improve the efficacy of acupuncture treatment in Parkinson’s disease.

Reference:

Wang S et al., Study on the mechanism of electroacupuncture scalp point penetration therapy in action on apoptosis in the Parkinson's disease rat model. Zhongguo Zhen Jiu. 2009 Apr;29(4):309-13.  http://www.ncbi.nlm.nih.gov/pubmed/19565741