Acupuncture Effective for Anxiety in Patients With Parkinson Disease

Acupuncture was associated with a significant reduction of anxiety among patients with Parkinson disease (PD), according to study findings published today in JAMA Network Open.

Despite being one of the most frequently reported nonmotor symptoms of PD, anxiety goes generally untreated among patients. Patients with PD who report anxiety show greater disability and poorer well-being than those without, noted researchers, and disturbances in gait and freezing of gait have been reported to be associated with these symptoms.

“Anxiety should be regarded as a substantial symptom of PD associated with movement disorders. However, there are a limited number of methods specifically developed to deal with anxiety in PD,” they added. “Considering shortcomings of existing therapies for anxiety in PD, the desire to explore effective alternative approaches with high feasibility and few adverse effects is growing in Western societies.”

With acupuncture having been recommended as a complementary and alternative therapy for neuropsychiatric symptoms of PD with level B evidence, researchers sought to further examine its utility for anxiety.

A randomized, double-blinded, clinical trial was conducted in the Parkinson clinic of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, China, to investigate the effect of acupuncture for anxiety in PD. Seventy eligible patients with idiopathic PD and anxiety were enrolled in the analysis between June 20, 2021, and February 26, 2022, and were randomized 1:1 to receive acupuncture or sham acupuncture for 8 weeks.

The primary outcome was Hamilton Anxiety Scale (HAM-A) score, with secondary outcomes including scores on the Unified Parkinson Disease Rating Scale (UPDRS), 39-item Parkinson Disease Questionnaire (PDQ-39), and serum levels of the adrenocorticotropic hormone (ACTH) and cortisol. Final follow-up was April 15, 2022.

Of the study cohort, 64 patients (91%) completed the intervention and the 8-week follow-up (mean [SD] age, 61.84 [8.47] years) included 30 women (46.9%) and 34 men (53.1%).

At the end of treatment, the variation of HAM-A score was 0.22 (95% CI, –0.63 to 1.07; P = .62) between the real acupuncture and sham acupuncture groups. After follow-up, the real acupuncture group exhibited a significant 7.03-point greater (95% CI, 6.18-7.88; P < .001) reduction in HAM-A score compared with the sham acupuncture group.

Regarding secondary outcomes, a significantly greater decrease in the UPDRS I score and PDQ-39 score was found in patients from the real acupuncture vs sham acupuncture groups (UPDRS I: 3.40; 95% CI, 2.36-4.45; P < .001; PDQ-39: 2.13; 95% CI, 1.15-3.10; P < .001). After the acupuncture period, the change of ACTH between the real acupuncture and sham acupuncture groups was statistically significant (2.16; 95% CI, 0.90-3.45; P < .001).

Four mild adverse reactions occurred during the study, and no serious adverse events were reported.

The study authors concluded that multicenter research should be considered to reduce influence of cultural differences, and economic benefits and patient acceptance should be considered in future studies to evaluate the application value of acupuncture.

“These findings suggest that acupuncture may improve overall motor functions and well-being of patients with PD by ameliorating the anxiety,” they wrote.

Reference

Fan JQ, Lu WJ, Tan WQ, et al. Effectiveness of acupuncture for anxiety among patients with Parkinson disease: a randomized clinical trial. JAMA Netw Open. Published online September 21, 2022. doi:10.1001/jamanetworkopen.2022.32133