Today is World Parkinson's Day. This week is Parkinson’s disease awareness week of UK. Parkinson’s disease (PD) is the second most common age-related neurodegenerative disorder after Alzheimer’s disease. An estimated seven to 10 million people worldwide have PD. There are an estimated 127,000 people in the UK living with PD.
There's currently no cure for Parkinson's
disease. Physiotherapy
can relieve muscle stiffness and joint pain through manipulation and exercise. Language
therapy can help to improve speaking. Levodopa usually used to improves
movement problems, but it often causes a lot of side effects. Long-term use of
levodopa is also linked to problems such as uncontrollable, jerky muscle
movements (dyskinesias) and "on-off" effects, where the person
rapidly switches between being able to move (on) and being immobile (off).
Acupuncture is widely used to treat PD in many countries.
Many clinical trials and laboratory research reports were published in the past
two decades. These reports showed us two facts:
1. Acupuncture is effective in PD treatment:
Shulman LM [1] used
acupuncture to treat 20 cases of PD. On the patient questionnaire, 85% of patients
reported subjective improvement of individual symptoms including tremor,
walking, handwriting, slowness, pain, sleep, depression, and anxiety; Ren XM [2] used acupuncture combined with madopar to treat 50 cases
of PD. A total effective rate of 92% was achieved with obvious alleviation of
motor disorder in the treatment group, which was significantly higher than that
in the madopar control group. The result indicates acupuncture can
enhance therapeutic effects of western medicine and lessen the dose of the
medicine needed; Arankalle DV[3] used electro-acupuncture to treat a case of
PD. Assessments were based on the Berg Balance Scale (BBS) and Parkinson's
Disease Questionnaire-39 items. The patient improvement on the BBS, his quality of life
showed improvement particularly on the 'activities of daily living',
'cognition' and 'communication' dimensions; Iseki C [4] reported
acupuncture can alleviate the nonmotor
symptoms of PD including pain, depression, and autonomic Symptoms; Fukuda S [5] reported
acupuncture have an immediately effects on tongue pressure including swallowing
reflex latency in PD; Lee SH [6] reviewed
25 randomized controlled trials (RCTs) on the topic of acupuncture treat PD.
The results showed acupuncture was effective
in relieving PD symptoms compared with no treatment and conventional treatment
alone, and acupuncture plus conventional
treatment had a more significant effect than conventional treatment alone; Yeo S [7] used electro-acupuncture to treat 10 patients in the hospital.
The acupoints GB34 and LR3 were selected. After 8 weeks treatment the
Unified Parkinson's Disease Rating Scale
(UPDRS) sub-scores and the depression scores for the patients had statistically
decreased compared to the scores before acupuncture treatment;
moreover, 8 weeks later, these scores remained stable. A positive correlation
was found between the UPDRS and the mean magnetic resonance signal change for
the thalamus.
2. These effects were supported by many scientific research
reports:
Wang L [8]
reported 29 PD patients were under the auditory evoked brain stem potential
(ABP) examination, the latent period of V wave and the intermittent periods of
III-V peak and I-V peak were significantly shortened after acupuncture
treatment. The difference of cumulative scores in Webster's scale was also
decreased in correlation analysis; My ex colleague Huang Y[9] used positron emission tomography (PET) and
the 18-flourodeoxyglucose tracer to study cerebral effects of acupuncture in PD. Five patients received scalp-acupuncture and Madopa, while the other five had
Madopa only. PET scans before and after acupuncture show
increased glucose metabolisms in parietal, temporal, occipital lobes, the
thalamus, and the cerebellum in the light-diseased hemisphere, and in parietal
and occipital lobes of the severe-diseased hemisphere. No changes were observed
in the Madopa-only group. This indicated acupuncture in
combination with Madopa may improve cerebral glucose metabolism in PD; in the other report [10] she used single
photon emission computed tomography (SPECT) measures of 99mT-ECD and
99mTc-TRODAT-4, before and after scalp acupuncture treatment. Patients who
received levodopa and complementary acupuncture had
increased regional cerebral blood flow (rCBF) in the frontal lobe, the
occipital lobe, the basal ganglion; Yang JL[11] investigated the
role of acupuncture in
neurotoxin-induced PD mice. The mice were evaluated for behavioral
changes, in terms of time of landing, after acupuncture treatment. The animals
were sacrificed and their brains assayed for dopamine and its metabolites and
tyrosine hydroxylase (TH) expression by using HPLC and immunohistochemistry/Western
blotting. The results showed that the time of landing of the three groups with
treatment was significant longer than normal group. Nonetheless, the
acupuncture group had a shorter time of landing than sham acupuncture group.
The number of TH (+) neurons and the expression of TH proteins were
significantly higher in the acupuncture group than in the sham acupuncture group.
These results conclude that acupuncture possibly attenuates neuronal damage in
MPTP-induced PD mice, which suggests acupuncture may be useful as a
complementary strategy when treating human PD; Yeo S[12] investigated the
reported association between acupuncture point
GB34 and PD. They use fMRI methods examined the neural responses of 12 patients
with PD and 12 healthy participants before and after acupuncture stimulation. The results showed acupuncture stimulation increased neural responses
in regions including the substantia nigra, caudate, thalamus, and putamen,
which are impaired caused by PD; Wang S[13]
investigated
the effect of electro-acupuncture at Fengfu (GV16) and Taichong (LR3) acupoints
in rat models of PD. Reverse transcription-PCR demonstrated that
brain-derived neurotrophic factor and glial cell line-derived neurotrophic
factor mRNA expression was significantly increased in the substantia nigra of
rat models of PD, and that abnormal behavior of rats was significantly
improved following electro-acupuncture treatment. These results indicated that
electro-acupuncture treatment up-regulated brain-derived neurotrophic factor
and glial cell line-derived neurotrophic factor mRNA expression in the
substantia nigra of rat models of PD; Wattanathorn J[14] aimed to determine
the effect of laser acupuncture at HT7
on memory impairment, oxidative stress status, and the functions of both
cholinergic and dopaminergic systems in hippocampus of animal model of PD. The
results showed that laser acupuncture at
HT7 enhanced memory and neuron density in CA3 and dentate gyrus. The decreased
AChE, MAO-B, and MDA together with increased GSH-Px in hippocampus of a 6-OHDA
lesion rats were also observed; Park JY[15] reported that p53
signalling mediates the protective effects of acupuncture treatment
in a mouse model of PD. They found that the acupuncture treatment
in the mouse PD model results in significant recovery to the normal in the
context of behaviour and molecular signatures. The gene network associated with
p53 signalling is closely involved in the protective effects of acupuncture treatment in PD. These data suggest
that p53 signalling mediates the protective effects of acupuncture treatment in PD.
Traditional Chinese medicine believes PD is mostly due to
liver & kidney yin deficiency this lead to liver yang excess. In some conditions
it might combined with blood stasis and/or phlegm heat. Bases on these TCM philosophy
acupuncturists select different acupoints in different conditions. Body
acupuncture, scalp acupuncture and electro- acupuncture can be selected. If
Chinese herbal medicine were added it will obtained a better treatment effect.
World Parkinson’s Day, be aware of PD !
Reference:
- Shulman LM. Acupuncture therapy for the symptoms of Parkinson's disease. Mov Disord. 2002; 17(4):799-802.
- Ren
XM.
Fifty cases of Parkinson's disease treated
by acupuncture combined with madopar. J
Tradit Chin Med. 2008;
28(4):255-7.
- Arankalle DV.
Effect of electroacupuncture on function and quality of life in Parkinson's disease: a case report. Acupunct Med. 2013;
31(2):235-8.
- Iseki
C. Acupuncture Alleviated the Nonmotor Symptoms
of Parkinson's Disease including Pain,
Depression, and Autonomic Symptoms. Case Rep Neurol Med. 2014;2014:953109.
- Fukuda S.
Immediate effects of acupuncture on
tongue pressure including swallowing reflex latency in Parkinson's disease. Acupunct Med. 2016;
34(1):59-61.
- Lee
SH. Clinical
effectiveness of acupuncture on Parkinson disease: A PRISMA-compliant systematic review
and meta-analysis. Medicine (Baltimore). 2017; 96(3):e5836.
- Yeo S.
A study of the effects of 8-week acupuncture treatment
on patients with Parkinson's disease. Medicine (Baltimore). 2018; 97 (50):e13434.
- Wang L.
Effect of acupuncture on the auditory
evoked brain stem potential in Parkinson's disease.
J Tradit Chin Med. 2002
- Huang
Y.
Complementary acupuncture treatment
increases cerebral metabolism in patients with Parkinson's
disease. Int J Neurosci. 2009;
119(8):1190-7.
- Huang
Y. Complementary acupuncture in Parkinson's disease: a spect study. Int J Neurosci. 2010;
120(2):150-4.
- Yang
JL. Neuroprotection
effects of retained acupuncture in
neurotoxin-induced Parkinson's disease mice.
Brain Behav Immun. 2011; 25(7):1452-9.
- Yeo
S. Acupuncture stimulation on GB34 activates neural
responses associated with Parkinson's disease.
CNS Neurosci Ther. 2012;
18(9):781-90.
- Wang
S. Electroacupuncture-regulated
neurotrophic factor mRNA expression in the substantia nigra of Parkinson's disease rats. Neural Regen Res. 2013; 25; 8(6):540-9.
- Wattanathorn
J. Laser Acupuncture at HT7 Acupoint Improves Cognitive
Deficit, Neuronal Loss, Oxidative Stress, and Functions of Cholinergic and Dopaminergic
Systems in Animal Model of Parkinson's Disease.
Evid
Based Complement Alternat Med. 2014:937601. doi: 10.1155/2014/937601.
- Park
JY. p53
signalling mediates acupuncture-induced
neuroprotection in Parkinson's disease. Biochem
Biophys Res Commun. 2015;
460(3):772-9.
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