Objective: To investigate the effect of acupuncture versus sham acupuncture for PDA.

Background: Anxiety in PD (PDA) is identified by continuous feeling of worry, muscle tension, and increased severity of tremors.¹  Disturbances in gait and freezing of gait have been reported to be associated with anxiety symptoms.Acupuncture has been recommended as a complementary therapy for neuropsychiatric symptoms of PD with level B evidence.

Method: This randomized double-blind trial enrolled with PDA patients, allocating them 1:1 to intervention (real acupuncture, RA) or control (sham acupuncture, SA) groups.

Eligible patients from the First Affiliated Hospital met: 1) idiopathic PD diagnosis; 2) Hoehn-Yahr stages 1-4; 3) Hamilton Anxiety Scale scores 14-29; 4) age 35-80 years; and 5) provided consent. Exclusion criteria included cognitive impairment (MoCA<23), levodopa unresponsiveness, substance abuse, recent acupuncture or anti-anxiety medication use (within 30 days), major organ dysfunction, or acupuncture intolerance.Randomization and Blinding Double-blinding was achieved using a patented sham needle device capable of angled penetration, ensuring identical appearance between real and sham needles. Patients wore eye masks during treatment. Both groups received 30-minute sessions, three times weekly for 8 weeks at identical acupoints: GV24, GV29, bilateral HT7, bilateral SP6.Trial Registration:ChiCTR2100047253.

Results: 70 eligible patients were enrolled, including 34 women(48.5%) and 36 men(51.4%). 64 patients (91%) completed the intervention and the two-month follow-up,including 30 women(46.9%) and 34 men(53.1%) with a mean (SD) age of 61.84(8.47) years. At the end of treatment, the variation of HAM-A score was 0.22 (95% CI, -0.63 to 1.07; P =0.62) between the RA and SA groups. At the end of follow-up,  RA group had significantly reduction in HAM-A score of 7.03 compared with SA group(95% CI, 6.18 to 7.88; P<0.001).After the acupuncture period,the change of ACTH between the RA and SA groups was statistically significant.(2.16[95% CI,0.90 to3.45],P<0.001).

Conclusion: Acupuncture is an effective treatment for PDA and can enhance the well-being of participants with PD. Mechanism of acupuncture may be related to the inhibition of HPA axis hyperactivity.

Table 1 Baseline demographic

Table 2 Comparison of the treatment effects

Table 3 Comparison of the treatment effects

Fig. 2. Therapeutic effects of acupuncture.

Fig 1. CONSORT flowchart.

References: 1. Dissanayaka NN,et al. Anxiety disorders in Parkinson’s disease: prevalence and risk factors. Mov Disord. 2010;25(7):838-845.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-study-on-acupuncture-improving-anxiety-in-parkinsons-disease-by-regulating-the-hpa-axis/