Parkinson’s Motor, Bowel Functions Improve With Electroacupuncture

Patients in trial using EA saw relief from constipation symptoms

Lindsey Shapiro, PhD avatar

by Lindsey Shapiro, PhD |

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A 12-week electroacupuncture (EA) regimen in Parkinson’s disease patients along with standard medications was well tolerated and led to improved motor function and some relief from constipation, a recent study showed.

Patients also reported gains in quality of life compared with those only receiving standard of care medications.

“Our study suggested that compared with conventional treatment, electroacupuncture significantly enhances motor function and bowel movements in patients with PD [Parkinson’s disease],” the researchers wrote. The team noted, however, that the specific benefits of EA in Parkinson’s patients warrants further investigation.

The study, “Electroacupuncture for motor dysfunction and constipation in patients with Parkinson’s disease: a randomised controlled multi-centre trial,” was published in eClinicalMedicine. 

Parkinson’s disease is associated with a range of motor and nonmotor symptoms that can have a profound impact on a person’s quality of life.

While levodopa is the main treatment for motor symptoms, its effectiveness is lost over time even as associated side effects tend to increase. It has limited effects on nonmotor symptoms.

Constipation is common with Parkinson’s patients and difficult to treat. It can also disrupt the absorption of levodopa.

Some patients turn to complementary or alternative treatments to address these challenges. Acupuncture, which involves inserting very small needles through the skin at strategic points on the body, is a common alternative for Parkinson’s patients.

EA is “a modern extension of acupuncture,” according to the researchers. It involves stimulating the acupuncture needles with a low electrical current in order to augment its benefits.

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Testing EA therapy on motor, constipation symptoms

To better establish EA’s potential advantages, researchers in China conducted a randomized, controlled clinical trial at four hospitals from September 2018 to September 2019 that compared EA therapy combined with usual Parkinson’s pharmacological treatment on motor and constipation symptoms.

A total of 166 adult Parkinson’s patients, ages 40-80, were enrolled and randomly assigned to the EA group or to the usual care group (conventional pharmacological treatment only, a control group). The prevalence of constipation was 36.1% in the EA group and 34.9% in the control group.

All received standard Parkinson’s and constipation medications, if needed, and those in the EA group received 30-minute EA sessions three times a week for 12 weeks —  36 sessions total.

The study’s main goal was to assess changes in disease severity, as assessed by the total score on the Unified Parkinson’s Disease Rating Scale (UPDRS), over 12 weeks. A reduction in UPDRS scores reflects reduced disease severity.

Patients in the EA group had significantly more meaningful UPDRS score reductions than the control group after 12 weeks, meeting its main goal. Specifically, EA group members had a 5.3-point drop, while the control group had a 3.9-point increase.

These differences were observed as early as four and eight weeks, and were maintained into weeks 16 and 24. Results were similar with motor and activities of daily living sub-scales of the UPDRS.

While the performance in the 20-meter walk test, a measure of motor function, was similar between the two groups after 12 weeks, EA participants saw significantly greater motor improvements by weeks 16 and 24, with a greater decrease in the time to complete the test than the control group.

Constipation also improved with EA from weeks four to 24, with patients in that group having significantly more spontaneous bowel movements a week than the control group. The EA group’s patients also had greater reductions in measures of constipation severity and improvements in constipation-associated quality of life after 12 weeks.

Likewise, significantly greater improvements in overall health-related quality of life were observed in the EA group compared with the control group, as assessed by the 39-item Parkinson’s disease questionnaire.

The most common EA-associated side effects were skin discoloration and small pools of clotted blood under the skin (hematoma) at the needle site, abdominal pain, and dizziness, none of which were serious. No patients withdrew from the study due to side effects.

Taken together, “the findings of our study suggested that compared with conventional pharmacological treatment, conventional pharmacological treatment combined with electroacupuncture significantly enhances motor function and increased bowel movements in patients with PD,” the researchers said, calling electroacupuncture a “safe and effective treatment for PD.”

They emphasized that the long-term effects of the program aren’t known even though their findings largely support EA for Parkinson’s symptoms.

“In clinical practice, we usually use continuous acupuncture for efficacy consolidation, and providing a longer course of treatment may improve long-term efficacy,” the researchers wrote. “Still, this hypothesis needs to be tested by further clinical studies.”