Efficacy of Acupuncture Therapy in Treating Non-Motor Symptoms of Parkinson’s Disease: A Systematic Review and Network Meta-Analysis

Xiaoyan Li, Peng Chen, Shaosong Wang, Chunchen Wang, Bin Li, Huilin Liu Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, People’s Republic of ChinaCorrespondence: Huilin Liu, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, No. 23, Behind Art Museum Street, Dongcheng District, Beijing, People’s Republic of China, Tel +86 13681395789, Email [email protected]: Recently, research on the management of Parkinson’s disease (PD), particularly non-motor symptoms (NMS), has been increasingly reported. This systematic review and network meta-analysis (NMA) aimed to evaluate the efficacy of acupuncture interventions for NMS in PD patients to identify the most effective strategy.Methods: Randomized controlled trials (RCTs) on acupuncture for NMS in PD were retrieved up to July 31, 2024, across eight databases: PubMed, Embase (OVID), Cochrane Library, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, VIP Database, and Wanfang Database. The quality of the included studies was assessed using the Cochrane handbook for systematic reviews.Results: 77 RCTs were included, involving 5538 PD patients. The NMA indicated that acupuncture_training_usual ([SUCRA] = 84.18%) was the best intervention for improving the anxiety state of PD patients. Abdominal_acupuncture_usual (94.15%) was a preferred intervention for improving the depressive state. Scalp_acupuncture_usual (99.98%) and Scalp_electroacupuncture (94.28%) can significantly improve the sleep quality of PD patients. Heat_sensitive_moxibustion_usual (94.65%) and Warm_acupuncture_moxibustion_usual (99.995%) can significantly improve the quality of life of PD patients. Acupuncture_usual (94.02%) may be considered a promising intervention for improving the psychological, emotional and cognitive functions. Additionally, shallow_acupuncture_usual (99.17%) was the safest option. Notably, acupuncture_moxibustion (98.24%) was the most effective intervention involving the largest number of participants.Conclusion: This analysis identifies the most effective acupuncture interventions for improving NMS in PD patients, including anxiety, depression, sleep quality, and overall quality of life, as well as additional benefits in pain management and gastrointestinal function. Future large-scale RCTs are needed to confirm these findings.Keywords: Parkinson’s disease, non-motor symptoms, acupuncture, network meta-analysis, systematic review