Efficacy and safety of acupuncture therapy for neuropsychiatric symptoms among patients with Parkinson's disease: A systematic review and meta-analysis.

OBJECTIVE: To systematically evaluate the efficacy and safety of acupuncture therapy for neuropsychiatric symptoms in patients with Parkinson's disease. METHODS: We searched eight databases from their inception until 14 April 2024, including PubMed, Cochrane Library, Embase, Web of Science, SinoMed, China National Knowledge Infrastructure, China Science and Technology Periodical Database, and Wanfang Database. The search aimed to find randomized controlled trials assessing the effectiveness of acupuncture for neuropsychiatric symptoms in patients with Parkinson's disease. Literature screening and data extraction were performed independently by the authors. Meta-analysis was conducted using RevMan V.5.3 software, and Stata 17.0 software was used for detecting publication bias and performing sensitivity analysis. RESULTS: Twenty-eight studies, involving 2148 participants, met the inclusion criteria. The meta-analysis revealed that acupuncture therapy improved depression-related scale scores (standardized mean difference (SMD) = -0.70, 95%CI [-0.98, -0.42], p < 0.00001), anxiety-related scale scores (SMD = -0.78, 95% CI [-1.43, -0.14], p = 0.02), Montreal Cognitive Assessment scores (weighted mean difference (WMD) = 2.74, 95% CI [2.43, 3.05], p < 0.00001), Mini Mental State Examination scores (WMD = 2.36, 95% CI [0.78, 3.94], p = 0.003), Yale-Brown Obsessive Compulsive Scale scores, and Parkinson's Disease Questionnaire-39 scores (WMD = -2.66, 95% CI [-4.83, -0.49], p = 0.02) compared to controls. CONCLUSION: This review supports the application of acupuncture to reduce the severity of neuropsychiatric symptoms including depression, anxiety, and impulse control disorders, and to improve cognition and quality of life in patients with Parkinson's disease. The adverse effects associated with acupuncture, either alone or as adjunctive therapy, were relatively minor.

Efficacy and safety of acupuncture therapy for Parkinson's disease with neuropsychiatric symptoms: protocol for a systematic review and meta-analysis.

INTRODUCTION: Neuropsychiatric symptoms (NPS) are common non-motor symptoms among patients with Parkinson's disease (PD) and significantly impact their overall quality of life detrimentally. Several studies have reported the clinical effect of acupuncture therapy in treating NPS in PD. Therefore, the objective of this systematic review is to evaluate the potential inclusion of acupuncture therapy as an integral component of complementary treatment for PD with NPS. METHODS AND ANALYSIS: From their inception until 1 December 2023, we will search eight databases, including PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, China Science Periodical Database, Chinese Citation Database and China Biology Medicine disc for randomised controlled trials examining the effectiveness of acupuncture for PD with NPS. Literature screening and data extraction will be carried out independently by the authors. RevMan V.5.3 software will be used for meta-analysis, while the Cochrane risk-of-bias tool will assess the potential for bias. ETHICS AND DISSEMINATION: This systematic review protocol does not require ethical approval because it does not include private information or data of participants. This article will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42022324494.

The effect of epigenetic aging on neurodegenerative diseases: a Mendelian randomization study.

Background: Aging has always been considered as a risk factor for neurodegenerative diseases, but there are individual differences and its mechanism is not yet clear. Epigenetics may unveil the relationship between aging and neurodegenerative diseases. Methods: Our study employed a bidirectional two-sample Mendelian randomization (MR) design to assess the potential causal association between epigenetic aging and neurodegenerative diseases. We utilized publicly available summary datasets from several genome-wide association studies (GWAS). Our investigation focused on multiple measures of epigenetic age as potential exposures and outcomes, while the occurrence of neurodegenerative diseases served as potential exposures and outcomes. Sensitivity analyses confirmed the accuracy of the results. Results: The results show a significant decrease in risk of Parkinson's disease with GrimAge (OR = 0.8862, 95% CI 0.7914-0.9924, p = 0.03638). Additionally, we identified that HannumAge was linked to an increased risk of Multiple Sclerosis (OR = 1.0707, 95% CI 1.0056-1.1401, p = 0.03295). Furthermore, we also found that estimated plasminogen activator inhibitor-1(PAI-1) levels demonstrated an increased risk for Alzheimer's disease (OR = 1.0001, 95% CI 1.0000-1.0002, p = 0.04425). Beyond that, we did not observe any causal associations between epigenetic age and neurodegenerative diseases risk. Conclusion: The findings firstly provide evidence for causal association of epigenetic aging and neurodegenerative diseases. Exploring neurodegenerative diseases from an epigenetic perspective may contribute to diagnosis, prognosis, and treatment of neurodegenerative diseases.

Decreasing mitochondrial fission ameliorates HIF-1α-dependent pathological retinal angiogenesis.

Angiogenesis plays a critical role in many pathological processes, including irreversible blindness in eye diseases such as retinopathy of prematurity. Endothelial mitochondria are dynamic organelles that undergo constant fusion and fission and are critical signalling hubs that modulate angiogenesis by coordinating reactive oxygen species (ROS) production and calcium signalling and metabolism. In this study, we investigated the role of mitochondrial dynamics in pathological retinal angiogenesis. We showed that treatment with vascular endothelial growth factor (VEGF; 20 ng/ml) induced mitochondrial fission in HUVECs by promoting the phosphorylation of dynamin-related protein 1 (DRP1). DRP1 knockdown or pretreatment with the DRP1 inhibitor Mdivi-1 (5 µM) blocked VEGF-induced cell migration, proliferation, and tube formation in HUVECs. We demonstrated that VEGF treatment increased mitochondrial ROS production in HUVECs, which was necessary for HIF-1α-dependent glycolysis, as well as proliferation, migration, and tube formation, and the inhibition of mitochondrial fission prevented VEGF-induced mitochondrial ROS production. In an oxygen-induced retinopathy (OIR) mouse model, we found that active DRP1 was highly expressed in endothelial cells in neovascular tufts. The administration of Mdivi-1 (10 mg·kg-1·d-1, i.p.) for three days from postnatal day (P) 13 until P15 significantly alleviated pathological angiogenesis in the retina. Our results suggest that targeting mitochondrial fission may be a therapeutic strategy for proliferative retinopathies and other diseases that are dependent on pathological angiogenesis.

Decoding the Key Functional Combined Components Group and Uncovering the Molecular Mechanism of Longdan Xiegan Decoction in Treating Uveitis.

Objective: Longdan Xiegan Decoction (LXD) is a famous herbal formula in China. It has been proved that LXD has been shown to have a significant inhibitory effect on suppresses the inflammatory cells associated with uveitis. However, the key functional combination of component groups and their possible mechanisms remain unclear. Methods: The community detecting model of the network, the functional response space, and reverse prediction model were utilized to decode the key components group (KCG) and possible mechanism of LXD in treating uveitis. Finally, MTT assay, NO assay and ELISA assay were applied to verify the effectiveness of KCG and the accuracy of our strategy. Results: In the components-targets-pathogenic genes-disease (CTP) network, a combination of Huffman coding and random walk algorithm was used and eight foundational acting communities (FACs) were discovered with important functional significance. Verification has shown that FACs can represent the corresponding C-T network for treating uveitis. A novel node importance calculation method was designed to construct the functional response space and pick out 349 effective proteins. A total of 54 components were screened and defined as KCG. The pathway enrichment results showed that KCG and their targets enriched signal pathways of IL-17, Toll-like receptor, and T cell receptor played an important role in the pathogenesis of uveitis. Furthermore, experimental verification results showed that important KCG quercetin and sitosterol markedly inhibited the production of nitric oxide and significantly regulated the level of TNF-α and IFN-γ in Lipopolysaccharide-induced RAW264.7 cells. Discussion: In this research, we decoded the potential mechanism of the multi-components-genes-pathways of LXD's pharmacological action mode against uveitis based on an integrated pharmacology approach. The results provided a new perspective for the future studies of the anti-uveitis mechanism of traditional Chinese medicine.

Acupuncture Treatment of Guillain-Barré Syndrome After Using Immune Checkpoint Inhibitors: A Case Report.

Guillain-Barré syndrome(GBS) is an autoimmune-mediated peripheral neuropathy. Immune checkpoint inhibitors (ICIs) are the standard treatment for cancer and may lead to immune-related adverse events (irAEs) such as GBS. Corticosteroids, plasma exchange (PE), and intravenous immunoglobulin (IVIG) are currently accepted treatments for ICI-induced GBS. However, there are still adverse reactions, and the effect of relieving symptoms is not as good as expected. Safe and effective complementary replacement therapy to alleviate GBS symptoms and ameliorate the quality of life is urgently required. In this case, a 63-year-old man received ICI therapy and antitumor chemotherapy for lung malignancy. After two courses of treatment, the patient gradually developed limb weakness, numbness, and pain at the ends of the limbs, with cerebrospinal fluid (CSF) albuminocytological dissociation, and electromyography (EMG) suggested demyelinating changes and was diagnosed as GBS. Although the patient received high doses of intravenous gamma globulin and limb weakness symptoms were alleviated, there was still significant numbness and pain in the extremities. After four times of acupuncture treatments, the patient complained that the symptoms of limb numbness and fatigue were significantly alleviated without any discomfort. This case report may provide a new alternative and complementary therapy for immune checkpoint inhibitor-induced GBS, but more definitive and robust evidence is needed to support its efficacy.

Efficacy of manual acupuncture versus placebo acupuncture for generalized anxiety disorder (GAD) in perimenopause women: study protocol for a randomized controlled trial.

BACKGROUND: Generalized anxiety disorder (GAD) is common among perimenopausal women. Acupuncture may be an effective treatment for GAD, but evidence is limited. The pathogenesis of GAD is not yet clear, but it is related to the hypothalamic-pituitary-adrenal axis and its excretion, cortisol (CORT), and adrenocorticotropic hormone (ACTH). The object of this study is to evaluate the efficacy of manual acupuncture (MA) versus placebo acupuncture (PA) for perimenopausal women with GAD. METHODS: This study is a single-center, randomized, single-blind clinical trial that will be conducted in the First Affiliated Hospital of Guangzhou University of Chinese Medicine. A total of 112 eligible GAD patients will be randomly assigned (1:1) to receive MA (n=56) or PA (n=56) three times per week for 4 weeks. The primary outcome measure will be the HAMA score. The secondary outcome measures will be the GAD-7 and PSQI scores and the levels of CORT and ACTH. The evaluation will be executed at baseline, 2 weeks, the end of the treatment, and a follow-up 3-month period. All main analyses will be carried out based on the intention-to-treat (ITT) principle. DISCUSSION: This study intends to compare the efficacy between MA and PA in the treatment of perimenopausal women with GAD and to further study the mechanisms underlying the effect. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2100046604 . Registered on 22 May 2021.

Association between fasting blood glucose and intracranial cerebral artery stenosis: a secondary analysis based on a retrospective cross-sectional study in Korean adults.

AIMS: Diabetes mellitus (DM) is one of the main risk factors for intracranial cerebral artery stenosis (ICAS), and fasting blood glucose (FBG) might be an effective predictor of ICAS. However, there are a few studies revealing the relationship between FBG and ICAS. We aim to identify the association between FBG and ICAS in Koreans. METHODS: This was a secondary study based on a cross-sectional study. A total of 1011 Korean individuals who were asymptomatic but with high cerebrovascular risk underwent an examination in a Korean medical centre from March 2008 to December 2014. The main measure was FBG, while the main outcome was ICAS. Multivariate logistic regression analyses of FBG in the presence of ICAS were performed to examine the potential association. The author used the data provided by the paper "Association between Serum Alkaline Phosphatase Level and Cerebral Small Vessel Disease" for secondary analysis. RESULTS: The average age of the participants was 64.2 ± 9.1 years old, and approximately 35% of them were males. There were 24 participants suffering from ICAS in the first FBG tertile (< 5.4 mmol/L), while there were 26 in the second tertile (5.4-7.1 mmol/L) and 50 in the third tertile (≥ 7.1 mmol/L). The non-adjusted relationship between FBG and ICAS was positive. After controlling potential confounders, the association of FPG with ICAS remained positive, as well as in subgroups analysis, such as age, sex, hypertension, diabetes mellitus, hyperlipidaemia and COAD. The association remained unchanged after adjusted sex, age, hypertension, DM, uric acid, hyperlipidaemia, and CAOD (OR = 1.08, 95% CI = 1.02-1.15). The analyses also showed that the positive association was statistically significant (P < 0.05) among individuals without diabetes. CONCLUSIONS: This study showed a positive relationship between FBG and ICAS, which suggests that clinicians may need to be simultaneously concerned about FBG and ICAS.

Sanfu herbal patch applied at acupoints in patients with bronchial asthma: study protocol for a randomized controlled trial.

BACKGROUND: Bronchial asthma is one of the most common inflammatory airway disorders. As one of the main non-drug therapies, the Sanfu herbal patch (SHP) has been widely used to treat bronchial asthma, although the evidence for its efficacy and associated mechanism are inconclusive. The objective of this trial is to clarify the clinical efficacy and safety of the SHP in the treatment of bronchial asthma in the chronic persistent or clinical remission stage and to provide high-quality data for further research. METHODS: We propose a multicentre, double-blinded, parallel, randomized, placebo-controlled clinical trial involving 4 study hospitals in China. A total of 72 eligible participants will be randomized into an SHP group and a placebo group. They will receive an SHP for 3 treatment sessions. The primary outcome will be changes in forced expiratory volume in 1 s after 3 treatment sessions. Secondary outcomes will include the following: (1) the Asthma Quality of Life Questionnaire, Asthma Control Test, and Asthma Long-term Follow-up Scale; (2) levels of Metallothionein-2 and Transgelin-2 in blood and urine; and (3) levels of IL-5, IL-13, IL-23, IL-25, and thymic stromal lymphopoietin in blood. Analysis of the data will be performed at baseline, at the end of the 2nd and 3rd treatment sessions, and at the 24-week follow-up. The safety of the SHP will be evaluated at each treatment session. DISCUSSION: The aims of this trial are to determine whether the SHP is more effective than placebo in the treatment of patients with bronchial asthma, as well as whether the SHP works by reducing airway inflammation and reversing bronchoconstriction. TRIAL REGISTRATION: Chinese Clinical Trial Registry ( http://www.chictr.org.cn ), ChiCTR1900024616. Registered on 19 July 2019.

[ZHUANG Li-xing's experience of using mind-regulation acupuncture for postherpetic neuralgia].

Professor ZHUANG Li-xing's clinical experience of using mind-regulation acupuncture for postherpetic neuralgia is summarized. Professor ZHUANG believes that the physical pain symptoms in patients could cause negative emotions, which often lead to a series of mental symptoms, which in turn aggravate or induce pain. Therefore, the treatment for this disease should start with mind regulation, with Baihui (GV 20) through Sishenzhen, Shenmen (HT 7), Neiguan (PC 6), Shenmai (BL 62), Zhaohai (KI 6), Siguan (Hegu (LI 4) and Taichong (LR 3)), Sanyinjiao (SP 6), Shuigou (GV 26) and Suliao (GV 25) as main acupoints to regulate mind and relieve pain, in combination of local analgesia and ear acupuncture, which has obtained satisfied curative effect.

Effect of acupuncture at 3 anti-fatigue acupoints in the treatment of cancer-related fatigue in patients with cancer: Protocol for a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Cancer-related fatigue (CRF), is a common distressing symptom of cancer. What's more, "Three anti-fatigue acupoints" is one of the most important components of "Jin's 3-needle therapy" created by Rui Jin, a professor of Guangzhou University of Chinese Medicine, which can be used in the treatment of CRF. In this article, researchers will assess the safety and effect of acupuncture at 3 anti-fatigue acupoints on CRF in patients with cancer. METHODS: Literature search for relevant articles up to October 2018 will be carried out in 9 databases: Cochrane Library, Embase, PubMed, VIP, CBM, CNKI, Wanfang Database, CiNii, and OASIS. The included literatures will be randomized controlled trials of acupuncture at 3 anti-fatigue acupoints on CRF in patients with cancer. The certain common scales, which reflect the patients' fatigue degree or life quality will be the primary outcome measures. The secondary outcome measures will be defined with the blood index. After collecting the data, we will utilize Stata V.13.0. to perform data synthesis, subgroup analysis, partial sequence analysis, sensitivity analysis, and so on. A funnel plot will be used to assess reporting biases. And the funnel plot will be evaluated by the Egger and Begg tests. The quality of evidence will be judged by the grading of recommendations assessment, development, and evaluation. RESULTS: The results of this systematic review and meta-analysis will be published in a peer-reviewed journal. CONCLUSION: Our study will provide the evidence for the clinical efficacy and safety of acupuncture at 3 anti-fatigue acupoints in the treatment of CRF.

Impact evaluation of CONSORT and STRICTA guidelines on reporting quality for randomized controlled trials of acupuncture conducted in China.

OBJECTIVE: To evaluate and compare the reports' qualities of acupuncture randomized controlled trials (RCTs) conducted in China before and after the implementation of two guidelines, i.e., the Consolidated Standards of Reporting Trials (CONSORT) statement and the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA). METHODS: Proportions of studies that reported CONSORT and STRICTA items were compared for the years before and after implementation of these two guidelines. In addition, the total score of each item's reporting were calculated and reported differences during different date ranges were compared. RESULTS: For CONSORT items (maximum score 8), there was evidence of a slight improvement in reporting between 1994-1995 and 1999-2000 combined (2.5±0.6) and 2004-2005 and 2009-2010 combined (3.0±0.9; difference 0.4, 95% confidence interval, 0.3 to 0.6, P<0.01). For STRICTA items (maximum score 17), there was evidence that a slight improvement in reporting between 1994-1995 and 1999-2000 combined (8.6±2.1) and 2004-2005 and 2009-2010 combined (10.1±1.8; difference 1.5, 95% confidence interval, 1.1 to 1.9, P<0.01). CONCLUSION: Quality of reporting for RCTs of acupuncture treatment conducted in China have generally improved since the introduction of the STRICTA and CONSORT guidelines.

[Vascular cognitive impairment with no dementia treated with auricular acupuncture and acupuncture:a randomized controlled trial].

OBJECTIVE: To compare the clinical efficacy on vascular cognitive impairment with no dementia (VCIND) between the combined therapy of auricular acupuncture and acupuncture and the simple acupuncture. METHODS: One hundred patients of VCIND were randomized into a combined therapy of auricular acupuncture and acupuncture group (a combined therapy group) and an acupuncture group, 50 cases in each one. The basic internal medicine treatment was applied in the two groups. Additionally, in the combined therapy group, auricular acupuncture and JIN's three needling therapy were used. pizhixia (AT4), xin (CO15), shen (CO10), gan (CO12), erzhong (HX1) were selected in auricular acupuncture, once every Monday, Wednesday and Friday; Niesanzhen, Zhisanzhen and Sishenzhen were selected in JIN's three needling therapy, once a day. In the acupuncture group, JIN's three needling therapy was just provided, once a day. The treatment was given for 4 weeks in the two groups. Montreal cognitive assessment (MoCA) and social function activities questionnaire (FAQ) were adopted for the evaluation comparison before treatment and in 2 weeks and 4 weeks after treatment in patients of the two groups. RESULTS: Compared with those before treatment, the total scores of MoCA were improved in 2 and 4 weeks after treatment in the two groups (all P<0.01). The score in the combined therapy group was improved more apparently as compared with that in the acupuncture group (P<0.01). FAQ score was reduced in the two groups (all P<0.05). The score in the combined therapy group was reduced more apparently as compared with that in the acupuncture group (P<0.05). As compared with the result in 2 weeks of treatment, MoCA score was improved in the two groups in 4 weeks of treatment (both P<0.01), the improvements in the combined therapygroup were more obvious than those in the acupuncture group (P<0.05) and FAQ score was reduced in the two groups (P<0.05), but the difference was not significant between the two groups (P>0.05). CONCLUSIONS: The combined therapy of auricular acupuncture and acupuncture effectively improve the cognitive function and social function, which are better than the effects of simple acupuncture in VCIND. The improvement of the combined therapy in social function is more advantageous in the treatment of the first two weeks.

[Post-stroke shoulder-hand syndrome treated with floating-needle therapy combined with rehabilitation training: a randomized controlled trial].

OBJECTIVE: To compare the clinical efficacy in the treatment of post-stroke shoulder-hand syndrome between floating-needle therapy and conventional acupuncture on the basis of rehabilitation training. METHODS: One hundred cases of post-stroke shoulder-hand syndrome were randomized into a floating-needle group and an acupuncture group, 50 cases in each one. The passive and positive rehabilitation training was adopted in the two groups. Additionally, in the floating-needle group, the floating-needle therapy was used. The needle was inserted at the site 5 to 10 cm away from myofasical trigger point (MTrP), manipulated and scattered subcutaneously, for 2 min continuously. In the acupuncture group, the conventional acupuncture was applied at Jianqian (EX-UE), Jianyu (LI 15), Jianliao (TE 14), etc. The treatment was given once every two days, 3 times a week, and 14 days of treatment were required. The shoulder hand syndrome scale (SHSS), the short form McGill pain scale (SF-MPQ) and the modified Fugl-Meyer motor function scale (FMA) were used to evaluate the damage severity, pain and motor function of the upper limbs before and after treatment in the two groups. The clinical efficacy was compared between the two groups. RESULTS: SHSS score, SF-MPQ score and FMA score were improved significantly after treatment in the two groups (all P < 0.01), and the improvements in the floating-needle group were superior to those in the acupuncture group (all P < 0.05). The total effective rate was 94.0% (47/50) in the floating-needle group, which was better than 90.0% (45/50) in the acupuncture group (P < 0.05). CONCLUSION: The floating-needle therapy combined with rehabilitation training achieves a satisfactory efficacy on post-stroke shoulder-hand syndrome, which is better than the combined therapy of conventional acupuncture and rehabilitation training.

Quality of reporting and its correlates among randomized controlled trials on acupuncture for cancer pain: application of the CONSORT 2010 Statement and STRICTA.

This study aims to analyze the quality of reporting and its correlates in randomized controlled trials (RCTs) on acupuncture for cancer pain. Quality of reporting for included papers was assessed against a subset of criteria adapted from the CONSORT 2010 statement and STRICTA. An overall quality score (OQS) and a combined key methodologic index score (MIS) was calculated for each trial. Factors associated with OQS and MIS were then identified. A total of 32 RCTs were included in the full text. The median OQS based on the CONSORT Statement and STRICTA was 4.0 and 0, respectively. The significant predictors for CONSORT OQS were year of publication and nationality of authors, for STRICTA it was nationality of authors and for MIS it was publication language. The quality of reporting in RCTs on acupuncture for cancer pain was poor. This indicates that RCTs on acupuncture for cancer pain need substantial improvement.