Abstract
Non-motor symptoms of Parkinson's disease (PD) have been receiving increasing attention. Approximately half of patients with PD have experience PD-related pain. We investigated the effect and mechanism of acupuncture in patients with PD who have pain. PD patients with pain were divided into acupuncture group and control group. Nine patients completed acupuncture treatment; seven patients who received only an analgesic agent underwent resting-state functional magnetic resonance imaging (rs-fMRI) twice. fMRI was performed to evaluate the functional connectivity of the brain regions. After treatment, a decrease in total scores on the King's Parkinson's Disease Pain Scale (KPPS) and Unified Parkinson's Disease Rating Scale was observed in the acupuncture group (−46.2 and −21.6%, respectively). In the acupuncture group, increased connectivity was observed in four connections, one in the left hemisphere between the middle temporal gyrus (MTG) and precentral gyrus, and three in the right hemisphere between the postcentral gyrus and precentral gyrus, supramarginal gyrus and precentral gyrus, and MTG and insular cortex. A significant correlation was noted between the changes in functional connectivity and KPPS. The involved connection was between the left middle frontal gyrus and the right precentral gyrus (R = −0.698, P = 0.037). Acupuncture could relieve pain in PD patients by modulating brain regions related to both sensory-discriminative and emotional aspects. The present study might increase the confidence of users that acupuncture is an effective and safe analgesic tool that can relieve PD-related pain.
Highlights
The non-motor symptoms (NMS) [1] of Parkinson’s disease (PD) have gained increasing attention because of their heavy burden on patients and patient caregivers [2] and are known to be integral to the concept of PD from prodromal to the palliative stage
No significant difference was found between patients with and without acupuncture treatment in terms of pain severity (KPPS, P = 0.114; visual analog scale (VAS), P = 1.000), disease duration (P = 0.918), motor severity (UPDRS-III, P = 0.351), or levodopa equivalent daily dose (P = 0.918), nor was a significant difference observed in psychological aspects (BDI-II, P = 0.351; Parkinson’s Disease Sleep Scale 2 (PDSS-2), P = 0.091; PDQ-39, P = 0.918) or cognitive aspects (MMSE, P = 0.091)
Decreases in King’s Parkinson’s Disease Pain Scale (KPPS) and Unified Parkinson’s Disease Rating Scale (UPDRS) total scores were observed (−46.2%, P = 0.023 and −21.6%, P = 0.005, respectively), but no significant differences were observed in Beck Depression Inventory II (BDI-II), PDSS-2, PDQ-39, and Mini Mental State Examination (MMSE) scores
Summary
The non-motor symptoms (NMS) [1] of Parkinson’s disease (PD) have gained increasing attention because of their heavy burden on patients and patient caregivers [2] and are known to be integral to the concept of PD from prodromal to the palliative stage. Patients might not report symptoms of PD Pain Relief by Acupuncture pain to their physicians because most patients are unaware that such symptoms can be linked to PD [3] Insufficient treatment for these symptoms may affect patients’ quality of life or even lead to hospitalization [3]. Pain in PD might be a consequence of motor fluctuations, dystonic muscle contraction, deep visceral pain, and musculoskeletal pain [1,2,3,4]. It can be influenced by factors such as age, sex, depression, and disease severity or duration [2, 3, 5]. These treatments lead to additional financial burden in medical treatment
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