Acupuncture Treatment Parkinson’s Disease

The mechanisms of acupuncture are varied and intertwined – the research is still ongoing. In the meantime,  we have outlined here 6 ways through which acupuncture benefits those who suffer from Parkinson’s Disease.

The most important mechanism for reducing dopamine neuron degeneration is by increasing neurotrophic factors like BDNF and GDNF. This method is superior to more common interventions like Deep Brain Stimulation and L-Dopa or Madopar administration.

Wherever you are in the world, look for an acupuncturist to help you.  If you are in Singapore, do seek us out at Chinese Doc Singapore.

#1 Mechanism – Acupuncture Delays Progress of Dopamine Neuron Degeneration

Existing Knowledge and Treatments:

Parkinson’s Disease is characteristically defined by the progressive degeneration of the dopamine neurons in the Substantial Nigra.

The best strategy for Parkinson’s is to slow down the degeneration of dopamine neurons.

Unfortunately, existing strategies, including L-dopa administration and deep brain stimulation of the subthalmic nucleus, do not provide significant therapeutic effect.

Neurotrophic factors:

Neurotrophic factors are substances that regulate the growth and survival of cells in the brain and nervous system. In Parkinson’s Disease, as with other neurodegenerative like Alzheimer’s and Multiple Sclerosis, neurotrophic factors deplete over time.

As such, anything that increases neurotrophic factors is good for Parkinson’s. The research on acupuncture postulates that:

1. Acupuncture with high-frequency stimulation increases the expression of brain derived neurotrophic factor (BDNF) mRNA, which then contributes to slowing down dopamine neuron degeneration.
2. Acupuncture with electrostimulation has a neuroprotective effect against the degeneration of dopamine neurons by activating endogenous BDNF and GDNF.
3. Acupuncture at points GB34 and LR3 significantly reduced dopamine neuron degeneration.
4. Acupuncture at acupuncture point ST36 could improve behavioral test and TH straining in the Substantial Nigra.
5. Electroacupuncture of GB34 results in improvement of behavioral impairment and reduction in tyrosine TH-positive dopamine neurodegeneration.

#2 Mechanism – Acupuncture Improves the Dopaminergic System of the Body

There is enough evidence to suggest that acupuncture is able to

1. modify how dopamine is released, synthesized and degraded.
2. modify how dopamine receptors function.

We know from research by Wang et al (2009) that electrostimulation of points GV20 and Taiyang are able to slow down dopamine degeneration.

There are two ways in which Acupuncture improves the Dopaminergic System.

(A) Acupuncture Increases Dopamine in the Brain

Most of this research was done to establish how stimulation of certain acupuncture points would cause an increase in dopamine levels in the brain.

Some of the points used and the results are:

1. Acupuncture at Gb34, PC6, LR3 and Du20 would increase the levels of dopamine, noradrenalin in the cerebral spinal fluid of patients.
2. Just needling Du20 could increase dopamine levels in the caudate nucleus and mesencephalon.
3. Acupuncture at Du20, Du16 and LR3 would significantly increase behavioral performance as well as striatal dopamine levels.
4. Electroacupuncture of the ‘four gates’ points LI4 and LR3 increased expression of PKA and CREB1, compounds which maintain dopamine balance in the brain.
5. From research that studied the effects of acupuncture on abnormal auditory brainstem responses, a single experimental acupuncture treatment was able to activate dopamine neurons and increase cerebral dopamine levels.

(B) Acupuncture Activates Dopamine Transport

Below are some research findings related to dopamine transport aka DAT:

1. Stimulating LI4 and LR3 once a day over the span of 21 days was able to significantly increase the number of cells with DAT-positive expression.
2. Electroacupuncture of the scalp was able to maintain levels of bilateral striatal dopamine transport.
3. Patients who received L-dopa and electroacupuncture to the scalp had increased regional cerebral blood flow in the frontal lobe, occipital lobe, basal ganglion and cerebellum.

We Can Support You For Parkinson’s Disease.

#3 Mechanism – Acupuncture Improves the Motor Control Network in the Brain

As dopamine neurons are depleted over time, the motor control network in the basal ganglia circuit starts to function abnormally.

Studies have reported the efficacy of acupuncture in correcting abnormal basal ganglia circuitry. This correction may mitigate against parkinson’s tremor. We have written another section that brings you on a deep dive into acupuncture points for parkinson’s tremor.

We know that:

1. Electroacupuncture is able to balance the activity of each nucleus in the basal ganglia circuit.
2. High frequency electroacupuncture is able to normalize levels of Substance P, which is reduced in Parkinson’s patients.
3. Electroacupuncture at Du20 and Du14 improves the motor control network by increasing GABA-nergic inhibition in the output structure of the basal ganglia.

#4 Mechanism – Acupuncture Activates Dopamine Transport

Below are some research findings related to dopamine transport aka DAT:

1. Stimulating LI4 and LR3 once a day over the span of 21 days was able to significantly increase the number of cells with DAT-positive expression.
2. Electroacupuncture of the scalp was able to maintain levels of bilateral striatal dopamine transport.
3. Patients who received L-dopa and electroacupuncture to the scalp had increased regional cerebral blood flow in the frontal lobe, occipital lobe, basal ganglion and cerebellum.

#5 Mechanism – Acupuncture Inhibits Microglial Activation and Protects against Inflammation

We know that MPTP activates the microglia in the Substantia Nigra, and that this activation increase inflammation in the brain.

In a study by Kang et al (2007), acupuncture on GB34 and LR3 reduced microglial activation, hence reducing brain inflammation in patients with Parkinson’s Disease.

#6 Mechanism – Acupuncture Improves the Peripheral Nervous System

Electro Scalp Acupuncture improves the abnormal tremor myoelectric potential. There are three studies that explored how, and the acupuncture points used as as below:

1. Xi et al (1996) used Du20 alone, with 39% of the participants seeing elimination of abnormal tremor myoelectric potential. There were 28% who did not see improvement.
2. Huang (2000b) used bilateral CTCA and MCA, with 25.8% of the participants seeing elimination of abnormal tremor myoelectric potential. There were 22.6% who did not see improvement.
3. Wang et al (2003) GB20, GB6, GB5 and Du21, with 79%% of the participants seeing elimination of abnormal tremor myoelectric potential.

In Summary

We have laid out 6 potential mechanisms through which Acupuncture helps in the treatment of Parkinson’s Disease.

If you are still not convinced, read on to learn 2 compelling reasons why you should consider get Acupuncture Treatment for Parkinson’s Disease!

And if it does interest you, here is research on different categories of acupuncture points to choose from when treating Parkinson’s Disease!

Acupuncture for Parkinson’s – Why It Makes Sense

#1  It doesn’t make practical sense to just use L-dopa or Madopar alone

L-dopa has been and still is the mainstay of treatment for Parkinson’s.

Unfortunately,  its long-term use can increase the potential for complications. If a patient’s PD symptoms do not interfere with daily life or negatively affect his or her job during the early phase of PD, treatment with levodopa or other antiparkinsonism drugs does not need to start early.

Research so far confirms that:

1. Because L-dopa does not really slow down disease progression, people do not start L-dopa upon initial diagnosis. They only benefit from using L-dopa when the symptoms of tremor or stiffness begin affecting the patient quality of life.
2. Once you begin using L-dopa, there is a “honeymoon period” where L-dopa supplementation does lead to an increase in dopamine levels. Unfortunately, its effectiveness often decreases and that same medication that worked before may no longer be beneficial for patients with advanced Parkinson’s Disease.

Because the mainstay of treatment (L-dopa) only offers symptomatic treatment but cannot delay disease progression, patients turn to acupuncture in the early stages of Parkinson’s Disease in expectation that neuronal degeneration is arrested even partially. While people may simplify and call it acupuncture for dopamine, it is more like enhancing brain function and circuitry as much as we can!

#2 Acupuncture is a must-use therapeutic intervention if you have Parkinson’s Disease

The research says it all

Comprehensive evidence has been compiled from a total of 179 randomized control trials involving a total of 11,717 participants. This has come inthe form of 12 systematic reviews (SRs) or meta-analyses (MAs) looking deeply into the safety and efficacy of acupuncture as therapeutic intervention.

All these SRs or MAs have compared the outcome of:

• acupuncture combined with medication versus
• medication alone.

The conclusion is clear: If you are also using L-dopa to treat your Parkinson’s, you will fare better adding on acupuncture if you want to better alleviate your symptoms.

What does this mean?

It means that even if you are using L-dopa as a drug intervention, it makes practical sense to also receive treatment for acupuncture.

How do you measure all of this?

The Unified Parkinson’s Disease Rating Scale (UPDRS) has been basis for assessing and evaluating any changes in Parkinson’s-related disabilities and impairments, behavior and mood, motor functions, etc.

Acupuncture combined with dopaminergic drugs had better outcomes compared to medication only for improving the UPDRS score.

What is interesting when comparing

• acupuncture only, and
• medication only

is that there is no significant difference in the scores.

What does this mean?

This suggests that acupuncture may achieve an efficacy close to that of medication.

It means that if you or someone you love suffers from Parkinson’s it makes a lot of practical sense to receive acupuncture treatment as one of the interventions.

Book In To See Acupuncturist For Parkinson’s Disease.

#3 Acupuncture Alone Can Improve The Webster Score

What is the Webster Scale?

The Webster Scale helps us assess the clinical severity of Parkinson’s Disease. It rates the following:

• Akinesia
• Rigidity
• Upper limb swing
• Gait
• Tremor
• Facial appearance
• Speech
• Self-care

How does acupuncture compare to medication when assessing the clinical severity of Parkinson’s Disease?

There are two outcomes here that you need to know from a 2021 research paper:

1. Acupuncture and medication is better than medication alone in alleviating clinical severity of Parkinson’s Disease.
2. Compared with medication alone, acupuncture alone produced a similar outcome for decreasing the Webster score.

What does this mean?

This means that while acupuncture alone can be used to effectively reduce the severity of Parkinson’s Disease, it makes practical sense to use acupuncture together with medication to manage Parkinson’s.

#4 Side Effects of Acupuncture vs Drugs

Side effects of Drugs for Parkinson’s Disease?

We already know that even when the oral dose of L-dopa is optimized, the risk for a worsening of movement disorders (dystonia) is always there.

We also know that other drugs used for treating Parkinson’s Disease may also cause or aggravate non-motor symptoms.

This is why treatment with L-dopa and other drugs is often delayed in patients with early-stage Parkinson’s Disease.

We know that acupuncture is able to arrive at a similar therapeutic outcome as these drugs, without the side effects. This makes it a worthwhile treatment intervention to consider.

Adverse effects of Acupuncture for Parkinson’s Disease?

Research has found no evidence for any serious adverse effects associated with acupuncture. It is a relatively safe treatment option.

Let Us Conclude With A Simple Summary!

The research says that (1) acupuncture may increase the therapeutic efficacy of drugs and (2) acupuncture may reduce the required dose of medication, thus reducing adverse effects of the drugs in use.

If you find this helpful, you may want to read up more about how acupuncture works in the treatment of Parkinson’s Disease.

We also have an article details the different acupuncture points that acupuncturists choose from when treating Parkinson’s Disease!

#1 Traditional Scalp Points

How to acupuncture for Parkinsons?

Enough has been said about scalp points in the treatment of conditions involving the brain.

Scalp acupuncture points are an indispensable part of treatment as they decrease the loss of dopaminergic neurons in the substantia nigra, and delay degeneration of dopaminergic neurons, postponing and reducing the progression of PD.
Scalp acupuncture is able to significantly increase the area density, numerical density of the positive neurons relating to tyrosine hydroxylase (TH) in the substantia nigra. This is likely what people talking about acupuncture for dopamine, but the treatment mechanism is slightly more intricate.
Overall, scalp acupuncture is able to

• increase the TH cells by elevating the synthesis GDNF mRNA – this means brain function in the substantia nigra is enhanced.
• decrease apoptosis – this means less cells are dying off.
• promote the reuptake of dopamine – this means more dopamine overall.

thus leading to an alleviation of Parkinsonian symptoms.

Some of the key points include:

1. Bai Hui (百会): Able to prevent cell death of the substantia nigra pars compacta, a type of cell which is located in the substantia nigra.
2. Si Shen Cong (四神聪): Another commonly used scalp acupuncture point combination. It is commonly used alongside let points (see below) LR3 and ST36 to promote their effects.

#2 Brain Mapping Scalp Points

How to acupuncture for Parkinsons?

Read on to learn more about the form of scalp acupuncture discovered and promulgated by Professor Jiao Shun Fa, a neurosurgeon from Shanxi Province in the 1970s.

The key areas of the scalp that acupuncturists use to treat PD include:

• MA: Motor Area
• CTCA: Chorea and Tremor Control Area

The CTCA (Chorea and Tremor Control Area) is a crucial area to needle when doing scalp acupuncture for Parkinson’s Disease. To locate the chorea-tremor area, the two landmark lines to define are:

• Anterior-posterior midline: The starting point of the midline is the middle point between the two brows (which is what many people refer to as the “third eye”). The ending point midline is the crevice at the lower border of the occipital protuberance.
• Eyebrow-occipital line: The eyebrow-occipital line is the horizontal line from the upper border of the eyebrow midpoint to the inferior border of the occipital protuberance.

Once these two landmark lines are defined, two additional points have to be marked:

• The first additional point is 0.5 cm posterior to the midpoint of the anterior-posterior midline
• The second additional point is the intersection of the eyebrow-occipital line and anterior border of the corner of the temporal hairline.

The line that is drawn between these two points is the MA (Motor Area).

The line 1.5 cm anterior and parallel to the MA is the CTCA (Chorea and Tremor Control Area).

The Chorea and Tremor Control Area (CTCA) is crucial for tremor control. Here, you will find the essential acupuncture points for parkinson’s tremor, with the needles usually targeting the neck, arm or leg secions of the CTCA. To master treatment of Parkinson’s Disease with acupuncture, you need be able to located the CTCA with precision.

We May Be Able To Help!

#3 Cranio Base Points

How to acupuncture for Parkinsons?

Next up are the points on the back of the neck, which is the base of the cranium.

The acupuncture technique called “the seven acupoints of cranial base” (SACB) was used as the adjunct to treat patients with PD in China recently and showed some interesting results. These acupuncture points reduced rotational behavior, significantly reduced the loss of dopaminergic neurons, and significantly elevated expression of TrkB in the lesioned substantia nigra.

These 7 points are as follow:

• • DU15 啞门 (Midline)
  • BL10 天柱 (Bilateral)
  • GB20 风池 (Bilateral)
    GB12 完骨 (Bilateral)

There is another set of  cranio base points which are similar but slightly different. They include points superior to the Superior Nuchal Line. They are:

• DU-17 脑户 and BL-9 玉枕: These are superior to the SNL but are likely to affect the cranio base.
• DU-15 亚门, DU-16 风府, BL-10 天柱, GB-20 风池: These points map onto the inferior border of the SNL.

The point is to choose points that stimulate the cranio base, which can be useful in treating Parkinson’s Disease.

#4 Peripheral Body Points

How to acupuncture for Parkinsons?

According to research done by SH Lee (2017), out of 25 clinical trials, the main points used on the four extremities are:

• LR3 (太冲)
• GB34 (阳陵泉)
• ST36 (足三里)
• KI3 (太溪)
• LI11 (曲池)

Acupuncture points LR3 and GB34 are often used in tandem with classical scalp point DU20 in in the treatment of Parkinson’s Diease. These 3 points help in preventing cell death in the SNpc.

Since PD is primarily associated with the gradual loss of cells in the Substantia Nigra, these 3 acupuncture points have been shown to prevent the death of the cells in this area of the brain, hence slowing down the progress of Parkinson’s.

We also know that stimulating ST36, GB34, LR3 significantly improves motor function, while slowing down dopaminergic neuronal loss in animal models of Parkinson’s Disease.

We also know that GB34 and ST36 in particular are able to activate motor-related brain regions such as the putamen, caudate nucleus, thalamus and cerebellum.

In Conclusion

If you are reading this, you are probably an acupuncturist trying to put it all together so that you can help your PD patient. I find that classifying acupuncture points in this matter is very helpful because it allows the acupuncturist to include a bit of everything we have in the arsenal, including all the good knowledge that has been researched through.

It is also helpful because this is knowledge that can be used to educate your patient. If you found this helpful, you may also want to read our research-backed article about the six potential mechanisms that acupuncture uses to treat Parkinson’s Disease.

You may also find helpful our piece of why every Parkinson’s patient should consider getting acupuncture treatment!!

Book in: Acupuncture Treatment for Parkinson’s Disease in Singapore