DOI QR코드

DOI QR Code

Effects of Acupuncture & Qigong Meditation on Nonmotor Symptoms of Parkinson's Disease

  • Kim, Jaejong (South Baylo University Integrative Medicine Research Institute) ;
  • Cho, Ki Heang (South Baylo University Integrative Medicine Research Institute) ;
  • An, So jung (South Baylo University Integrative Medicine Research Institute) ;
  • Cui, Shanqin (South Baylo University Integrative Medicine Research Institute) ;
  • Kim, Sun Wook (South Baylo University Integrative Medicine Research Institute) ;
  • Suh, Joseph (South Baylo University Integrative Medicine Research Institute) ;
  • Lee, Young (South Baylo University Integrative Medicine Research Institute)
  • Received : 2020.03.24
  • Accepted : 2020.07.10
  • Published : 2020.11.30

Abstract

Background: Parkinson's disease(PD) affects not only motor symptoms, but also nonmotor symptoms. This study is a clinical trial to determine whether Qigong and acupuncture affect nonmotor symptoms of PD. Methods: A 2-arm parallel and randomized trial was performed with 21 participants who had received either Qigong meditation only [control group (CG)] or acupuncture and Qigong meditation [experimental group (EG)]. The participants' levels of the discomfort in nonmotor symptoms from Parkinson's disease were evaluated by using the Unified Parkinson's Disease Rating Scales (UPDRS 1) and Test of Smell Identification (TSI) before and after 12 treatments at baseline and 1 month after 12 treatments. Results: The both CG and EG showed improvements in the UPDRS 1 score after treatment by 5.6 ± 5.15 (p= 0.003; 74%) and 4.8 ± 3.80 (p = 0.004; 79%), respectively. The both CG and the EG did improvements in the TSI after treatment by 10.3 ± 4.37 (p < 0.001; 84%) and 12.6 ± 1.77 (p = 0.022; 100%), respectively. However, statistical differences were not observed between the CG and the EG using the UPDRS 1 and the TSI scores. Conclusion: The combination of Qigong and acupuncture and Qigong alone was shown to improve the nonmotor symptoms and olfactory function of PD. In the future, large-scale clinical studies on alternative treatment for PD and studies on mechanisms affecting nonmotor symptoms of acupuncture and Qigong are needed.

Keywords

References

  1. The Michael J [Internet]. Fox Foundation: Parkinson's Disease Causes. [cited 2019 Feb 7]. Available from: https://www.michaeljfox.org/understandingparkinsons/living-with-pd/topic.php?causes&navid=causes.
  2. Dick FD, De Palma G, Ahmadi A, Scott NW, Prescott GJ, Felice A. Environmental risk factors for Parkinson's disease and parkinsonism: the Geoparkinson study. Occup Environ Med 2017;64:666-672. https://doi.org/10.1136/oem.2006.027003
  3. Braak H, Del Tredici K, Rub U, de Vos RA, Steur EN J, Braak E. Staging of brain pathology related to sporadic Parkinson's disease. Neurobiol Aging 2003;24:197-211. https://doi.org/10.1016/S0197-4580(02)00065-9
  4. Gallagher DA, Lees AJ, Schrag A. What are the most important nonmotor symptoms in patients with Parkinson's disease and are we missing them? Mov Disord 2010;25:2493-2500. https://doi.org/10.1002/mds.23394
  5. Khedr EM, El Fetoh NA, Khalifa H, Ahmed MA, El Beh KMA. Prevalence of non motor features in a cohort of Parkinson's disease patients. Clin Neurol Neurosurg 2013;115:673-677. https://doi.org/10.1016/j.clineuro.2012.07.032
  6. Negre-Pages L, Grandjean H, Lapeyre-Mestre M, Montastruc JL, Fourrier A, Lepine JP et al. Anxious and depressive symptoms in Parkinson's disease: the French cross-sectional DoPAMiP study. Mov Disord 2010;25:157-166. https://doi.org/10.1002/mds.22760
  7. Degardin A, Houdayer E, Bourriez JL, Destee A, Defebvre L, Derambure P et al. Deficient "sensory" beta synchronization in Parkinson's disease. Clin Neurophysiol 2009;120:636-642. https://doi.org/10.1016/j.clinph.2009.01.001
  8. Schulte EC, Winkelmann J, When Parkinson's disease patients go to sleep: specific sleep disturbances related to Parkinson's disease. J Neurol 2011;258:328-335. https://doi.org/10.1007/s00415-011-5933-0
  9. Khoo TK, Yarnall AJ, Duncan GW, Coleman S, O'Brien JT, Brooks DJ et al. The spectrum of nonmotor symptoms in early Parkinson disease. Neurology 2013;80:276-281. https://doi.org/10.1212/WNL.0b013e31827deb74
  10. Oh Y-S, Kim JS, Hwang EJ, Lyoo CH. Striatal dopamine uptake and olfactory dysfunction in patients with early Parkinson's disease. Parkinsonism Relat Disord 2018;56:47-51. https://doi.org/10.1016/j.parkreldis.2018.06.022
  11. Hawkes CH, Shephard BC, Daniel SE. Is Parkinson's disease a primary olfactory disorder? QJM 1999;92:473-480. https://doi.org/10.1093/qjmed/92.8.473
  12. Munhoz PR, Moro LA, Silveira-Moriyama L, Teive HA. Non-motor signs in Parkinson's disease: A review. Arq Neuropsiquiatr 2015;73:454-462. https://doi.org/10.1590/0004-282X20150029
  13. Vennemann MM, Hummel T, Berger K. The association between smoking and smell and taste impairment in the general population. J Neurosci 2008;255:1121-1126.
  14. Lin T, Cheng C, Chen S, Liou C, Huang C, Chuang Y. Mitochondrial Dysfunction and Oxidative Stress Promote Apoptotic Cell Death in the Striatum via Cytochrome c/Caspase-3 Signaling Cascade Following Chronic Rotenone Intoxication in Rats. Int J Mol Sci 2012;13:8722-8739. https://doi.org/10.3390/ijms13078722
  15. Vickers AJ. How to randomize. J Soc Integr Oncol 2006;4:194-198. https://doi.org/10.2310/7200.2006.023
  16. True Random Number Service [Internet]. 2019. Available from: https://www.random.org/.
  17. The R Foundation [Internet]. A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. 2018. Available from: https://www.R-project.org/.
  18. Ikemoto S. Brain reward circuitry beyond the mesolimbic dopamine system: a neurobiological theory. Neurosci Biobehav Rev 2010;35:129-150. https://doi.org/10.1016/j.neubiorev.2010.02.001
  19. Iannilli E, Stephan L, Hummel T, Reichmann H, Haehner A. Olfactory impairment in Parkinson's disease is a consequence of central nervous system decline. J Neurol 2017; 264: 1236-1246. https://doi.org/10.1007/s00415-017-8521-0
  20. Miwa T, Furukawa M, Tsukatani T, Costanzo RM, DiNardo LJ, Reiter ER. Impact of olfactory impairment on quality of life and disability. Arch Otolaryngol Head Neck Surg 2001;127:497-503. https://doi.org/10.1001/archotol.127.5.497
  21. Soudry Y, Lemogne C, Malinvaud D, Consoli SM, Bonfils P. Olfactory system and emotion: Common substrates. Eur Ann Otorhinolaryngol Head Neck Dis 2011;128:18-23. https://doi.org/10.1016/j.anorl.2010.09.007
  22. Rochet M, El-Hage W, Richa S, Kazour F, Atanasova B. Depression, Olfaction, and Quality of Life: A Mutual Relationship. Brain Sci 2018;8:80. https://doi.org/10.3390/brainsci8050080
  23. Fullard ME, Morley JF, Duda JE. Olfactory dysfunction as an early biomarker in Parkinson's disease. Neurosci Bull 2017;33:515-525. https://doi.org/10.1007/s12264-017-0170-x
  24. Hong JY, Sunwoo MK, Ham JH, Lee JJ, Lee PH, Sohn YH. Apathy and olfactory dysfunction in early Parkinson's disease. J Mov Disord 2015;8:21-25. https://doi.org/10.14802/jmd.14029
  25. Jenner P. Oxidative stress in Parkinson's disease. Ann Neurol 2003;53:26-38. https://doi.org/10.1002/ana.10483
  26. Crotty GF, Ascherio A, Schwarzschild MA. Targeting urate to reduce oxidative stress in Parkinson disease. Exp Neurol 2017;298:210-224. https://doi.org/10.1016/j.expneurol.2017.06.017
  27. Asanuma M, Miyazaki I, Ogawa N. Dopamine- or L-DOPA-induced neurotoxicity: the role of dopamine quinone formation and tyrosinase in a model of Parkinson's disease. Neurotox Res 2003;5:165-176. https://doi.org/10.1007/BF03033137
  28. Zhang L, Zhang L, Li L, Holscher C. Semaglutide is neuroprotective and reduces a-synuclein levels in the chronic MPTP mouse model of Parkinson's disease. J Parkinsons Dis 2019;9:157-171. https://doi.org/10.3233/JPD-181503
  29. Gratuze M, Josset N, Petry FR, Pflieger M, Jong LE, Truchetti G, et al. The toxin MPTP generates similar cognitive and locomotor deficits hTau and Tau knock-out mice. Brain Res 2019;1711:106-114. https://doi.org/10.1016/j.brainres.2019.01.016
  30. Love S, Jenner P. Oxidative stress in neurological disease. Brain Pathol 2006;9:55-56. https://doi.org/10.1111/j.1750-3639.1999.tb00210.x
  31. Dias V, Junn E, Mouradian MM. The role of oxidative stress in Parkinson's disease. J Parkinsons Dis 2013;3:461-491. https://doi.org/10.3233/JPD-130230
  32. Wi S, Lee JW, Kim M, Park CH, Cho SR. An enriched environment ameliorates oxidative stress and olfactory dysfunction in Parkinson's disease with α-synucleinopathy. Cell Transplant 2018;27:831-839. https://doi.org/10.1177/0963689717742662
  33. Hussain A, Pooryasin A, Zhang M, Loschek LF, Fortezza ML, Friedrich AB et al. Inhibition of Oxidative Stress in Cholinergic Projection Neurons Fully Rescues Aging-Associated Olfactory Circuit Degeneration in Drosophila. Elife 2018;10:32018.
  34. Stowe R, Ives N, Clarke CE, Deane K, van Hilten, Wheatley K et al. Evaluation of the efficacy and safety of adjuvant treatment to levodopa therapy in Parkinson's disease patients with motor complications. Cochrane Database Syst Rev 2010;7:CD007166.
  35. Tomlinson CL, Stowe R, Patel S, Rick C, Gray R, Clarke CE. Systematic review of levodopa dose equivalency reporting in Parkinson's disease. Mov Disord 2010;25:2649-2653. https://doi.org/10.1002/mds.23429
  36. Fukaya C, Yamamoto T. Deep brain stimulation for Parkinson's disease: recent trends and future direction. Neurol Med Chir (Tokyo) 2015;55:422-431. https://doi.org/10.2176/nmc.ra.2014-0446
  37. Singh M, Girishan KV S, Bajaj J, Garg K. Deep brain stimulation for movement disorders: Surgical nuances. Neurol India 2018;66:122-130. https://doi.org/10.4103/0028-3886.226461
  38. Poewe W. Treatments for Parkinson disease-past achievements and current clinical needs. Neurology 2009;72:65-73. https://doi.org/10.1212/WNL.0b013e31819908ce
  39. Yu-Wai-Man P. Genetic manipulation for inherited neurodegenerative diseases: myth or reality? Br J Ophthalmol 2016;100:1322-1331. https://doi.org/10.1136/bjophthalmol-2015-308329
  40. Lee SH, Lim S. Clinical effectiveness of acupuncture on Parkinson disease: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore) 2017;96:e5836. https://doi.org/10.1097/MD.0000000000005836
  41. Xia Y, Wang HD, Ding Y, Kang B, Liu WG. Parkinson's disease combined with depression treated with electroacupuncture and medication and its effect on serum BDNF. Zhongguo Zhen Jiu 2012;32:1071-1074. [in Chiense].
  42. Arankalle DV, Nair PM. Effect of electroacupuncture on function and quality of life in Parkinson's disease: A case report. Acupunct Med 2013;31:235-238. https://doi.org/10.1136/acupmed-2012-010285
  43. Wang H, Pan Y, Xue B, Wang X, Zhao F, Jia J et al. The antioxidative effect of electro-acupuncture in a mouse model of Parkinson's disease. PLoS One 2011;6:e19790. https://doi.org/10.1371/journal.pone.0019790
  44. Yu Y, Ju W, Li Z, Wang D, Wang Y, Xie A. Acupuncture inhibits oxidative stress and rotational behavior in 6-hydroxydopamine lesioned rat. Brain Res 2010;1336:58-65. https://doi.org/10.1016/j.brainres.2010.04.020
  45. Kang JM, Park HJ, Choi YG, Choe IH, Park JH, Kim YS et al. Acupuncture inhibits microglial activation and inflammatory events in the MPTP induced mouse model. Brain Res 2007;1131:211-219. https://doi.org/10.1016/j.brainres.2006.10.089
  46. Huo LR, Liang XB, Li B, Liang JT, He Y, Wang XM. The cortical and striatal gene expression profile of 100 Hz electroacupuncture treatment in 6-hydroxydopamine-induced Parkinson's disease model. evid Based Complement Alternat Med 2012;2012:908439.
  47. Wayne PM, Manor B, Novak V, Costa MD, Hausdorff JM, Goldberger AL et al. A Systems Biology Approach to Studying Tai Chi, Physiological Complexity and Healthy Aging: Design and Rationale of a Pragmatic Randomized Controlled Trial. Contemp Clin Trials 2012;34:21-34.
  48. Song R, Grabowska W, Park M, Osypiuk K, Vergara-Diaz G, Bonato GP et al. The impact of Tai Chi and Qigong mind-body exercises on motor and non-motor function and quality of life in Parkinson's disease: A systematic review and meta-analysis. Parkinsonism Relat Disord 2017;41:3-13. https://doi.org/10.1016/j.parkreldis.2017.05.019
  49. Liu XL, Chen S, Wang Y. Effects of health qigong exercises on relieving symptoms of Parkinson's disease. evid Based Complement Alternat Med 2016;2016:5935782.