Gait Disturbance Improvement and Cerebral Cortex Rearrangement by Acupuncture in Parkinson's Disease: A Pilot Assessor-Blinded, Randomized, Controlled, Parallel-Group Trial

Neurorehabil Neural Repair. 2020 Dec;34(12):1111-1123. doi: 10.1177/1545968320969942. Epub 2020 Nov 16.

Abstract

Background: Parkinson's disease (PD) leads to impaired mobility and limited independence.

Objective: We investigated the effects of acupuncture on gait disturbance and analyzed hemodynamic changes caused by acupuncture in the cerebral cortex of patients with PD.

Methods: Participants (n = 26) with gait disturbance due to PD were randomly assigned to the intervention (acupuncture twice a week for 4 weeks + conventional therapy) or control (conventional therapy) groups. We analyzed gait parameters using the GAITRite system and hemodynamic responses in the cerebral cortices using functional near-infrared spectroscopy, Unified Parkinson's Disease Rating Scale (UPDRS) scores, neurotransmitter levels, as well as the immediate effects of acupuncture in patients with PD.

Results: The participants tended to walk with hypometric gait (high cadence, short steps) overground. After acupuncture treatment, those in the intervention group showed a significant reduction in cadence and the UPDRS scores involving "walking and balance" compared with those in the control group (P = .004 and P = .020, respectively); the stride, swing, and single support times were significantly increased (P = .006, P = .001, and P = .001, respectively). Oxyhemoglobin levels in the intervention group while walking on a treadmill were significantly increased in the prefrontal and supplementary motor areas. The oxyhemoglobin levels in the prefrontal cortex and swing time revealed significant positive correlations.

Conclusions: Our findings indicated that acupuncture tended to improve hypometric gait and rearranged activation of the cerebral cortex. Thus, acupuncture may be a useful complementary treatment for gait disturbance, including hypometric gait, in patients with PD. Trial Registration Number. Clinical Research Information Service (KCT0002603), https://cris.nih.go.kr/cris/index.jsp.

Keywords: Parkinson’s disease; acupuncture; gait; near infrared spectroscopy.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acupuncture Therapy*
  • Aged
  • Animals
  • Cerebral Cortex / diagnostic imaging
  • Cerebral Cortex / physiopathology*
  • Female
  • Functional Neuroimaging
  • Gait Disorders, Neurologic / diagnostic imaging
  • Gait Disorders, Neurologic / etiology
  • Gait Disorders, Neurologic / therapy*
  • Humans
  • Male
  • Middle Aged
  • Neuronal Plasticity / physiology*
  • Outcome Assessment, Health Care
  • Parkinson Disease / complications
  • Parkinson Disease / diagnostic imaging
  • Parkinson Disease / therapy*
  • Pilot Projects
  • Single-Blind Method
  • Spectroscopy, Near-Infrared

Associated data

  • CRiS/KCT0002603