Effectiveness of Acupuncture for Anxiety Among Patients With Parkinson Disease: A Randomized Clinical Trial

Anxiety is one of the most common manifestations in patients with Parkinson disease, affecting approximately 31% of these individuals. Although it is a frequent and debilitating symptom, anxiety in Parkinson disease often remains inadequately treated. This condition is closely related to accelerated progression of motor symptoms, including worsening of tremor and gait disturbances. Patients with Parkinson disease who also experience anxiety show greater disability and poorer quality of life compared with those without anxiety.

The conventional treatments available, such as antiparkinsonian drugs and anxiolytics, offer limited clinical benefit, while psychological therapies such as cognitive behavioral therapy, although promising, have a high cost that reduces patient adherence.

This study aimed to investigate the efficacy of true acupuncture versus sham (placebo) acupuncture for the treatment of anxiety in patients with Parkinson disease. It was a randomized, double-blind clinical trial conducted at a hospital in China between June 2021 and April 2022. Seventy eligible patients were enrolled and randomly divided into two groups: one received true acupuncture and the other sham acupuncture. The researchers developed a specialized sham-needle device to ensure that neither patients nor acupuncturists knew which treatment was being administered.

Treatment consisted of 30-minute sessions, three times per week for eight weeks, using specific acupuncture points traditionally used for anxiety and Parkinson disease. Follow-up of patients continued for an additional eight weeks after treatment ended.

The results revealed important findings about the effects of acupuncture on Parkinson-related anxiety. Sixty-four patients completed the study, with a mean age of approximately 62 years. At the end of the eight-week treatment period, both groups showed significant improvement in anxiety as measured by the Hamilton Anxiety Rating Scale, with no statistical difference between them. This suggests there was a substantial initial placebo effect.

However, two months after treatment ended, the group that received true acupuncture maintained the improvement, showing a 7.03-point reduction on the anxiety scale compared with the placebo group. In addition, the true acupuncture group also showed better outcomes on scales evaluating Parkinson motor symptoms and quality of life. Blood tests revealed that acupuncture reduced levels of the hormone ACTH, which is related to stress and anxiety, providing a biological basis to explain the observed effects.

For patients with Parkinson disease and anxiety, these results suggest that acupuncture may be a valuable and safe therapeutic option. The study demonstrated that, although there may be an initial placebo effect, the benefits of true acupuncture become clearly superior over the long term. During the study, only four mild adverse reactions were reported, indicating that the treatment is well tolerated. For health care professionals, these findings indicate that acupuncture may be considered as a complementary treatment for anxiety in patients with Parkinson disease, especially given the limitations of conventional treatments.

Improvement in anxiety was also reflected in better motor function and overall quality of life, suggesting that treating anxiety can yield broad benefits for these patients.

It is important to consider some limitations of this study. First, all participants were Chinese, and because acupuncture is a traditional Chinese therapy widely accepted in this culture, the placebo effect observed may have been influenced by cultural factors. Future studies in more diverse populations will be needed to confirm these results. In addition, some items on the anxiety scale used may overlap with symptoms of Parkinson disease itself, which may have affected measurement accuracy.

The eight-week treatment period was also relatively short, and longer studies could provide more robust information about the durability of benefits. Despite these limitations, this was the first rigorously controlled study to demonstrate that acupuncture can effectively reduce anxiety in patients with Parkinson disease, offering hope for a more holistic and integrated therapeutic approach for this complex condition.